Vascular Flashcards
(38 cards)
warfarin reversal
4F PCC, 1000 units for any bleed,1500 units for intracranial bleed;
INR 2-4 at 25 U/kg,
INR 4-6 at 35 U/kg,
INR >6 at 50 U/kg; maximum dose 5000 U capped at 100 kg body weight
dabigatran reversal.
riva and apixaban reversal.
idarucizumab.
andexanet alfa.
Acute limb ischemia:
Audible arterial and venous.
Audible venous only.
Inaudible arterial and venous.
Viable: revasc immediately without imaging.
Threatened: revasc imm.
Amputate.
“wood-like” firmness of limb after revasc/trauma
compartment syndrome
mesenteric ischemia treatment
percutaneous revasc or open surgical reconstruction
Pre CABG testing
carotid u/s if >65 yo + left main stenosis/ PAD/ smoking/ TIA/ carotid bruit
arterial ulcer
dry and to affect the lateral ankle or distal feet.
TBI
supranormal ABI measurements (>1.4).
Acute ischemic stroke antihypertensive
No thrombolysis, 24 hours: 220/120
Thrombolysis, 24 hours: 180/110 before admin, 180/105 post
*If acute dissection, pre-eclampsia, unstable coronary syndrome, or acute heart failure: lower thresholds
ABI calculation
Use higher arm pressures. Leg pressures should correspond to the side.
INR goal for stroke prevention
2.5
DOAC CI
CKD IV or worse
headache+ jaw fatigability+ shoulder stiffness.
young Asian woman with fevers and arm fatigue when brushing hair.
giant cell arteritis. diagnose with temporal artery biopsy.
subclavian artery stenosis, takayasu arteritis (pulseless disease, aorta and its branches). steroids
thromboangiitis obliterans (Buerger’s disease)
inflammatory vascular disease not associated with atherosclerosis. ischemic digits, discoloration, claudication, abnormal Allen test
rash, fatigue, and weight loss
Polyarteritis nodosa, small aneurysms like the beads of a rosary (“rosary sign”)
Dissection treatment
IV BB to reduce heart rate to <60 bpm and systolic blood pressure to 100-120 mm Hg. Intravenous vasodilator (nitroprusside or nicardipine) can be used to achieve blood pressure reduction in addition to beta-blockers, if necessary.
Secondary Raynaud due to
autoimmune rheumatic diseases, meth use, other drugs
cholesterol embolization treatment
supportive care, risk factor modification
highest mortality dissection
involves the aortic root, Partial thrombosis of the false lumen in type B
CEA indicated
stroke/TIA within the prior 6 months + >70% stenosis on ultrasound OR >50% on catheter angiography + acceptable surgical risk
Edoxaban and dabigatran need to be preceded by
lovenox.
Critical limb ischemia
severe PAD+ rest pain, nonhealing ulcers, or gangrene. Revasc-contrast angiography.
AAA surveillance
> 2.5 cm but <3.0 cm, rescreen after 10 years.
3.0-3.9, repeat imaging every 3 years.
4.0-4.9, repeat imaging in 12 months.
5.0-5.4, repeat imaging in 6 months.
Elective AAA repair
> 5.5 cm in men, >5 cm in women OR rapid expansion OR associated with peripheral arterial aneurysms or peripheral artery disease.
