The arterial occlusive disease develops through inflammatory alterations in the arterial walls (arteriosclerosis), which leads to the adsorption of thrombi and eventually to vascular obliteration. Mainly affected are the medium and small arteries of the extremities.
Cigarette smoking (nicotine abuse) is one of the most significant risk factors for the development of arteriosclerosis and is to be regarded as the main cause of PAOD in many patients. However, a PAOD can also occur in non-smokers, and therefore the designation smoker's leg is not always applicable.
The complete occlusion of an artery results in necrosis of the skin as well as deep-lying tissue sections (subcutis, muscle) and ulcerations in the supply area. The smoker's leg exhibits a livid-black discoloration of the skin in the affected areas (dry gangrene). The alterations begin mostly in the periphery of the foot (toes) and then continue to proximal.
The treatment of smoker's leg is the same as that of a severe PAOD. Among others, the following surgical procedures are employed:
Thrombendarterectomy (TEA): Removal of atherosclerotic materials Percutaneous transluminal angioplasty (PTA): Balloon dilatation of vascular stenosis Bypass operation: Bypassing the stenosis through a vascular transplant.
In advanced cases and/or when the above-mentioned procedures are not possible or are not successful, the amputation of the affected leg is necessary.
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