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Flashcards in Vascular anaesthesia Deck (11)
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1
Q

What is the STANFORD classification of aortic dissection?

A

Stanford A: involves ascending +/- descending aorta

Stanford B: involves descending aorta only

2
Q

What is the DEBAKEY classification of aortic dissection?

A

Debakey I: involves BOTH ascending AND descending aorta
Debakey II: Ascending only
Debakey III: Descending only

3
Q

List the clinical features of a aortic dissection.

A
SYMPTOMS
- Sudden onset, severe, stabbing chest pain
- Back/abdominal pain
- ACS
- Syncope
SIGNS
- Tachycardia
- New diastolic murmur (AR)
- Differential pulses
- ACS
- Hyper/Hypotension
- Stroke
4
Q

Is there a specific biomarker for aortic dissection?

A

Smooth muscle myosin heavy chain protein. Not widely available.

5
Q

What is a good target BP for management of acute aortic dissection?

A

100-110 mmHg systolic

6
Q

What is the first line management for hypertension in acute aortic dissection?

A

Beta blockers:

  • Labetolol 50mg over 1 min IV push with infusion of 1-2 mg/min titrated to response
  • Esmolol 500 mpg/kg over 1 min with infusion of 50-200 mpg/kg/min titrated to response. Bolus as above for each infusion dose adjustment.
7
Q

What is NASCET?

A

North American Symptomatic Carotid Endarterectomy Trial

8
Q

What is NASCET show?

A

For 50 - 69% stenosis, NNT = 10 to prevent stroke or death at 30 days, NNT = 15 for ipsilateral stroke prevention at 5 years.

9
Q

What is ECST?

A

European Carotid Surgery Trial

10
Q

What did ECST show?

A

NNT = 9 for 80-100% stenosis to prevent major stroke or death at 3 years

11
Q

What are the NICE recommendations for CEA following TIA

A

Perform within 2 weeks (48 hours preferable)