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Surgery > Peripheral Arterial Disease > Flashcards

Peripheral Arterial Disease Flashcards

1
Q

what is it due to

A

atherosclerosis- stenosis of arteries

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2
Q

what is it due to

A

atherosclerosis- stenosis of arteries

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3
Q

what is the main symptom

A

intermittent claudication

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4
Q

symptoms

A

cramping pain- calf, thigh, buttock after walking given distance and relieved by rest, ulceration, gangrene, foot pain at rest eg burning pain at night relieved by hanging legs over side of bed

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5
Q

what is the classification

A

Fontaine- 1: asymptomatic. 2: intermittent claudication. 3: ischaemic rest pain. 4: ulceration/gangrene (critical ischaemia)

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6
Q

signs

A

absent femoral, popliteal or foot pulses. cold white legs, atrophic skin, punched out ulcers, postural/dependent colour change, cap refill >15s

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7
Q

tests

A

exclude DM, arteritis, FBC (anaemia, polycythaemia), U&E (renal disease), lipids, ECG- cardiac ischaemia, thrombophilia screen, serum homocysteine, ABPI

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8
Q

what is a normal ABPI

A

1-1.2

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9
Q

what is the ABPI in PAD

A

0.5-0.9

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10
Q

what is the ABPI in critical limb ischaemia

A
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11
Q

what is the first line imaging

A

colour duplex USS. if considering intervention- MRI/CT angiography

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12
Q

treatment

A

risk factor modification- clopidogrel, management claudication- supervised exercise programmes, vasoactive drugs. percutaneous transluminal angioplasty, surgical reconstruction, amputation

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13
Q

how is surgical reconstruction performed

A

with bypass graft. femoral-popliteal bypass, fem-fem crossover, aorto-bifem byupass graft, autologous vein graft superior to prosthetic graft

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14
Q

how soon is it needed for revascularisation of acute limb ischaemia

A

4-6h

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15
Q

what are the 6 Ps of ischaemia

A

Pale, Pulseless, Painful, Paraesthesia, Perishingly cold, Paralysed

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16
Q

what are the 6 Ps of ischaemia

A

Pale, Pulseless, Painful, Paraesthesia, Perishingly cold, Paralysed

17
Q

what is the main symptom

A

intermittent claudication

18
Q

symptoms

A

cramping pain- calf, thigh, buttock after walking given distance and relieved by rest, ulceration, gangrene, foot pain at rest eg burning pain at night relieved by hanging legs over side of bed

19
Q

what is the classification

A

Fontaine- 1: asymptomatic. 2: intermittent claudication. 3: ischaemic rest pain. 4: ulceration/gangrene (critical ischaemia)

20
Q

signs

A

absent femoral, popliteal or foot pulses. cold white legs, atrophic skin, punched out ulcers, postural/dependent colour change, cap refill >15s

21
Q

tests

A

exclude DM, arteritis, FBC (anaemia, polycythaemia), U&E (renal disease), lipids, ECG- cardiac ischaemia, thrombophilia screen, serum homocysteine, ABPI

22
Q

what is a normal ABPI

A

1-1.2

23
Q

what is the ABPI in PAD

A

0.5-0.9

24
Q

what is the ABPI in critical limb ischaemia

A
25
Q

what is the first line imaging

A

colour duplex USS. if considering intervention- MRI/CT angiography

26
Q

treatment

A

risk factor modification- clopidogrel, management claudication- supervised exercise programmes, vasoactive drugs. percutaneous transluminal angioplasty, surgical reconstruction, amputation

27
Q

how is surgical reconstruction performed

A

with bypass graft. femoral-popliteal bypass, fem-fem crossover, aorto-bifem byupass graft, autologous vein graft superior to prosthetic graft

28
Q

how soon is it needed for revascularisation of acute limb ischaemia

A

4-6h

29
Q

what may acute limb ischaemia be due to

A

thrombosis in situ, emboli (more likely if no prev arterial disease), graft/angioplasty occlusion, trauma

30
Q

what are the 6 Ps of ischaemia

A

Pale, Pulseless, Painful, Paraesthesia, Perishingly cold, Paralysed

31
Q

what does the onset of fixed mottling imply

A

irreversibility

32
Q

management acute limb ischaemia

A

urgent open surgery or angioplasty.

33
Q

when can carotid endarterectomy be performed

A

if stenosis 70% or above

Surgery (18 decks)

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