Peripheral Arterial Disease

Question 1

Define peripheral arterial disease

Answer 1

narrowing or blockage of vessels that carry blood from heart to peripheries

Question 2

what is PAD caused and influenced by

Answer 2

build up of fatty plaque in atherosclerosis arteries
genetic and environmental factors

Question 3

who has PAD

Answer 3

elderly more than young
male more than female
people who use tobacco
diabetics
high cholesterol/ hypertensive
ischemic heart disease

Question 4

what and how does intermittent claudication turn into

Answer 4

critical ischaemia by a degree of severity

Question 5

signs and symptoms of intermittent claudication

Answer 5

pain comes on with exercise that is relatively consistant
pain would relieve when standing and worsen when going uphill

Question 6

signs and symptoms of critical ischaemia

Answer 6

rest pain
tissue loss
embolism
thrombosis
trauma

Question 7

investigations-vascular studies

Answer 7

ABPI- >0.9 = normal
0.9-0.5 = moderate risk - claudication
<0.5 = severe - rest pain
venous duplex- measure blood pressure in limb’s veins

Question 8

investigations-radiology

Answer 8

angiogram
MR angiogram

Question 9

management factors

Answer 9

-nature of symptoms:critical vs non-critical ischaemia
risk to life or limb
-general state of health
-social circumstances: quality of life

Question 10

management of chronic disease

Answer 10

medical
endovascular
open surgery

Question 11

management of chronic disease - medical

Answer 11

lifestyle changes- smoking,diet, exercise, etc
anti-platelet therapy
statins
phosphodiesterase inhibitor

Question 12

management of chronic disease - endovascular

Answer 12

percutaneous angioplasty
stents

Question 13

management of chronic disease - open surgery

Answer 13

femoro popliteal bypass- using graft to bypass blockage in femoral/popliteal artery
amputation- 50% die within 3ys

Question 14

management of acute diseases

Answer 14

-treatment: open surgey
thrombolysis
other endovascular options