Peripheral arterial occlusive disease
When the blood stops flowing
Underestimated and overlooked
All kinds of aches and pains come with age. It's quite normal, something you have to live with as you grow old. Thoughts like these are often to blame when patients play down – or simply ignore – the first symptoms of peripheral occlusive vascular disease (POVD).
"Window-shopper's disease"
Yet the first noticeable signs of the disease are extremely unpleasant. Your legs, calves and buttocks begin to hurt. Eventually, it becomes agony to walk long distances. Sufferers have to stand still frequently – sometimes pretending to be window shopping. Which is why the disease is also called "window shopper's disease" in Germany.
Contracted blood vessels – inadequate blood supply
It is caused by poor blood circulation, itself the result of a hardening of the arteries. In peripheral occlusive vascular disease, optimal blood circulation is prevented by a narrowing or blocking of the arteries in the extremities, especially the legs. Pain begins in these badly supplied "peripheral" (a medical term meaning adjacent to the trunk) parts of the body. Typical POVD risk factors include smoking, high blood pressure, high blood-fat levels and diabetes.
Threat of leg amputation
In the later stages, ulcers develop and the tissue that is insufficiently supplied with blood can even die off. Many patients have to have a leg amputated. In Germany alone peripheral occlusive vascular disease causes an estimated 35,000 amputations a year. Many of these could have been avoided by early diagnosis and treatment.
In fact even more things could be prevented, because POVD is often a sign of vascular problems in other parts of the body. Indeed, patients with POVD tend to die ten years earlier than healthy people on average, often of a heart attack.
Only one-third of the people affected go to see a doctor
What is particularly problematic is the fact that the disease can already reach an advanced stage without any symptoms appearing. This is one reason why it is massively underdiagnosed. In the October 2007 edition of the German Ärztezeitung (Doctors' Newspaper), an expert was quoted as saying: "We only know a third of the patients who have POVD, so hospitals and general practices only get to see the tip of the iceberg." Improved diagnostic procedures by general practitioners would therefore be desirable. All the more so since studies have shown that patients who suffer no pain have an equally high mortality risk as those with symptoms.
Early diagnosis possible
The good news is that even if there are no symptoms, a GP can reliably diagnose POVD by carrying out a so-called AAI (ankle-arm index) measurement. This reveals constrictions of the leg arteries even before there are any symptoms.
Drugs can help
If the disease is already in progress, special drugs can help. Bayer Schering Pharma offers such a drug in some European countries. Administered intravenously, it improves the microcirculation in the vessels affected by the disease. At the same time, it is designed to reduce the pain associated with disturbances of the circulation and to improve the healing of ulcers. This can lead to a significant improvement in the quality of life for the people affected.
Advice for patients
Every body reacts differently to medicines. Therefore it is impossible to tell which medicine works best for you. Please consult your physician.
