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Flashcards in Peripheral arterial disease Deck (18)
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1

2 types of classification scheme for peripheral arterial disease

Fontaine classification
Rutherford classification

2

Imaging tests to do for peripheral arterial disease? (give order)

1. Duplex USS
2. CT/MR angiogram

3

Bedside investigation for peripheral arterial disease?

Ankle Brachial Pressure Index

4

What is the ABPI score associated with intermittent claudication?

ABPI < 0.8

5

What is the ABPI score associated with Critical Limb Ischaemia

ABPI < 0.3

6

6 P's associated with Acute limb Ischaemia

Pain
Perishingly cold
Paraesthesia
Paralysis
Pulseless
Pallor

7

2 examples of tissue loss in Critical limb ischamia

Ulceration
Gangrene

8

Normal ABPI range?

0.9 - 1.1

9

Risk factors for chronic lower limb ischaemia

Smoking
Hypertension
Hyperlipidaemia
Diabetes Mellitus

10

SSx of chronic limb ischaemia (intermittent claudication)

Severe cramp which resolves on stopping walking
Cold lower limbs
Dry skin
Hairless
Absent or diminished peripheral pulses

11

SSx of critical limb ischaemia

Ischemic rubor
Dependency rubor (When raising feet in Bueger’s test, colour is white and placing feet back on the ground turns red again)

Rest pain
Tissue loss --> ulceration/gangrene

12

Criteria for critical limb ischaemia

Fulfil just 1 criterion:

Rest pain
Requiring opiate analgesia and/or tissue loss (ulceration or gangrene) present for more 2 weeks
ABPI < 0.5 or ankle systolic pressure < 50mmHg

13

1st line imaging for peripheral arterial disease?

Duplex USS (CT/MR angiogram if stenosis higher up)

14

Preventive Mx for PAD?

Clopidogrel 75mg OD (1st line)
Aspirin 75mg OD (2nd line)

15

Symptomatic Mx for PAD?

Naftidrofuryl oxalate (1st line)
Cilostazol (2nd line)

IV Iloprost used if patient unsuitable for surgery

16

Indications for amputation?

Gangrene

17

Procedure for chronic/critical limb ischaemia?

Percutaneous balloon angioplasty +/- endovascular stent
Bypass graft
--> if have lifestyle limiting symptoms
--> medical and lifestyle treatments fail

18

Treatment for acute limb ischaemia

Irreversible --> amputation
Complete --> embolectomy, bypass graft
Incomplete --> Heparinisation