VASC - Arterial disease & aneurysms Flashcards Preview

â–º Med Misc 43 > VASC - Arterial disease & aneurysms > Flashcards

Flashcards in VASC - Arterial disease & aneurysms Deck (10):
1

(3) types of Atherosclerosis –athero-thrombosis

•Degenerative
•Generalised
•Segmental

2

causes of an arterial occlusion

Atherosclerosis –athero-thrombosis

•Embolism (Cardiac, Arterial to arterial)
•Pro-coagulant state
•Low flow state
•Thrombosed aneurysm
•Dissection
•Fibro-muscular hyperplasia
•Arteritis
•Entrapment
•Advential cysts

3

Define Claudication pain

Calf pain on exertion (+/- thigh, +/- buttock)
•Onset and severity related to workload
•Relieved with rest
•Reproducible

4

Define Ischaemic rest pain

•Should only be in the most distal part of the limb
•Implies that perfusion is so poor that anaerobic metabolism is present in skin and nerves of extremity

•Matters whether foot perfusion is aided by gravity
•Patients awake with burning pain in extremity
•Often sit up and hang feet over edge of bed for relief
•In worse case, spend all night sleeping in a chair

5

3 types/consequences of Critical limb ischaemia (CLI)

•Ischaemic rest pain
•Ulcers
•Gangrene

Measure ankle pressure & toe pressure.

6

(3) Patterns of lower limb occlusive disease

•Aorto-iliac (inflow)
•Femoro-popliteal (outflow)
•Tibial / crural

7

Claudication interventions

Angioplasty +/- stenting
•best for short segments
•better in proximal arteries

Endarterectomy
•short segments

Bypass
•longer blocks

8

Describe Sudden / severe ischaemia pain

(usually an embolus)
•sudden onset
•pain
•altered feeling
•pale / mottled extremity
•coolness
•pain on using muscles or paralysis of muscles (especially weakness of anterior compartment muscles)
•pulseless

Later pain in extremity lessens as nerve function ceases due to ischaemia

9

Pathology of aneurysm

•Destruction of elastin
•Eventual failure of collagen
•Local inflammation (matric proteins, metallo-proteinases)

Rupture is uncommon less than 5cm

10

Rx aneurysm

Primary prevention
•Cigarette smoking embargo
•Control of hypertension?

Secondary prevention for rupture
•Screening and treatment of those aneurysms > 5 – 5.5 cm

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