Chronic Limb Ischaemia Flashcards Preview

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Flashcards in Chronic Limb Ischaemia Deck (14)
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1
Q

What is chronic limb ischaemia?

A

Peripheral artery disease that results in symptomatic reduced blood supply to the limbs

Typically caused by atherosclerosis

Symptoms for > 2 weeks

2
Q

Risk factors of chronic limb ischaemia

A

Smoking
Diabetes
Hypertension
Hyperlipidaemia

3
Q

Clinical features of chronic limb ischaemia

A

Intermittent claudication
Rest pain
Slow cap refill

4
Q

What is Buerger’s test?

A

Assessment of arterial sufficiency

  • lie patient flat
  • raise leg until pale
  • lower leg until colour returns
5
Q

What is Buerger’s angle?

A

Angle at which the limb goes pale

<20 degrees = severe ischaemia

6
Q

What is Leriche Syndrome?

A

Form of PAD affecting aortic bifurcation

Presents with buttock/thing pain and erectile dysfunction

7
Q

Signs of aorto-illiac obstruction

A

Claudication of buttocks, thighs & calves
Femoral & distal pules absent
Bruit over aorto-illiac region
Impotence (Leriche)

8
Q

Signs of illiac obstruction

A

Unilateral thigh & calf claudication
Bruit over illiac region
Unilateral absence of pulse

9
Q

Signs of femoropopliteal obstruction

A

Unilateral calf claudication

Femoral pulse palpable

10
Q

Signs of a distal obstruction

A

Claudication in foot

Distal pulses absent

11
Q

Differential diagnosis for chronic limb ischaemia

A

Spinal stenosis

  • pain of initiation of movement
  • relieved only by sitting
12
Q

Investigations for suspected chronic limb ischaemia

A

ABPI

  • > 0.9 = normal
  • 0.8-0.9 = mild
  • 0.5-0.8 = moderate
  • <0.5 = severe

Doppler ultrasound

Cardiovascular risk assessment

  • blood pressure
  • lipid profile
  • blood glucose
  • ECG
13
Q

Conservative management of chronic limb ischaemia

A

Lifestyle advice

  • smoking cessation
  • exercise
  • weight loss

Statin
Clopidogrel

Diabetes control

14
Q

Surgical management of chronic limb ischaemia

A

Offered if:

  • risk factor modification discussed
  • supervised exercise failed to improve symptoms

Angioplasty
Bypass grafting

Amputation for patients unsuitable for revascularisation