Microvascular disease or the disorder of very small blood vessels may increase the risk of leg amputation, suggested a new study.
In microvascular disease, tiny vessels that carry blood to muscles and other tissues throughout the body stop functioning properly. While the disease is commonly diagnosed in the eyes (retinopathy) or the kidney (nephropathy), study authors believe they indicate microvascular dysfunction throughout the body.
The new research noted that on an average of nine years, participants with microvascular disease had a 3.7-fold increased risk of lower limb amputation and experienced 18 per cent of all amputations, regardless of the location of disorder in the body.
Published in the American Heart Association’s journal Circulation, the research studied patients with both microvascular disease and peripheral arterial disease (PAD). It noted almost 23-fold increased risk of amputation in people with microvascular disease compared to those without any vascular disease, whereas those with PAD had a 13.9-fold increased risk of lower limb amputation and suffered 22 per cent of all amputations.
PAD causes narrowing of the arteries and is typically found in the legs. It causes cramping, pain or fatigue in the leg muscles while walking or climbing stairs. If left untreated, PAD can also lead to gangrene.
“This study advances the idea that microvascular disease is a system-wide disorder rather than only affecting one part of the body,” said Joshua A Beckman, MD, lead author of the study and professor of medicine and director of Vascular Medicine at Vanderbilt University Medical Center in Nashville, Tennessee.
“PAD (in the legs) has long been considered a sign that a patient likely also has narrowed arteries leading to the heart or brain. If a patient has PAD, they have a higher risk of other cardiovascular diseases, such as heart attacks and strokes,” Beckman said. “Our study suggests that microvascular disease in any part of the body, such as the eyes, kidneys or feet (neuropathy) may be linked to decreased blood vessel function in other parts of the body, putting patients at risk for potential lower-limb amputations.”
Based on the findings, Beckman suggested that patients with microvascular disease require close observation and care of their feet to detect sores or injuries early to promote healing and reduce amputations. “Patients with both microvascular disease and PAD have the highest risk of lower-limb amputation and need maximal medical therapies to reduce their risk,” Beckman said.