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Flashcards in Vascular Deck (12):
1

When should a carotid endartectomy be considered?

When there is >70% occlusion of the carotid artery

2

What are the indications for embolectomy?

Paraesthesia and paralysis

3

What are the 6 Ps of limb ischaemia?

Pain
Pulseless
Paraesthesia
Poikilothermia
Paralysis
Pallor

4

What is an ABPI?

How is it calculated and what values are significant?

What should also be remembered

Ankle-brachial pressure index

Posterior tibial artery pressure (Doppler US)/Brachial BP (auscultation)

5

What are the common causes of unilateral limb swelling?

Long-standing venous disease
Acute DVT
Lymphoedema
Extrinsic pressure (eg pregnancy/tumour)
Klippel-Trenaunay syndrome
Lipoedema
Diffuse/hysterical oedema

6

What are the common causes of bilateral limb swelling?

Heart failure
Renal failure
Liver cirrhosis
Hypoproteinaemia
Hereditary angioedema

7

What are the risk factors for TIA?

Hypertension
Hyperlipidaemia
Diabetes mellitus
Smoking
Atrial fibrillation

8

Whet the stages of atherogenesis?

1. Initiation and formation

Intimal lesion occur at predisposed sites as a result of endothelial dysfunction or smooth muscle cell accumulation

Lipid accumulation depends on loss of integrity of the endothelial barrier
- Attracts macrophages

2. Adaptation stage

Plaque encroachment on lumen leads to vessel remodelling to maintain lumen size
- Regulated in part through haemodynamic shear stress

Has limits and further plaque growth leads to stenosis

Plaque grows through increased cells and matrix turnover, surface thrombus and plaque haemorrhage

3. Clinical stage

Plaque complications
- Ulceration, fissuring, aneurysm formation

Plaque stability not just a function of size but important are the active biological processes within it

Luminal stenosis >75% clinical complications:
a. Angina
b. MI
c. Stroke

Regression is possible - statins

9

What is the Stanford Classification of Aortic Dissection?

Stanford Type A
- Proximal to the left subclavian (=pulse deficits)
- Requires surgical management

Stanford Type B
- Occurs distal to the left subclavian (=no pulse deficits)
- Requires medical management (BP control)

10

Whet the stages of atherogenesis?

1. Initiation and formation

Intimal lesion occur at predisposed sites as a result of endothelial dysfunction or smooth muscle cell accumulation

Lipid accumulation depends on loss of integrity of the endothelial barrier
- Attracts macrophages

2. Adaptation stage

Plaque encroachment on lumen leads to vessel remodelling to maintain lumen size
- Regulated in part through haemodynamic shear stress

Has limits and further plaque growth leads to stenosis

Plaque grows through increased cells and matrix turnover, surface thrombus and plaque haemorrhage

3. Clinical stage

Plaque complications
- Ulceration, fissuring, aneurysm formation

Plaque stability not just a function of size but important are the active biological processes within it

Luminal stenosis >75% clinical complications:
a. Angina
b. MI
c. Stroke

Regression is possible - statins

11

What is the Stanford Classification of Aortic Dissection?

Stanford Type A
- Proximal to the left subclavian (=pulse deficits)
- Requires surgical management

Stanford Type B
- Occurs distal to the left subclavian (=no pulse deficits)
- Requires medical management (BP control)

12

What is the Trendelenburg test?

Can confirm superficial or deep leg vein valve incompetence

The leg is elevated to collapse all veins and pressure is applied to the long saphenous vein just below the saphenous-femoral junction

The patient then stands up and if the vein remains unfilled then the point of incompetence is the junction

The procedure is repeated if the vein fills at a point lower down