Atherosclerosis of the carotid arteries ICD 10. Atherosclerosis of the peripheral arteries - description, causes, symptoms (signs), diagnosis, treatment. What is obliterating atherosclerosis of the arteries of the lower extremities
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Insufficient blood supply to the brain with slowing blood flow, a tendency to stagnation, slow reactions of expansion and contraction to external and internal irritations leads to the fact that a patient with cerebral atherosclerosis begins to experience headaches - dull, worsening with fatigue and becoming almost constant over time. . There is often noise and ringing in the head, dizziness with staggering during a sudden change in body position and when walking, redness of the face with sweating or paleness, and sometimes “flying spots” before the eyes. During a long conversation (report, speech), “stumbling” on syllables may occur.
As a rule, sleep is disturbed - it becomes intermittent, with sudden awakenings, palpitations and fears, often with unpleasant dreams, and falling asleep during the day while working is noted.
One of the first symptoms of cerebral atherosclerosis is a decrease in mental activity, weakening of attention, and inability to quickly grasp what is essential. A typical symptom is impaired memory for recent events while intact for long-past events. It is important to note that mechanical memorization is more impaired than logical semantic memory. Along with weakening of mental activity, emotional instability in the form of tearfulness, suspiciousness, anxiety, irritability, pickiness, and grumpiness is typical. Mental “stuckness” is characteristic – slow recovery from the slightest failures, a tendency to depressive reactions.
When examining patients with cerebral atherosclerosis, a number of objective disorders are also revealed. First of all, coordination of movements is impaired. The gait becomes unstable, staggering appears in a standing position, and subtle manipulations with the hands become unclear. The pace of movements slows down, and trembling of the head, chin, or one or both hands may appear. Nystagmus is sometimes noted. The pupils may change their shape, become uneven, and their reaction to light is sluggish. Facial asymmetry is common - one corner of the mouth is lower than the other, the tongue deviates to the side when protruding. Even with normal blood pressure, the pulsation of the vessels in the neck becomes visible, the temporal arteries become tortuous, and the pulsation in the arteries may weaken. When pressing on the arteries, their pain is noted. When examining the fundus, narrowing of the arteries and tortuosity of the veins are detected.
The blood cholesterol level is elevated (more than 250 mg per 100 ml). X-rays of the skull often reveal calcification of the internal carotid and basilar arteries supplying the brain.
Atherosclerotic disease complicated by occlusion can cause thromboembolism, trophic ulcers and gangrene. Diagnosis of any of these problems requires knowledge of the coding of conditions specified in ICD 10. Atherosclerosis of the lower extremities in the International Classification of Diseases, 10th revision, is in section I70 - I79.
Usually, the code of a specific disease is well known to doctors specializing in the treatment of vascular pathology. However, doctors of all specialties may encounter problems with the circulatory system presented in ICD 10, so you should have information on specific conditions that arise against the background of vascular diseases. Blockage of arterial trunks anywhere in the body can manifest itself in a variety of symptoms. Knowing the diagnosis code will help you quickly navigate a large number of vascular diseases.
Group of diseases associated with atherosclerotic lesions
All diseases that occur against the background of uncomplicated or complicated atherosclerosis are systematized under the code I70 and include the following pathology options:
- atherosclerotic disease of the aorta (I70.0);
- damage to the renal arteries (I70.1);
- atherosclerosis of the arteries of the lower extremities (I70.2);
- narrowing of any other arteries caused by pathological atherogenesis (I70.8);
- multiple or unspecified pathological process occurring against the background of atherosclerosis (I70.9).
The doctor can use any code from ICD 10 to indicate a diagnosis of vascular pathology. It is necessary to divide atherosclerosis of the lower extremities into 2 parts - complicated or uncomplicated. Obliterating vascular atherosclerosis is coded I70.2.
Vascular complications of the legs, systematized in the International Classification
Pathology of the aorta or large main arteries is of great importance for ensuring blood flow in the legs. In particular, if an atherosclerotic plaque has led to disruption of blood flow, then an expansion similar to a saccular aneurysm will form above the narrowing. If atherosclerosis provokes the formation of aneurysmal expansion in the area of the aorta or underlying vessels, then the doctor will set the following code from the 10th revision classification:
- aneurysm of the abdominal aorta with or without rupture (I71.3-I71.4);
- dilatation of the iliac arteries (I72.3);
- aneurysm of the arteries of the lower extremities (I72.4);
- aneurysmal dilatation of specified or unspecified localization (I72.8 -I72.9).
In the group of peripheral vascular pathology, the International Classification of the 10th revision identifies the following pathology options:
- vascular spasm of small arteries or Raynaud's syndrome (I73.0);
- thromboangiitis obliterans, combining inflammation and thrombosis (I73.1);
- specified or unspecified peripheral vascular diseases (I73.8-I73.9).
If atherosclerosis in the area of the vessels of the legs causes thrombotic complications, then these types of problems are grouped in the following codes:
- thromboembolism of the abdominal aorta (I74.0);
- thrombosis of the arteries of the lower extremities (I74.3);
- obstruction of the iliac arteries by thrombi or emboli (I74.5).
The obliterating variant of vascular pathology is coded as standard. If severe complications occur (gangrene, trophic ulcers), the ICD 10 code corresponds to the usual code, as does atherosclerosis of the arterial trunks of the femur and leg (I70.2).
Every doctor needs to know and use the International Classification of Diseases codes. In the case of pathology of the blood vessels of the legs, it is important to understand that under one code there can be different options - obliterating or uncomplicated atherosclerosis of the lower extremities. Depending on the preliminary diagnosis, the doctor will use optimal and informative diagnostic methods to confirm the disease variant and choose the best type of therapy. The presence of complications is of great importance: if the doctor sees gangrenous foci, then treatment must be started immediately. However, in all cases, prevention will give the best effect, so you should follow the doctor’s recommendations at the stage of minimal atherosclerotic symptoms, without waiting for skin ulceration or gangrenous lesions of the legs to appear.
Generalized atherosclerosis (code according to the international classification ICD-10 - I70) is a pathology that affects several arteries at once. The disease develops as a result of a violation of lipid metabolism in the body. It causes different symptoms depending on the location of the lesion, often similar to other diseases. Therefore, pathology requires a thorough examination.
The main reason why generalized atherosclerosis occurs is increased cholesterol levels in the blood. Lipids penetrate the walls of blood vessels, eventually forming an atherosclerotic plaque there. The following factors can influence the development of pathology:
- Hereditary predisposition. If there are people in the family who suffer from high levels of cholesterol in the blood, then the risk of atherosclerosis increases in other close relatives.
- Smoking and alcohol abuse. Cigarettes and alcohol contain many harmful substances that gradually destroy the vascular wall and make them more fragile.
- High blood pressure. When pressure increases in the body, the heart begins to push blood into the vessels with greater force. As a result, their walls are damaged, creating conditions for the development of atherosclerosis.
- Frequent stress and emotional overstrain. When a person is overexcited, the body produces adrenaline. This substance provokes increased heartbeat and increased pressure inside the blood vessels.
- Lack of physical activity. People who lead a sedentary lifestyle are often susceptible to the development of atherosclerosis, since excess fat is not burned, as happens when moving. As a result, the amount of lipids constantly increases.
To prevent the development of atherosclerotic disease, all of these factors must be excluded from a person’s life.
How does pathology develop?
Generalized atherosclerosis develops gradually, so its course is divided into several stages. There are 3 stages in total:
- First. Lipid stains form on the vascular wall. They appear in areas that are damaged or have blood stagnation. Under the influence of fats, the walls become loose and swell.
- Second. Where cholesterol accumulates, connective tissue appears, which leads to the formation of a full-fledged atherosclerotic plaque. It gradually increases in size and can block the lumen of blood vessels.
- Third. The plaques continue to grow, and they become denser because calcium salts are deposited. At this stage, blood circulation in the body is disrupted, and there is a high probability of blockage of the lumen.
If measures are not taken to eliminate plaques, complications such as stroke, heart attack, and ischemia may develop.
Localization and symptoms
Generalized atherosclerosis can occur in different parts of the body. In most cases, it is detected in the vessels of the brain, cervical spine, heart, and lower extremities. Several lesions appear in different places at once. The most dangerous disease is considered to develop in the coronary arteries.
Symptoms of generalized atherosclerosis manifest differently depending on where the lesion is located. Therefore, doctors distinguish several types of pathology, which are characterized by separate symptoms.
The first is atherosclerosis of the coronary arteries. In this case, the heart is affected, so the signs of the disease are associated with disturbances in its functioning. Patients complain of symptoms such as:
- Pain in the chest.
- Heartbeat disturbances.
- Regular heart attacks.
The pathology can lead to the development of heart failure, heart attack, angina pectoris and even death.
Attention! The insidiousness of coronary artery disease is that it occurs for a long time without any symptoms. Often doctors only recognize the pathology after an autopsy or at an advanced stage.
The second form of the disease is atherosclerosis of the brachiocephalic arteries. It poses no less danger to human life, since the brain is affected. The symptoms are in many ways similar to those of an ischemic stroke:
- Attacks of dizziness.
- Fainting.
- Loss of sensation in the lower and upper extremities.
- Decreased visual acuity.
- Nausea.
- Speech function disorders.
Other neurological signs may also appear.
The next type of disease is atherosclerosis of the lower extremities. The main symptom of the pathology is lameness. It does not bother me all the time, but only during attacks of pain in the legs that interfere with normal movement.
Complications
Generalized atherosclerosis can cause serious complications if left untreated. They arise due to the fact that the disease provokes a narrowing of the vascular lumens. This entails the development of ischemia, hypoxia, and sclerosis.
As the plaque grows, vascular blockage occurs, which leads to poor circulation, acute vascular failure, heart attack, stroke, ruptured aneurysm and death.
Diagnostics
To identify vascular atherosclerosis, a comprehensive examination is carried out using laboratory and instrumental methods. These include:
- Blood test to determine cholesterol levels.
- X-ray to help identify diseased areas of the arteries.
- Angiography, which allows you to assess the condition of blood vessels and blood flow.
- Ultrasound examination visualizes blood vessels, which helps determine the location of the lesion.
If necessary, diagnostics is supplemented with other instrumental methods. Based on the data obtained during the examination, the doctor makes a final diagnosis and selects the most optimal treatment tactics.
Treatment
Treatment of generalized atherosclerosis is carried out using conservative and surgical methods. Patients are prescribed medications that lower cholesterol levels, strengthen vascular walls, and normalize blood circulation. Statins, fibrates, bile acid sequestrants, and nicotinic acid help with this.
Surgery is performed in severe cases when it is impossible to get rid of the pathology using a conservative method. To eliminate plaques, various operations are performed that help remove lipid thrombus and expand the lumen of the vessel.
Diet food
The goal of the diet is to normalize cholesterol levels. To achieve this, exclude from the diet all foods containing a lot of fat: fatty meat, butter, smoked meats, canned food.
The menu includes more plant foods: vegetables, fruits, herbs, cereals. You are allowed to eat lean meats and fish. You can drink green tea and natural juices.
Prevention
To prevent the development of atherosclerosis, the following is recommended:
- Follow the rules of healthy eating.
- To refuse from bad habits.
- Exercise.
- Monitor your body weight.
- Promptly treat pathologies that cause vascular problems.
- Avoid stress.
Generalized atherosclerosis is a serious disease that requires immediate treatment. Therefore, you cannot ignore elevated blood cholesterol levels and postpone a visit to the doctor.
Such lipid and cholesterol accumulations, called atherosclerotic plaques in medicine, can significantly increase in size as the disease progresses and thereby provoke the appearance of not only a fairly pronounced narrowing (stenosis) of the lumens of the arteries, but also their complete closure, which in most cases leads to ischemia of the lower extremities.
In order to most fully present the mechanism of pathological changes in this disease, it is recommended to familiarize yourself with medical sources containing various illustrations on the topic, as well as photos of obliterating atherosclerosis of the lower extremities.
Prevalence of the disease
Obliterating atherosclerosis of the arteries of the lower extremities is considered the most common vascular disease. According to generalized data from various medical studies, with atherosclerosis, occlusive-stenotic lesions of the arteries of the legs are found in 20% of patients. It is noted that this disease most often occurs in people belonging to a more mature age category. According to statistics, between the ages of 45 and 55 years, this disease is detected in only 3-4% of people, while at older ages it is detected in 6-8% of the population. It is also important to note the fact that atherosclerotic diseases are most often diagnosed in the male half, and in particular, in those men who abuse tobacco smoking for a long period of time.
Causes of the disease
Medical specialists are inclined to believe that the main reason for the development of the disease in question lies in lipid metabolism disorders, namely in a significant increase in the level of lipophilic natural alcohol (cholesterol) in the blood. However, they also note that the accumulation of cholesterol in the vessels alone is not enough to cause atherosclerosis. In order for atherosclerosis obliterans to develop, in addition to an increase in cholesterol levels, some risk factors must also be present that can adversely affect the structure and protective properties of the artery. Such factors include:
- mature age (45 years and older);
- gender (male);
- smoking (nicotine initiates the appearance of persistent vascular spasms, which often contributes to the development of various pathological processes);
- various serious illnesses (diabetes mellitus, hypertension, etc.);
- unhealthy diet (excess animal fats);
- lack of physical activity;
- overweight;
- excessive psycho-emotional and physical stress;
- frostbite of the extremities, as well as frequent hypothermia;
- previous leg injuries.
Currently, representatives of medicine believe that in addition to all of the above conditional causes of atherosclerosis, there is also a risk factor for the development of atherosclerotic diseases such as genetic predisposition. It has been scientifically proven that in some cases, an excessive increase in cholesterol in a person’s blood may be due precisely to his genetic inheritance.
Classification and symptoms of the disease
Symptoms of obliterating atherosclerosis of the lower extremities and their severity usually directly depend on the nature of the disease itself and on the stage of its development, determined by both the degree of blockage of the artery and the severity of the resulting disturbances in the blood supply in the legs.
Modern medicine identifies four main stages of development of this disease, each of which is expressed by a specific clinical picture. These include:
- Stage 1 (is the initial asymptomatic stage of the disease, diagnosed by taking a biochemical blood test, which reveals elevated lipid levels);
- stage 2 (expressed by the appearance of primary signs of the disease in the form of numbness, chilliness, muscle cramps and mild pain in the lower extremities);
- stage 3 (characterized by a fairly pronounced clinical picture, in which severe pain appears in the legs, lameness may be observed, and thinning of the skin and the formation of small bleeding wounds and ulcers are detected);
- Stage 4 (defined as the most severe and is expressed by the appearance of constant pain, muscle atrophy, total lameness, as well as the occurrence of gangrene and trophic ulcers). Medical specialists warn that obliterating atherosclerosis of the vessels of the lower extremities is a serious and dangerous disease, untimely treatment of which can lead to the appearance of gangrene of the leg with its subsequent loss. This means that if any of the above symptoms occur, it is important to immediately consult a doctor in order to promptly diagnose and treat the developed disease.
Diagnosis of the disease
The diagnosis of “obliterating atherosclerosis ICD 10 code 170” is made on the basis of the collected anamnesis, manifested clinical signs, as well as laboratory and instrumental research methods, including passing some tests (urine, blood) and undergoing a number of special medical examinations (rheovasography, Dopplerography, thermometry, arteriography and functional load tests).
Treatment of the disease
After carrying out all the necessary diagnostic procedures followed by making an accurate diagnosis, the doctor individually prescribes to the patient the most suitable treatment for obliterating atherosclerosis. When drawing up a treatment regimen for this disease, the doctor always takes into account the stage of its development, the severity of existing ischemic disorders and the presence or absence of any complications.
Relief of pathological processes in atherosclerotic diseases can include both a set of therapeutic and health measures aimed at adjusting everyday lifestyle, as well as conservative, endovascular or surgical methods of treatment.
Treatment and health measures in such cases include:
- to give up smoking;
- hypocholesterol diet food;
- elimination of existing diseases and pathologies that aggravate the course of atherosclerosis;
- dosed physical activity;
- prevention of hypothermia of the skin of the legs and feet, as well as their protection from injury.
Treatment of obliterating atherosclerosis of the lower extremities, carried out conservatively, involves the use of physiotherapy, the use of antibiotic ointments, as well as the use of various vasodilators, vitamins, antispasmodics and drugs that improve tissue nutrition and blood microcirculation.
Endovascular treatments include balloon dilatation, angioplasty and arterial stenting. In modern medicine, these treatment methods are considered to be fairly effective non-surgical methods of restoring blood circulation through the vessels.
Surgical treatment is carried out only when a number of severe complications arise against the background of severe ischemia that is resistant to medication. The main surgical methods for treating atherosclerosis of the legs are: prosthetics (replacement of the affected part of the vessel with a prosthesis), bypass surgery (restoration of blood flow using an artificial vessel), thromboendarterectomy (liquidation of the affected artery).
In cases where gangrene appears against the background of atherosclerotic disease, multiple necrosis of leg tissue is observed, and it is not possible to restore blood flow through surgery, amputation of the affected part of the leg is prescribed.
Progressive atherosclerosis is one of the main causes of disability caused by amputation of the lower extremities, and, therefore, for each patient suffering from this disease, it is important to begin in time to carry out all the necessary treatment procedures and strictly follow the basic medical instructions and recommendations.
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Atherosclerosis (I70)
Included:
- arteriolosclerosis
- arteriosclerosis
- arteriosclerotic vascular disease
- atheroma
- degeneration:
- arterial
- arteriovascular
- vascular
- deforming or obliterating endarteritis
- senile:
- arteritis. endarteritis
The following additional codes are used to indicate the presence or absence of gangrene, for optional use with the corresponding subcategories in I70.
- 0 without gangrene
- 1 For gangrene
Excludes: atherosclerosis of renal arterioles (I12.-)
Sclerosis (medial) of Mönckeberg
In Russia, the International Classification of Diseases, 10th revision (ICD-10) has been adopted as a single normative document for recording morbidity, reasons for the population's visits to medical institutions of all departments, and causes of death.
ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. No. 170
The release of a new revision (ICD-11) is planned by WHO in 2017-2018.
With changes and additions from WHO.
Processing and translation of changes © mkb-10.com
Obliterating atherosclerosis of the vessels of the lower extremities (ICD code 10): treatment and prevention
If blood flow through the arteries of the legs is disrupted, accompanied by a narrowing of their lumen and partial absence of vascular patency in the femoral and popliteal areas, obliterating atherosclerosis of the vessels of the lower extremities is diagnosed, having an ICD10 code: 170.2.
Blockage of the lumen of blood vessels occurs as a response to the accumulation of a large number of lipid and cholesterol formations. These plaques, initially small, gradually increase in size and grow in the lumen of the artery. Stenosis of the arteries occurs, and then they are completely closed.
ICD 10 classifies obliterating atherosclerosis of the vessels of the lower extremities as a pathology associated with an overwhelming excess of cholesterol on the walls of the arteries. This disease is common in 20% of elderly patients with atherosclerosis.
But it has been noted that in people of pre-retirement age, the number of diagnosed cases of atherosclerosis of the lower extremities is close to 4%, and after 10 years - twice as often.
Causes
In order for excess cholesterol in the blood to cause such a serious disease as atherosclerosis of the vessels of the lower extremities, included in the international classification ICD 10, there must be a combination of several factors influencing the structure of the arteries:
- Hereditary prerequisites (in persons who have relatives with atherosclerosis, there is a common gene that provokes this disease);
- Being male;
- Elderly age;
- Hypertension;
- Diabetes;
- Adherence to smoking;
- Improper eating behavior;
- Obesity;
- Physical inactivity;
- Frequent physical activity;
- Hypothermia and frostbite of the legs;
- History of leg injuries.
Stages and symptoms of the disease
The severity of symptoms and their nature depend on the degree of development and progression of atherosclerosis of the lower extremities (ICD code 10), the involvement of the arteries of the legs in the process and the blocking of their lumen.
There are 4 stages, differing in clinical manifestations:
- The first stage - the diagnosis is established only by the results of laboratory blood tests that detect excess cholesterol levels. There are no symptoms of the disease that are noticeable to the patient.
- The second stage is characterized by the presence of the first noticeable signs of the disease, including numbness, pain in the lower extremities, the appearance of muscle cramps and chilliness (which is explained by a deterioration in the blood supply to these parts of the body).
- At the third stage, clinical symptoms clearly appear: thinning of the skin on the legs, ease of skin damage and the appearance of wounds; lameness and severe pain in the lower extremities appear.
- The fourth stage is a serious condition. The patient's lameness becomes permanent, persistent pain persists, and the leg muscles atrophy. The development of trophic ulcers and gangrene is likely, which can have fatal consequences including loss of a limb.
If the described signs are identified, if alarming phenomena appear, it is necessary to consult a doctor as soon as possible for examination, diagnosis and treatment. Left unattended, atherosclerosis of the vessels of the lower extremities (ICD code 10) leads to disability.
Diagnostics
Diagnostics consists of:
- Taking anamnesis;
- Assessment of clinical symptoms;
- Instrumental and hardware examination;
- Laboratory examination.
Laboratory tests include blood and urine tests.
Instrumental studies include Dopplerography to determine the characteristics of blood supply in the lower extremities, rheovasography, arteriography, angioscanning and thermography.
Attention is also paid to differentiating atherosclerosis disease (CAD) from thromboangitis and endarteritis.
Treatment
After confirming the diagnosis in a medical institution, the doctor selects the most suitable treatment regimen for the patient, which takes into account the characteristics of the course of the disease, the condition of the body and the stage of the disease.
Treatment can be conservative, with health measures, endovascular or surgical.
Treatment is designed to solve priority problems:
- Reduce and facilitate the passage of pain in the patient;
- Promote endurance during everyday walking;
- Stop the development of plaques in blood vessels and prevent the formation of ulcers.
With conservative treatment, medications are prescribed to restore blood supply to the legs; vitamin complexes; ointments containing antibiotics; local agents that stimulate regeneration; physiotherapy; drugs to improve blood microcirculation.
Endovascular treatment involves acting directly on damaged vessels. These are dilatation, stenting, angioplasty (its essence is the dilation of blood vessels using local anesthesia).
Surgical treatment comes to the rescue if nothing else has helped. Then doctors resort to thromboendarterectomy or bypass surgery (organizing a bypass for blood flow).
With advanced gangrene, in irreversible cases, amputation of the limb is performed.
Any treatment brings the best results with an integrated approach, including drug therapy, household health measures, and natural remedies of traditional medicine.
- Treatment of concomitant diseases that complicate the treatment of atherosclerosis;
- Quitting smoking;
- Rationing of physical activity;
- Protect the lower extremities from hypothermia;
- Control of eating behavior in order to reduce cholesterol and lipids, adherence to dietary recommendations to reduce and normalize weight.
Traditional medicine
- Infusions and decoctions of medicinal herbs: hawthorn, burdock, sweet clover, clover.
- Using decoctions and tinctures to apply medicinal dressings soaked in the decoction. For dressings and applications, decoctions of string, plantain, St. John's wort, sage, chamomile, and moss are used.
- To restore liver function, which is extremely important in the treatment of atherosclerosis, milk thistle or immortelle are used, separately taking their decoction orally.
- The use of artichoke in food as a plant with restorative properties, and garlic tincture.
Prevention
Like any type of atherosclerosis, obliterating atherosclerosis of the lower extremities (ICD 10) is easiest to prevent if you regularly monitor your health and know the risk factors.
You can delay its appearance or eliminate it completely if you make the rule of life a sufficient amount of physical activity, walking in the fresh air, excluding alcoholic beverages and tobacco, reducing the proportion of sweet and flour products in the diet, and an almost complete absence of canned food, fatty, fried, and spicy foods.
It is necessary to avoid hypothermia of the lower extremities, stagnation of blood in them due to uncomfortable shoes and high heels. Sitting in one place for a long time without changing posture also provokes problems with blood circulation.
People with diabetes will help their skin on their legs, especially their feet, if they rub it with a small amount of insulin.
Code of atherosclerosis of vessels of the lower extremities according to ICD-10
Atherosclerotic disease complicated by occlusion can cause thromboembolism, trophic ulcers and gangrene. Diagnosis of any of these problems requires knowledge of the coding of conditions specified in ICD 10. Atherosclerosis of the lower extremities in the International Classification of Diseases, 10th revision, is in section I70 - I79.
Usually, the code of a specific disease is well known to doctors specializing in the treatment of vascular pathology. However, doctors of all specialties may encounter problems with the circulatory system presented in ICD 10, so you should have information on specific conditions that arise against the background of vascular diseases. Blockage of arterial trunks anywhere in the body can manifest itself in a variety of symptoms. Knowing the diagnosis code will help you quickly navigate a large number of vascular diseases.
Group of diseases associated with atherosclerotic lesions
All diseases that occur against the background of uncomplicated or complicated atherosclerosis are systematized under the code I70 and include the following pathology options:
- atherosclerotic disease of the aorta (I70.0);
- damage to the renal arteries (I70.1);
- atherosclerosis of the arteries of the lower extremities (I70.2);
- narrowing of any other arteries caused by pathological atherogenesis (I70.8);
- multiple or unspecified pathological process occurring against the background of atherosclerosis (I70.9).
The doctor can use any code from ICD 10 to indicate a diagnosis of vascular pathology. It is necessary to divide atherosclerosis of the lower extremities into 2 parts - complicated or uncomplicated version. Obliterating vascular atherosclerosis is coded I70.2.
Vascular complications of the legs, systematized in the International Classification
Pathology of the aorta or large main arteries is of great importance for ensuring blood flow in the legs. In particular, if an atherosclerotic plaque has led to disruption of blood flow, then an expansion similar to a saccular aneurysm will form above the narrowing. If atherosclerosis provokes the formation of aneurysmal expansion in the area of the aorta or underlying vessels, then the doctor will set the following code from the 10th revision classification:
- aneurysm of the abdominal aorta with or without rupture (I71.3-I71.4);
- dilatation of the iliac arteries (I72.3);
- aneurysm of the arteries of the lower extremities (I72.4);
- aneurysmal dilatation of specified or unspecified localization (I72.8 -I72.9).
In the group of peripheral vascular pathology, the International Classification of the 10th revision identifies the following pathology options:
- vascular spasm of small arteries or Raynaud's syndrome (I73.0);
- thromboangiitis obliterans, combining inflammation and thrombosis (I73.1);
- specified or unspecified peripheral vascular diseases (I73.8-I73.9).
If atherosclerosis in the area of the vessels of the legs causes thrombotic complications, then these types of problems are grouped in the following codes:
- thromboembolism of the abdominal aorta (I74.0);
- thrombosis of the arteries of the lower extremities (I74.3);
- obstruction of the iliac arteries by thrombi or emboli (I74.5).
The obliterating variant of vascular pathology is coded as standard. If severe complications occur (gangrene, trophic ulcers), the ICD 10 code corresponds to the usual code, as does atherosclerosis of the arterial trunks of the femur and leg (I70.2).
Every doctor needs to know and use the International Classification of Diseases codes. In the case of pathology of the blood vessels of the legs, it is important to understand that under one code there can be different options - obliterating or uncomplicated atherosclerosis of the lower extremities. Depending on the preliminary diagnosis, the doctor will use optimal and informative diagnostic methods to confirm the disease variant and choose the best type of therapy. The presence of complications is of great importance: if the doctor sees gangrenous foci, then treatment must be started immediately. However, in all cases, prevention will give the best effect, so you should follow the doctor’s recommendations at the stage of minimal atherosclerotic symptoms, without waiting for skin ulceration or gangrenous lesions of the legs to appear.
The information on the site is provided for informational purposes only and cannot replace the advice of your attending physician.
What is obliterating atherosclerosis of the arteries of the lower extremities
Obliterating atherosclerosis of the lower extremities is a fairly common chronic pathology of the arteries, which is characterized by the appearance of mild lameness, a feeling of numbness and coldness of the feet.
This disease appears as a result of the formation of atherosclerotic plaques. Gradually, the lumen of the vessel narrows and ischemia of the lower extremities develops.
If treatment is not started in time, a person may become disabled, because the disease provokes gangrene and even the loss of a leg. ICD 10 code – I70.2. Atherosclerosis of the arteries of the extremities.
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- Only a DOCTOR can give you an ACCURATE DIAGNOSIS!
- We kindly ask you NOT to self-medicate, but to make an appointment with a specialist!
- Health to you and your loved ones!
Causes
Pathology leads to circulatory failure in the vessels of the lower extremities. As a result of its development, a person suffers greatly and may lose his ability to work. The disease usually affects large vessels or medium-sized arteries.
- The main manifestation of leg ischemia is considered to be intermittent claudication, which is accompanied by pain, numbness and muscle stiffness when moving. As a result, the person is forced to stop. Gradually, the pain and tightness disappear, but after the start of movement they appear again.
- The damaged limb, as a rule, has a paler shade than the healthy one. In addition, it is cold to the touch. Even minor injuries heal very poorly and can lead to ulcers.
- The sensation of numbness and pain may be associated with ischemia of the nerve trunks. This condition is called ischemic neuritis. If treatment for the disease is not started in time, it will lead to gangrene and amputation of the limb.
- Depending on the walking distance, the degree of damage to the vessel bed is determined. When pain occurs, a person should stop and wait for it to disappear.
- Without adequate therapy, the pathology continues to develop, which gradually provokes a decrease in walking distance, a decrease in physical activity, and disruption of the usual lifestyle.
- Most often, people mistake such sensations for muscle fatigue, which is associated with age or problems with the veins. At the same time, they perceive the pain syndrome as a cramp, postponing visits to the doctor. As a result, the problem gets significantly worse.
The lumen of the artery gradually narrows, which leads to its complete closure. Doctors say that patients seek medical help too late, when the disorder becomes irreversible.
Risk factors
The main factors that can provoke such violations include the following:
- smoking;
- systematic increase in pressure;
- high blood cholesterol;
- being overweight;
- insufficiently active lifestyle;
- diabetes;
- heart and vascular diseases in close relatives.
Vascular disorders in the legs pose a real threat to life. In the structure of the number of deaths from pathologies of the heart and blood vessels, they occupy 3rd place. This number is associated with the development of the most severe complication of the pathology - gangrene of the limb.
This condition provokes the need for amputation. With a high amputation, the probability of death is 25%. That is why it is necessary to take into account risk factors for the development of atherosclerosis at a young age and engage in prevention.
Without surgery, about 50% of patients die within a year of diagnosing critical ischemia.
Symptoms
To promptly identify this violation, you need to pay attention to the presence of the following signs:
- the appearance of fatigue in the muscle tissue of the thighs or calves when covering a distance of 500 m or less;
- leaden heaviness in the lower extremities or pain in the muscles that force a person to pause when walking;
- changes in the condition of the skin - peeling, hair loss, thinning of the epithelium may appear.
These symptoms indicate atherosclerotic damage to the blood vessels of the legs. To prevent dangerous complications, it is very important to immediately contact a vascular surgeon.
In this case, the doctor can assess the condition of the carotid arteries and prescribe a cardiac examination. The fact is that atherosclerosis is systemic in nature, and therefore it can affect various groups of vessels and be generalized.
If a sharp pain syndrome appears in the legs, paleness and coldness of the lower extremities, you should immediately call an ambulance. Perhaps this will help save the limb.
Classification
Currently, experts offer the following classification of pathology:
Diagnostics
Diagnosis of obliterating atherosclerosis of the vessels of the lower extremities includes several stages. First, the specialist must assess the intensity of pulsation in the limbs.
If there are atherosclerotic plaques, this indicator will be weak or disappear below the affected area. If abnormal pulsations are detected, other arteries are examined to rule out the presence of more extensive lesions.
Of no small importance is the determination of the ankle-brachial index, which is the ratio of the pressure of the arteries of the lower leg and shoulder. In a normal state, this indicator exceeds one. If a person has atherosclerosis, it decreases provided there is no damage to the arteries of the arms.
If a patient has normal pulsation, this does not exclude the presence of pathology. To make an accurate diagnosis, duplex scanning or Doppler ultrasound is performed.
Thanks to this, it is possible to evaluate blood flow and measure its speed. Often, for diagnostic purposes, multislice computed tomography and radiography using a contrast agent are also performed.
Treatment of obliterating atherosclerosis of the arteries of the lower extremities
There are many ways to treat this disease; the doctor must choose a specific method, taking into account the stage of the pathology.
Conservative therapy
At the initial stage of the disease, conservative therapy is sufficient, which must certainly be comprehensive.
It is very important to exclude the influence of factors that lead to vascular spasms:
- Adequate physical activity is also important.
- If a person has intermittent claudication, they need to walk for a minute every day. Thanks to this, it will be possible to develop small arteries, which will help build muscle strength and increase the distance covered without pain.
- If a person experiences pain and compression in muscle tissue, he definitely needs to stop. After the symptoms disappear, you can continue walking.
- Many patients tolerate swimming or cycling much better. It is important to remember that these types of physical activity are undoubtedly very useful, but they cannot completely replace walking.
- Treatment of this disease requires correction of high blood pressure.
- It is also necessary to normalize cholesterol levels and blood glucose levels in patients suffering from diabetes.
- For therapy to be as effective as possible, medications are used to reduce the tone of small vessels, increase the flexibility of red blood cells and prevent thrombus formation in the vessels.
- Balneological procedures and physiotherapy are also very useful.
- Hyperbaric oxygen therapy is often used.
You will find a description of cardiac atherosclerosis in this article.
Surgery
In advanced cases, surgery cannot be avoided. Surgical interventions can be performed in various ways:
- In this case, a small puncture is made in the femoral artery and long thin instruments are used to access the affected leg vessel.
- The operation is performed under X-ray control.
- Thanks to the use of innovative technologies, it is possible to expand part of the vessel from the inside using a special balloon.
- If necessary, the surgeon installs a thin metal frame that helps prevent re-narrowing.
- If a person has a blockage of a vessel of no more than 7-9 cm, the damaged area with plaque and blood clots is removed.
- If the occlusive process has become more widespread or there is a pronounced deposition of calcium in the wall of blood vessels, a bypass of the blood flow is used.
- Also in such cases, resection of part of the artery can be performed, which is replaced with a synthetic prosthesis or biomaterial.
If treatment does not give the desired results, and limb ischemia progresses and gangrene develops, amputation becomes necessary. Its level is determined individually. In this case, the blood supply to the limb must be taken into account.
Also, in some cases, various types of symptomatic interventions are performed:
- It represents the intersection of the nerve plexuses that are responsible for vasoconstriction.
- This operation is performed when arterial blockages recur and is an addition to reconstructive interventions.
- With this procedure, it is possible to normalize blood circulation in the extremities due to the expansion of small arteries.
- It is also an auxiliary procedure that helps improve blood circulation.
- This can be achieved by stimulating the appearance of new small vessels in the lower extremities, which occurs after damage to bone tissue.
Leeches
Folk remedies for obliterating atherosclerosis of the arteries of the lower extremities include the use of leeches.
There is an opinion that substances entering the human blood during this procedure help eliminate atherosclerotic plaques and prevent their reappearance.
Leeches help strengthen blood vessels and increase blood circulation in microcapillaries. As a result, the blood supply to the tissues is significantly improved, they receive significantly more nutrients and oxygen.
For the procedure to bring maximum benefit, it must be carried out by a hirudologist - a specialist who knows how to work with leeches.
- reduction of muscle spasm;
- improvement of blood circulation in capillaries;
- elimination of swelling and stagnation in the legs;
- reduction of pain syndrome;
- stabilization of the immune system;
- decreased blood pressure;
- improvement of hematopoiesis;
- formation of a stable biochemical composition of blood.
- severe forms of anemia;
- bleeding disorders;
- low pressure;
- hemorrhagic diathesis;
- pregnancy;
- oncological diseases;
- allergic reactions.
Thanks to this treatment, you can get many positive effects:
However, the use of leeches also has certain contraindications. These include:
If the patient has chronic diseases, after a hirudotherapy session there is a risk of their exacerbation. Therefore, it is so important to inform the doctor about all existing pathologies.
Obliterating atherosclerosis of the legs is an extremely dangerous disease that can lead to negative health consequences. If therapy is not started in time, there is a risk of leg amputation and even death. That’s why it’s so important to consult a specialist if alarming symptoms appear.
Read about the treatment of cerebral atherosclerosis with folk remedies in another publication.
If blood flow through the arteries of the legs is disrupted, accompanied by a narrowing of their lumen and partial absence of vascular patency in the femoral and popliteal areas, obliterating atherosclerosis of the vessels of the lower extremities is diagnosed, having an ICD10 code: 170.2.
Blockage of the lumen of blood vessels occurs as a response to the accumulation of a large number of lipid and cholesterol formations. These plaques, initially small, gradually increase in size and grow in the lumen of the artery. Stenosis of the arteries occurs, and then they are completely closed.
ICD 10 classifies obliterating atherosclerosis of the vessels of the lower extremities as a pathology associated with an overwhelming excess of cholesterol on the walls of the arteries. This disease is common in 20% of elderly patients with atherosclerosis.
But it has been noted that in people of pre-retirement age, the number of diagnosed cases of atherosclerosis of the lower extremities is close to 4%, and after 10 years - twice as often.
Male patients are at risk, especially those who continue to smoke.
Causes
In order for excess cholesterol in the blood to cause such a serious disease as atherosclerosis of the vessels of the lower extremities, included in the international classification ICD 10, there must be a combination of several factors influencing the structure of the arteries:
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Stages and symptoms of the disease
The severity of symptoms and their nature depend on the degree of development and progression of atherosclerosis of the lower extremities (ICD code 10), the involvement of the arteries of the legs in the process and the blocking of their lumen.
There are 4 stages, differing in clinical manifestations:
- The first stage - the diagnosis is established only by the results of laboratory blood tests that detect excess cholesterol levels. There are no symptoms of the disease that are noticeable to the patient.
- The second stage is characterized by the presence of the first noticeable signs of the disease, including numbness, pain in the lower extremities, the appearance of muscle cramps and chilliness (which is explained by a deterioration in the blood supply to these parts of the body).
- At the third stage, clinical symptoms clearly appear: thinning of the skin on the legs, ease of skin damage and the appearance of wounds; lameness and severe pain in the lower extremities appear.
- The fourth stage is a serious condition. The patient's lameness becomes permanent, persistent pain persists, and the leg muscles atrophy. The development of trophic ulcers and gangrene is likely, which can have fatal consequences including loss of a limb.
If the described signs are identified, if alarming phenomena appear, it is necessary to consult a doctor as soon as possible for examination, diagnosis and treatment. Left unattended, atherosclerosis of the vessels of the lower extremities (ICD code 10) leads to disability.
Diagnostics
Diagnostics consists of:
- Taking anamnesis;
- Assessment of clinical symptoms;
- Instrumental and hardware examination;
- Laboratory examination.
Laboratory tests include blood and urine tests.
Instrumental studies include Dopplerography to determine the characteristics of blood supply in the lower extremities, rheovasography, arteriography, angioscanning and thermography.
Attention is also paid to differentiating atherosclerosis disease (CAD) from thromboangitis and endarteritis.
Treatment
After confirming the diagnosis in a medical institution, the doctor selects the most suitable treatment regimen for the patient, which takes into account the characteristics of the course of the disease, the condition of the body and the stage of the disease.
Treatment can be conservative, with health measures, endovascular or surgical.
Treatment is designed to solve priority problems:
- Reduce and facilitate the passage of pain in the patient;
- Promote endurance during everyday walking;
- Stop the development of plaques in blood vessels and prevent the formation of ulcers.
With conservative treatment, medications are prescribed to restore blood supply to the legs; vitamin complexes; ointments containing antibiotics; local agents that stimulate regeneration; physiotherapy; drugs to improve blood microcirculation.
Endovascular treatment involves acting directly on damaged vessels. This is dilatation stenting, angioplasty (its essence is in dilation of blood vessels using local anesthesia).
Surgical treatment comes to the rescue if nothing else has helped. Then doctors resort to thromboendarterectomy or bypass surgery (organizing a bypass for blood flow).
With advanced gangrene, in irreversible cases, amputation of the limb is performed.
Any treatment brings the best results with an integrated approach, including drug therapy, household health measures, and natural remedies of traditional medicine.
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Traditional medicine
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Prevention
Like any type of atherosclerosis, obliterating atherosclerosis of the lower extremities (ICD 10) is easiest to prevent if you regularly monitor your health and know the risk factors.
The diet should be adjusted so as not to contain excess cholesterol-causing foods. There are scientifically proven dietary recommendations, but they are remembered only when the disease has already appeared.
You can delay its appearance or eliminate it completely if you make the rule of life a sufficient amount of physical activity, walking in the fresh air, excluding alcoholic beverages and tobacco, reducing the proportion of sweet and flour products in the diet, and an almost complete absence of canned food, fatty, fried, and spicy foods.
It is necessary to avoid hypothermia of the lower extremities, stagnation of blood in them due to uncomfortable shoes and high heels. Sitting in one place for a long time without changing posture also provokes problems with blood circulation.
People with diabetes will help their skin on their legs, especially their feet, if they rub it with a small amount of insulin.