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Enfermedad Vascular Periférica

¿Qué es y cómo se trata?

La enfermedad vascular periférica (EVP) afecta a los vasos sanguíneos fuera del corazón. Es un grave problema circulatorio, que afecta a las arterias que transportan la sangre hacia los brazos y las piernas. Esta patología puede aumentar el riesgo de sufrir un ataque cardíaco. Aproximadamente un tercio de los pacientes con enfermedad vascular periférica que sufrieron un ataque cardíaco o ACV, fallecieron a causa del mismo. Asimismo, si la Enfermedad Vascular Periférica no se trata, los síntomas pueden empeorar.

¿Cuáles son las causas?

La enfermedad vascular periférica ocurre cuando las arterias se estrechan debido a la acumulación de placa, a partir del colesterol, los depósitos de grasa, calcio y otras sustancias en la sangre. Las arterias obstruidas pueden evitar que la sangre rica en oxígeno llegue a los músculos cuando éstos más lo necesitan, y esa falta de oxígeno provoca dolor. Movilizarse puede resultar muy difícil, provocando lesiones graves, seguidas de infecciones que deriven en la pérdida de un miembro.

¿Cuáles son los síntomas?

Uno de los síntomas clásicos de la EVP es el adormecimiento y calambres en las piernas, cadera o nalgas mientras se hace ejercicio, o simplemente al caminar. Este dolor desaparece cuando se descansa, un síntoma denominado claudicación intermitente. Otras de las señales son entumecimiento o cosquilleo en las piernas, pies o dedos del pie, cambios en el color de la piel (pálida, azulada o enrojecida), piel fría (por ejemplo, en las piernas, pies, brazos o manos), impotencia e infecciones/úlceras que no sanan. Los síntomas generalmente aparecen en la parte del cuerpo donde las arterias están obstruidas. Pero hay quienes padecen la enfermedad vascular periférica y no sienten ningún síntoma, por eso es importante ser consciente del riesgo.

¿Cómo se realiza el diagnóstico?

El examen más común para detectarla es el índice tobillo-brazo, que compara la presión sanguínea en las piernas y en los brazos mediante un brazalete. Si las presiones son diferentes, podría significar la existencia de enfermedad vascular periférica, y en ese caso se pueden realizar otros exámenes para determinar con certeza la patología.

¿En qué consiste el tratamiento?

Este depende de la gravedad del cuadro. Se pueden realizar ejercicios o tomar medicamentos, y también hay varias opciones para ayudar a que la sangre vuelva a fluir libremente a través de las arterias afectadas. Entre ellas:

  • Angioplastia: consiste en pasar un catéter con un pequeño balón desinflado en un extremo, a través de la arteria obstruida. Después de haber sido insuflado, el balón comprimirá la placa contra las paredes de la arteria.
  • Implante de stent: durante una angioplastia, se puede colocar en la arteria un tubo diminuto con malla de metal, denominado stent, para ayudar a mantenerla abierta.
  • Aterectomía: se utiliza un catéter especial para cortar y quitar la placa de las arterias.
  • Endarterectomía: se utiliza un catéter especial para abrir los vasos sanguíneos obstruidos, mediante la remoción de la placa acumulada en la pared interior de las arterias.
  • By Pass: se toma un vaso sanguíneo sano de otra parte del cuerpo, o un pequeño tubo artificial, y se lo utiliza para crear un desvío para que la sangre pueda fluir salteando la parte obstruida de la arteria.

Prevención 

La detección temprana de esta enfermedad puede ser una gran ventaja. Para prevenirla se aconseja no fumar, tener una dieta saludable con bajo colesterol y hacer ejercicio.