Why poor blood flow to the legs is common in diabetics and older adults and how minimally invasive treatments are changing outcomes

Legs feeling unfavorably and not moving is a health issue that tends to be overlooked until it slows down a person's ability to move, continue doing daily activity, or heal from minor wounds.

Poor blood flow to the legs is very common among diabetics and senior citizens both have an increased chance of developing peripheral artery disease (PAD) which means the arteries that send blood to the leg's limbs are blocked fully or partially.Many times, patients do not connect symptoms with blood flow issues and therefore do not look for help and instead attribute their problems as a natural consequence of ageing.

Some common symptoms that people with poor circulation to the legs will experience include, leg pain while walking, numbness, cramps, heavy calves, cold feet, delayed healing of minor wounds and discoloration of the skin. These symptoms may be signs of inadequate blood flow to your legs and should never be classified as normal.

Poor circulation is experienced by many people around the world and diabetes is one of the largest causes of it.

With consistently high levels of blood glucose (sugar), the walls of the blood vessels become damaged over time, making them narrow and less flexible. Additionally, diabetes damages the nerves, which means someone with diabetes may not experience the symptoms of pain or discomfort until blood flow has been significantly affected.

The presence of both reduced blood flow and a loss of feeling in the foot are 2 reasons why many complications occur as a result of diabetes.Age is a contributing factor as well; as a person ages, collection of fat within the arteries occurs and creates a loss of elasticity & restricts normal blood flow. More rapid buildup of fatty deposits occurs in people with risk factors such as high blood pressure or cholesterol; being overweight; smoking; being physically inactive.Poor blood circulation can lead to serious issues if not treated properly. For some patients with a modest cut or blister on their foot that has poor blood flow, healing can take too long.

As a result, their chance of getting infected, developing gangrene and needing amputation increases. Thus, the importance of early diagnosis.Historically, many patients thought blocked arteries were a surgical problem and required extensive surgery to unblock them. However, there have been tremendous advancements in the field of Interventional Radiology, which is a specialty area that utilizes image-guided, minimally invasive techniques to diagnose and treat blocked blood vessels without the need for large incisions.Using advanced imaging techniques such as ultrasound, fluoroscopy and CT imaging, interventional radiologists can get access to the diseased artery through a very small puncture, usually made in the groin or wrist, and perform procedures such as angioplasty, which involves inflating a small balloon inside the narrowed artery to help restore normal blood flow through the artery. Sometimes, a stent is placed in the artery to help keep it open.These minimally invasive procedures have many benefits compared to traditional surgery in appropriately selected patients. Since no large incisions are made and significant amounts of blood are not lost during the procedure, most patients experience less pain and have much shorter hospital stays and quicker recoveries following these types of procedures compared to the same procedure performed surgically.

Most patients can go home on the same day as their procedure and return to their normal activities much sooner.The biggest advantage of these minimally invasive procedures is that they allow for timely access to the blood supply, as the timely restoration of the blood supply will greatly decrease the incidence of non-healing ulcers, infections and amputations, particularly in diabetic patients.While prevention remains a key factor in foot management for patients with Diabetes Type 1 or Type 2, regular self-examination of feet; maintaining blood glucose levels within normal limits; avoiding going barefoot; and seeking immediate medical attention for non-healing wounds.Aging does not imply diminished blood supply. Diminished blood supply can be diagnosed and treated as a medical problem. Advancements in interventional radiology have made available safer, less invasive treatment options to improve circulation, preserve mobility, and greatly enhance a patient's quality of life. If your legs have something to tell you, do not ignore them; timely diagnosis and intervention can make a significant difference.Dr. Avik Bhattacharya, Interventional Radiologist - CK Birla Hospitals, CMRI