Chronic Lower Limb Ischemia Flashcards Preview

Cardiology > Chronic Lower Limb Ischemia > Flashcards

Flashcards in Chronic Lower Limb Ischemia Deck (19):
1

What is claudication?

Muscle ischemia

2

Risk factors for intermittent claudication

Male
Older
Diabetes
Smoking
Hypertension
Hypercholesterolemia
Fibrinogen

3

Non-invasive investigation of lower limb ischemia

Measurement of ABPI
Duplex ultrasound scanning

4

Invasive investigation of lower limb ischemia

Magnetic resonance agiography
CT angiography
Catheter angiography

5

What is ABPI?

Ankle pressure (mHg) divided by brachial pressure (mmHg)

6

Normal ABPI

0.9-1.2

7

Claudication ABPI

0.4 - 0.85

8

Severe ABPI

0 - 0.45

9

Treatment for lower limb ischemia

Slowing progression
- SMOKING
- lipid lowering
- antiplatelets
- hypertension Rx
- diabetes Rx
- life style issues
INFORMATION

-exercise training
-drugs CILOSTOZOL
-angioplasty/stenting
-surgery

10

Exercise training and drugs

1 hour per day
(start with 30 mins 3 times per week for minimum of 6 months)

-CILOSTOZOL

11

Surgery for lower limb ischemia

Endaractomy
Bypass

12

Autologous bypass

Made with vein
(prosthetic = dacron, aPTFE)

13

What is critical limb ischaemia?

-When you have pain at REST (lying, sleeping)
-Ulcers/gangrene (trauma, footwear)

14

Symptoms of critical limb ischemia

Pain at rest…..rest pain
Toes and forefoot
Requires strong analgesia
Worse at night
Helped by sitting and putting the leg in a dependent position
Helped by getting up and walking about

15

Risk factors for amputation in limb ischemia?

Smoking
Diabetes

Smoking
major risk factor for peripheral arterial disease (>coronary)
1-in-10 of IC patients will lose a leg every 5 years if the continue to smoke
Diabetes
Incidence 2-5% population
45% of all major amputees diabetic

16

Epidemiology

Men >55 years, 5% with symptoms

17

Investigation summary

ABPI
Duplex
Angiography (MRI, catheter CT)

18

Management summary for intermittent claudication/critical limb ischemia

Risk reduction
Angioplasty, surgery
Amputation

19

Outcome of intermittent claudication and critical limb ischaemia is dependent on what?

Smoking tbh!