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Lower Limb Arteriopathy in Nice

Dr. Ilya Khantalin, Vascular Surgeon in the Alpes-Maritimes

Lower Limb Arteriopathy

Dr. Ilya Khantalin in Nice

Dr. Ilya Khantalin, vascular surgeon in Saint-Laurent-du-Var near Nice, provides comprehensive care for lower limb arteriopathy, a complex condition with multiple manifestations and consequences. Also known as Peripheral Arterial Disease (PAD), this condition results from a narrowing or blockage of the arteries supplying blood to the legs.

This vascular disease is common in elderly patients, smokers, and individuals with diabetes or cardiovascular disorders.

Vascular diseases are recognized as Long-Term Illnesses (Affections de Longue Durée – ALD), allowing for 100% coverage by French Social Security.

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What is Lower Limb Arteriopathy?

Vascular Surgeon in Saint-Laurent-du-Var

Lower limb arteriopathy is an arterial disease characterized by the progressive narrowing of blood vessels due to the accumulation of atheromatous plaques—a process called atherosclerosis. This narrowing restricts blood flow to the muscles and tissues in the legs, leading to potentially severe symptoms, including amputation.

Symptoms and Treatment of Lower Limb Arteriopathy

Vascular Surgery Specialist in Saint-Laurent-du-Var

Symptoms may vary among patients, but the most common signs include:

  • Intermittent claudication: pain in the legs, often felt in the calves, that appears while walking and disappears at rest
  • Rest pain: in advanced cases, pain may occur even at rest, particularly when lying down, and may be especially troublesome at night
  • Ulcers and necrosis: inadequate blood supply to the lower limbs may lead to hard-to-heal wounds, increasing the risk of ulcers and even tissue necrosis

PAD is a progressive disease that, without proper management, can lead to serious complications. Untreated arteriopathy can result in critical limb ischemia, greatly increasing the risk of amputation. Therefore, early diagnosis and appropriate treatment are essential.

Lower limb arteriopathy is most often caused by atherosclerosis—an accumulation of cholesterol, fat, and other substances in the arteries. Risk factors include:

  • Age: over 55
  • Sex: men are seven times more likely than women (it occurs much later in women)
  • Smoking: damages arterial walls
  • High blood pressure: puts stress on blood vessels
  • Diabetes: contributes to arterial stiffness and plaque buildup
  • Kidney failure
  • Hypercholesterolemia and high triglyceride levels
  • Sedentary lifestyle and overweight

Patients with one or more of these risk factors should regularly monitor their vascular health for early detection and management of PAD.

Diagnosing lower limb arteriopathy involves several clinical and paraclinical tests. During a consultation, the vascular surgeon will assess symptoms, examine peripheral pulses, and use screening tests such as:

  • Ankle-Brachial Index (ABI): a simple test that compares blood pressure in the ankles and arms. An abnormal ABI indicates impaired circulation in the legs
  • Doppler Ultrasound: analyzes blood flow in the arteries and detects narrowing
  • Blood pressure measurement
  • CT angiography of the aorta and lower limbs
  • Angiography: in uncertain cases or to pinpoint lesion locations, imaging such as CT or MRI angiography is often recommended

These exams are essential for establishing a precise diagnosis and formulating a treatment plan based on the severity of the condition.

Treatment options vary depending on the disease’s progression and the patient’s general condition. In general, treatments are divided into conservative and invasive approaches.

Initial management often includes lifestyle modifications and medication. Common prescriptions include:

  • Antiplatelet agents (e.g., aspirin) to reduce clotting risk
  • Statins to lower cholesterol and slow atherosclerosis progression
  • Vasodilators and angiotensin inhibitors to improve blood circulation

Lifestyle changes are essential: smoking cessation, a balanced diet, and regular physical activity tailored to the patient’s condition.

In advanced PAD, surgery may be necessary:

  • Endovascular angioplasty: a minimally invasive procedure using a balloon to dilate the narrowed artery. A stent may be inserted to keep the artery open
  • Endoluminal angioplasty: Dr. Khantalin uses the JetStream atherectomy system—an innovative technique based on similar principles to standard endoluminal angioplasty, allowing effective removal of arterial blockages alongside conventional treatments
  • Arterial bypass surgery: if angioplasty is insufficient, a bypass may be performed using a vein or prosthetic graft to reroute blood flow
  • Thromboendarterectomy: a procedure to remove atheromatous plaques from arteries, restoring proper blood flow

Procedures are selected based on the blockage’s location, severity, and the patient’s overall health.

Ongoing follow-up is essential to prevent complications and slow disease progression. Monitoring includes:

  • Regular consultations with a vascular surgeon to assess disease evolution
  • Monitoring of risk factors: blood pressure, cholesterol, blood sugar
  • Support for smoking cessation and management of cardiovascular risk factors

Follow-up tests such as Doppler ultrasound or ABI help evaluate circulation in the legs. Additionally, vascular rehabilitation (supervised physical exercise) can improve patients’ exercise tolerance and quality of life.

Lower limb arteriopathy is a serious condition requiring tailored management and regular follow-up. Dr. Ilya Khantalin, vascular surgeon in Saint-Laurent-du-Var, offers expert care for accurate diagnosis, appropriate treatment, and thorough monitoring to prevent complications and preserve quality of life.

For any questions or to schedule an appointment, please contact Dr. Khantalin.

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