Vascular Disrases Flashcards
(33 cards)
Thoracic aneurysm
2:1 male
Descending aorta
Make>70 female>80
TAA > 5 cm survival 60%
AAA
> 3 cm
50% increase in size to proximal segment
AAA
70% asymptomatic
>5 has 25% chance of rupture
7.” Has 75% chance
AAA
EAVR low risk upfront but equalizes to open repair in12 mos
Lower extremity aneurysms
Diameter >2 mm Iliac 20% popliteal 80% 59^ bilateral 50% asptomatic Can cause DVT limb ischemia 50% associated withAAA
Dissection
3-5% death Acute2 weeks HTN Marfan Bicuspid Coarctation Cocaine
Dissection
Debater 1 Stamford A proximal
Stanford B debakey 3 distal
Dissection
Treatment
Nipride esmolol
Surgery
PVD treatment
Only cilostazol is useful
But don’t use in CHF
Dissection therapy
Ascending open surgery
Descending endo vascular
AAA below renal endo vascular
PVD
Normal people 10 year survival 90%
Asymptomatic pvd 40%
Symptomatic 75%
Check for pvd
All over 70
50-69 DM and smoker
ABI
Highest arm pressure
For left highest on the left
For right highest on the right
Pvd
Therapy
Anti platelet 1 Antihypertensive <70 Antiplatelet single therapy class1 Exercise class 1 Cilostazol class1
Endovascular therapy
Disabling life style class- 1 Failure medical therapy class 1 No stents in femoral popliteal or tibial For cli class 1
Treatment for stroke
Asa persantine and Lipitor
Etiology of ischemia
30% aortic
30% cardio
Tia
Typically less than 1 hour
Risk of stroke 10% in 3 mos
Aaa
Less common in woman but more likely to rupture
Stroke
Kills more woman than breast cancer
Stroke
Blacks double the risk
Twice likely to die
Sickle cell is a risk
Stroke
SBP 220/120 no BP meds no tPA
Sbp 185-220 lower BP them tPA
Nicardipine, Labetalol
Major stroke
Ecst surgical 2.8 medical 16.8
Nascet surgical 9% medical 26%
Vascular surgical 7.8% medical 25%
High risk CEA
80 years CHF angina copd crf mi Lesion above c2 Below clavicle Contra lateral occlusion Prior CEA Laryngeal ca Xrt Laryngeal nerve paralysis contes lateral
