PVD: Aortic. PAD Flashcards Preview

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Flashcards in PVD: Aortic. PAD Deck (34):
0

What diameter Ao is considered a AAA?

>3cm or 50% inc in size c/w prox segment

1

Most common site for thoracic Ao aneurysm?

Desc thoracic Ao

2

Timing of Ascending TAA repair

>5.5cm for most patients
>4.5cm for bicuspid AV, Marfans or Ehlers-Danlos

3

Timing of descending TAA repair

>6.5cm

4

Can you do endovascular repair for an ascending Ao aneurysm?

No

5

Surgical morbidity for descending TAA repair

Paraplegia

6

Is open surgery or endovascular preferred for AAA repair?

Endovascular

7

What is difference in mortality b/w endovascular or open AAA repair? Morbidity?

None
Lower morbidity with endovascular

8

Timing of repair of AAA

>5.5cm

9

What to do with pt with AAA 4-5.4cm?

U/S or CT every 6-12 months

10

What to do for pt with AAA <4cm?

U/S every 2-3 yrs

11

When do you repair a AAA regardless of diameter?

sxs

12

Guidelines for management of AAA

4cm- U/S every 2-3 yrs
4-5.4cm- U/S or CT every 6-12months
5.5cm- repair

Any sxs = repair

13

USPSTF recs for AAA screening

Screen any man age 65-75 who ever smoked
No routine screening for women (even with family hx)

14

When can you screen a person for AAA if they have a first degree relative with AAA?

When it is a MAN 60 yrs old or older (not women)

15

When do you intervene on a lower ext aneurysm?

>2cm

16

Where are lower ext aneurysms most commonly found?

Popliteal 80%
Iliac 20%

17

50% rule for lower ext. aneurysms

50% bilateral
50% assoc. w/ AAA (should screen)
50% asymptomatic

18

What to do if a pt has lower ext aneurysm?

Imaging of contralateral ext and AAA screen
If lesion >2cm, repair
If lesion <2cm, annual imaging

19

Which medication increases functional capacity in claudication?

Cilostazol

20

How to calculate ABI

Take ipsilateral Highest ankle pressure. Divide it by HIGHEST brachial pressure on EITHER side.

21

What is a normal ABI?

.91-1.3

22

What is an abnormal ABI?

< .9

23

ADA rec for screening diabetics for PAD

Do ABI in diabetics > 50 y/o, if normal, repeat in 5yr

24

What med can you use for an asymptomatic pt with PAD?

Aspirin

25

Class I recs for patients with PAD

ASA
Antihypertensives, DM, smoking cessation
High dose statins

26

Do you use DAPT for PAD?

No. Single therapy.

27

When do you use Plavix in PAD?

As alternate to ASA

28

What is the most high yield Rx for pt's with PAD and intermittent claudication?

Home exercise

29

What is the blackboard warning for cilostazol

Do not give in CHF

30

What is the class of recommendation for prophylactic endovascular intervention on an asymptomatic pt with lower ext PAD?

III

31

When can you do intervention on PAD?

Sxs are LIFESTYLE limiting AND inadequate response to exercise and meds and favorable risk of procedure.

32

Can you put a stent in femoral, popliteal, tibial arteries?

No

33

If pt has CLI, which lesion should you fix first?

Inflow (Ao, femoral or iliac)