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Flashcards in Vascular Deck (7)
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1

AAA

If >5.5cm or symptomatic

duplex uss--> CTA for planning

young/fit/complex - open
old - EVAR

unstable rupture - always emergency open

2

PAD

Conservative - Smoking cessation, Exercise therapy

Medical - BP Control, Statin therapy, Clopidogrel

Surgical - Endarterectomy, Bypass surgery (vein /
PTFE graft), Angioplasty (PTA) +/-
stenting

Amputation if gangrenous

3

Acute limb ischaemia

Medical - Local thrombolysis (streptokinase, tPA), LMWH

Surgical -- Angioplasty** +/- stent, Embolectomy (fogarty)** +/- faciotomy, Amputation

Follow up - Warfarin long-term, Tx Embolic source, *Reperfusion injury

4

Diabetic foot

Prevention / Conservative / No Infection - Optimise diabetic control, Patient education – self-care, self-examination, Refer to podiatry to optimize footwear, reduce pressure areas.

Dry gangrene – allow auto-amputation + healing by 2º intention.

Infected Diabetic Foot - Debridement & Revascularisation (Angioplasty / bypass)

Wet gangrene - Amputation

(Below knee – preserve mobility in young / active patient.

Above knee – absent femoral pulse; some mobility.

Through knee – already immobile patient.)

Empirical antibiotics

5

Stroke/Carotid stenosis

Conservative - Smoking cessation, Glycaemic control, Exercise therapy

Best Medical Therapy - Antiplatelet (aspirin / clopidogrel), Statin therapy, BP control

Surgical (urgent within 2 weeks!) - Carotid endarterectomy with patch repair.
Carotid stenting – only applicable in re-do carotid stenosis.(Higher risk of stroke compared to endarterectomy!)

6

DVT

Medical / Surgical Tx - Anti-coagulation (LMWH, Warfarin), Catheter-directed thrombolysis, Mechanical thrombectomy

DVT Prophylaxis - Reduce risk factors (mobilization), Compression stockings, Pneumatic compression

7

Varicose veins

Conservative - Compression stockings (contraindicated if concurrent PVD – check ABPI), Regular exercise, Elevating affected area

Endovenous Surgery - Radiofrequency ablation, Endovenous laser ablation (EVLT), Foam sclerotherapy

Open Surgery - Ligation and stripping, Phlebectomy