Obliterating endarteritis

The pathogenesis of obliterating endarteritis very difficult. Schematically it can be represented as follows: it is the first link - spasm of the vessels, i.e., functional disorder, leading further to organic changes in the vascular wall. Their development is caused by ischemia of the vessel wall, in violation of its innervation, allergies. The blood supply of the vascular wall suffers due to compression vasa vasorum spazmirovannah muscles of the vessel. This is due to spasm of ischemia causes powerful pain impulsaciu, and in response to inadequate centripetal impulses arise changes centrifugal vasomotor and trophic innervation. They are, on the one hand, to strengthen and spread spastic narrowing of the vessel, on the other,to the disturbance of trophism of the vascular wall and degenerative changes in it, which are particularly quickly come ischemia. There is a destruction of endothelium. On deprived of endothelium areas can form clots. Irritation of great intensity are also a number of humoral shifts promoting thrombosis (blood coagulability), spasm (hyperadrenalism) and others Finally, there is a violation of tissue exchange, acting as allergens, denatured proteins determine the development of giperergicakie reaction in the vascular wall. The value of allergic factor seems to be increasing in cases where inadequate centripetal impulses have its source of chronic infection in the periphery of the limbs. In these cases cannot be excluded and direct impact absorbed from the hearth products on peripheral vessels. Organic changes in the vessel are the second part of the pathogenesis; they result in a reduction in clearance and an opportunity of its obliteration and sharp ischemia. Pathological process is not limited to major vessels, the same changes are also found in collateral network; in some cases defeat it comes at the same time, others later, under the influence of defeat highway as a source of pathological activity. Originally collateral circulation is insufficient only at the moment functional load legs when walking (relative failure); the coming of the absolute failure manifests itself in a state of rest, particularly in a horizontal position.