Flashcards in Peripheral Artery Disease Deck (103)
Define Peripheral artery disease
A disorder where there is a stenosis or occlusion in the aorta or distal arteries of the limbs
What is the most common cause of peripheral artery disease?
Other than atherosclerosis what are causes of peripheral artery disease?
The highest prevalence of atherosclerotic PAD occurs in the ______ decade of life?
What factors increase risk of atherosclerotic PAD
What is the most modifiable of all the risk facotors of atherosclerotic PAD?
What sized vessels is atherosclerotic PAD usually located in?
Large and medium sized-typically at branch sites
What are the 3 primary sites of involvement of atherosclerotic PAD?
Lower leg/foot (distal vessels)
Which of the 3 primary sites of involvement is most commonly effected by atherosclerotic PAD?
Femoral and popliteal
What percentage of Pt's with Atherosclerotic PAD are symptomatic?
What is the most common symptom of atherosclerotic PAD
Claudication-pain, ache, cramp, numbness or sense of fatigue during exercise and relieved with rest (intermittent claudication)
The site of claudication is always __________ to the site of the lesion?
What are the general PE findings of a patient with atherosclerotic PAD?
Decreased/absent pulse distal to obstruction
Presence of bruit over narrowed artery
Muscle atrophy distal to lesion
What are the general PE findings of a patient with SEVER atherosclerotic PAD?
smooth shiny skin
reduced skin them
pallor to skin
If pt has aortoiliac dz what would you expect to see?
a. claudication in calves and feet only
b. strong femoral pulses
c. decrease ABI throughout entire leg with decreased waveforms
C-Decreased ABI throughout entire leg with decreased waveforms
Where does claudication occur in aortoiliac artery disease?
Calves, thighs, or buttocks
Other than claudication what other signs/symptoms may occur in a pt with aortoiliac artery disease?
femoral pulse and distal pulse absent/weak
bruit over aorta, iliac or femoral artery (or all 3)
ABI decrease throughout entire LE
What artery is the MOST common to be occluded by atherosclerosis?
Superficial femoral artery
What signs and symptoms will be found on a patient with Femoral/popliteal artery disease?
symptoms confined to calf
atrophic changes in lower leg and foot
femoral pulse is normal, decreased pulses in pop and pedal pulses
What signs and symptoms are specific to pt's with lower leg/foot arterial disease?
rest pain confined to dorsum of foot and relived with dependency (hanging foot off side of bed)
pain is severe, burning and may awaken pt from sleep, skin is cool, atrophic and hairless
pedal pulses are absent
Which disease is a major risk factor for lower leg/foot arterial disease?
What vessels are primarily involved in lower leg/foot arterial disease?
What is a normal ABI?
greater than 1.0
In the presence of stenosis _____ in the legs is decreased
Patients with severe PAD have an ABI less than
What noninvasive testing can be done to determine extent of AsPAD?
Treadmill-assess claudication with exercise
Duplex Doppler US-useful in medium and superficial arteries
MRA, CTA prior to surgery
Management goals for ALL PAD?
Improve ability to walk/symptoms
What can progression of PAD lead to?
limb ischemia and amputation
Conservative TX for ALL pt's with PAD?
risk factor reduction
-control BP/HTN (ACE-I)
-Lower cholesterol w/ a statin (LDL goal less than 100)
-tx DM aggressively
Consistent moderate exercise