Vascular Flashcards
stages of PAD
intermittent claudication
night pain
rest pain/critical limb ischaemia
Ix for PAD
ABPI ( <0.9 = PAD)
Duplex
what is buergers test
elevate the affected leg (notice the leg turn pale); hang leg over side of bed (note Reactive Hyperaemia)
non surgical Mx for PAD
exercise program
Antiplatelet (clopidogrel)
Statin
symptomatic relief for PAD
naftidofuryl oxylate
px of arterial ulcer
punched out, dry base, necrotic
on a hairless, red, shiny leg
px of venous ulcer
wet, sloping edges, larger
found in the gaiter region
Px of chronic venous disease
swollen limb
haemosiderin deposition
lipodermatosclerosis
venous eczema
permissive hypotension
how does it work
Aggressive fluid resus is avoided
introducing too much fluid quickly → higher cardiac output → increased MABP → peripheral vasodilation → more blood loss
two Mx for AAA
open repair
EVAR (not if they are haemodynamically unstable) shorter hospital stay
blood pressure in aortic dissection
hypertensive
Ix in aortic dissection
CT angiography
surgical Mx of aortic dissection
TEVAR
initial Ix for carotid artery stenosis
duplex ultrasound
classifying carotid artery stenosis and respective Mx
- minor– 0 to 49% narrowed
- moderate– 50 to 69%narrowed
- severe – 70 to 99% blocked
moderate or severe / >50% stenosed = carotid endarterectomy / stent
choice between stent and CEA depends on patient
medical management of carotid artery stenosis
aspirin/clopidogrel
statin (atorvastatin 80mg)
smoking cessation, control of HTN, diabetes
what are the two cases in which AAAs need to be referred immediately for surgical repair
over 4cm and growing rapidly (more than 1cm in 1 yr)
> 5.5cm
two main categories of acute limb ischaemia and what are the characteristics
Thrombus (rupture of an atherosclerotic plaque):
Chronic onset, previous claudication with sudden deterioration
vasculopath risk factors e.g diabetes, MI, stroke, TIA
The other leg will also have reduced or absent pulses
Embolus (from A fib/recent MI):
Very sudden onset
No previous claudication
