Blocked Arteries

         Heart & Vascular Care at EvergreenHealth, Kirkland WA
 Flow restored after
stent placement

 

Arterial occlusive disease or blocked arteries will lead to a wide spectrum of problems.  The symptoms produced are dependent entirely on the location of the blockage and the extent of blockage.  The leading cause for blocked arteries is atherosclerotic disease.  This is an affliction usually associated with aging; however, there are several known risk factors to include genetic predisposition, diabetes, elevated cholesterol, and smoking.  Atherosclerosis is a gradual process, which can lead to progressive narrowing of the arteries.  When the narrowing reaches a critical point then symptoms can occur.

If the blockage is located in arteries feeding the legs, then a condition referred to as claudication can occur.  This is leg pain, which occurs during exercise, commonly in the calf, thigh or buttocks.  The pain is often reproducible at a certain distance and is relieved with rest.  In more severe cases, blocked leg arteries can lead to pain at rest or even tissue loss and gangrene.  Claudication carries a very low risk for limb loss; however, it is a marker for atherosclerotic disease of the heart.  Therefore, modifying risk factors such as smoking cessation, and lowering cholesterol level are most important.  The indication for treatment with claudication is dependent on the severity of the symptoms.

Rest pain, tissue loss, and gangrene can occur in the setting of more severe vascular disease.  In this situation, the disease process is more advanced, involving multiple segments of blocked arteries.  In contrast to someone with claudication, the risk of limb loss is very high if blood flow is not restored.

There are three primary arteries that feed the intestines: the celiac artery, superior mesenteric artery, and inferior mesenteric artery.  Arterial blockages involving the individual intestinal arteries are usually very well tolerated.  However, if the blockages involve 2 of the three arteries then symptoms of food intolerance, weight loss, and intestinal gangrene can occur.

Arterial blockages involving the renal arteries can lead to more unique problems such as severe hypertension and kidney failure.  As the renal arteries reach a critical point of narrowing, a hormone from the kidney called renin is released. Renin is a potent hormone, which leads to severe hypertension.  If left untreated, irreversible kidney damage occurs leading to kidney failure.

The diagnosis of blocked arteries can be accomplished quickly and painlessly utilizing modern ultrasound technology.  The non-invasive vascular laboratory at EvergreenHealth Heart & Vascular Care is ICAVL accredited and has the capability to perform the entire spectrum of vascular evaluations.

The treatment for blocked arteries depends on the site of blockage and severity of the symptoms.  Treatment may consist of medical therapy and risk factor modification, endovascular or catheter based treatment, or open surgery.  Fortunately, most arterial blockages can be treated with minimally invasive catheter based therapies such as angioplasty and stenting.