Peripheral Vascular Disease Flashcards Preview

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Flashcards in Peripheral Vascular Disease Deck (28):
1

What is intermittent claudication?

Pain in the back of the calves after exertion, relieved after a while by rest

2

What causes intermittent claudication?

Insufficient blood reaching the exercising muscle, i.e. muscle is starved of oxygen

3

What classification/staging is used to grade claudication?

Fontaine staging

4

Name two non-invasive investigations for lower limb ischaemia

Ankle brachial pressure index (ABPI)
Duplex ultrasound scan

5

Name three invasive investigations for lower limb ischaema

Magnetic resonance angiography
CT angiography
Catheter angiography

6

How is ABPI measured?

Ankle pressure / Brachial pressure (mm Hg)
using systolic pressures

7

What range for ABPI would indicate claudication?

0.4-0.85

8

Name some non-invasive therapy for limb ischaemia

Stop smoking
Increase exercise
Antiplatelet drugs
Statins

9

Is angioplasty + stenting indicated for lower limb ischaemia?

Yep

10

What is endarterectomy?

Cutting out the inside of an artery (remove plaque and fibrous tissue)

11

Describe critical limb ischaemia

Pain in toes/foot/leg at rest, worse at night (lying down), relieved by walking about for a bit
Can cause ulcers/gangrene

12

What is the general pathogenesis behind AAA?

Defect in collagen-elastin regulation, causing excessive dilation + increase in aortic wall stress

13

What are some typical features of AAA?

Abdo pain
Pulsatile mass
May be asymptomatic unless ruptured

14

What does expansile mean? How does it differ from pulsatile?

Expansile mass pushes hands in opposite directions; pulsatile mass pushes hands up and down

15

What 2 non-invasive investigations are done for AAA?

Ultrasound
CT scan

16

What is the investigation of choice for AAA?

Ultrasound - tells us whether there is an AAA or not

17

What can a CT scan tell us about an AAA?

Whether it is ruptured or not

18

At what size would an AAA be considered/referred for elective repair?

5.5 cm

19

What is involved in endovascular aneurysm repair (EVAR)?

Stent inserted via groin and passed up until the weakened part of the artery aneurysm is reached, where it seals off the aneurysm from inside the artery

20

What are the benefits of EVAR over open surgery?

Less mortality
Faster recovery

21

What are the benefits of open surgery over EVAR?

Possible in almost everyone
Rare further interventions

22

Which veins in the leg make up the deep venous system?

Tibials, popliteals, femorals

23

Which veins in the leg make up the superficial venous system?

Saphenous, perforators

24

How do varicose veins arise?

Back pressure due to incompetent valves causes blood to pool in superficial veins

25

What are secondary varicose veins?

Arise due to DVT

26

What is thrombophlebitis?

Inflammation of veins caused by a clot, causing scarring/fibrosis

27

Name a non-interventional management of varicose veins

Compression stockings
N.B. contraindicated in those with low ABPI

28

Name interventional management of venous insufficiency

Foam sclerotherapy (chemical thrombophlebitis)
Endovenous ablation