Vascular surgery Flashcards
(25 cards)
What is the most common cause of occlusive disease in the lower extremity?
Peripheral Vascular Disease
What is the degenerative pathophysiologic process of peripheral vascular disease?
- Formation of plaque/stenosis
- Thrombosis/Ischemia
- Embolism
- Aneurysm formation of weak vessel wall
What are the listed risk factors of peripheral vascular disease?
- Hypercholesterolemia
- elevated triglycerides
- Cigarette smoking
- Hypertension
- Diabetes mellitus
- Obesity
- Genetic predisposition
- Gender (Males>Female)
- Impaired long term glucse regulation
- Homocysteine
- C-reactive protien
What are the symptom of peripheral vascular disease?
- Mottling
- IMPOTENCE
- Cold extremites
- Claudication
- Ulceration
What is the mortality rate of patient diagnosed with peripheral vascular disease?
- 5 years/30%death
- 10 years/70%death
What is the treatment of peripheral vascular disease?
- Pharmacologic therapy
- Surgical
What is the greatest risk to vascular surgery?
-Myocardial infarction (MI)
T/F: Beta blockers and statins have a cardiovascular protective feature when used during anesthesia?
TRUE
What monitors or preoperative testing should be anticipated for a vascular surgery?
- A Line
- Swan (PAC)
- TEE
- EKG
What are risk factors for an abdominal aortic aneurysm?
- Atheroscherosis
- Proteolysis of elastin and collagen within a vessel wall
- HTN
- Cigarette Smoking
- Genetic predisposition
- Obesity
T/F: Obesity may mask the signs and symptoms of AAA.
-TRUE
T/F: Minimal blood factor is associated with a endovascular AAA repair.
FALSE
What is the systemic anticoagulation of heparin when performing a endovascular precedural?
50-100 units/kg
What are some advantages of Endograph vascular procedure?
- hemodynamic stability
- decrease in embolic events
- decrease blood loss
- reduced surgical stress response
- Decrease in renal dysfunction
- decrease in post op pain
What are the complication of an endograph vascular procedure?
- Endograph thrombosis
- endograft migration
- Endograft rupture
- Graft infection
- Iliac artery rupture
- Lower extremity ischemia
- Ischemic gut
What are contraindication for a surgical repair of a AAA?
- Intractable angina
- Recent MI
- Sever pulmonary dysfunction
- Chronic renal insufficiency
What law is in used in the aneurysmal dimensions?
-Law of Laplace
List the monitors that would be used during a AAA repair?
- EKG
- Pulse oximetry
- Capnography
- Temperature
- Urinary catheter
- Nerve Stimulator
- A line
- PAC
What are the SITE for cross clamping during a AAA?
- Suprarenal
- Justarenal
- Infrarenal
T/F: The Suprarenal is the most commonly clamped site for a AAA.
FALSE (Infrarenal)
T/F: Increase in afterload will cause an increase in myocardial wall tension.
TRUE
What is a Neuroendocrine response?
Mediated by cytokines and tumor necrosis factor, as well as plasma catecholamines and cortisol
What will occur if there is a interruption of blood flow to the artery of adamkiewicz and collateral blood flow?
Post Op Parapegia
T/F: The incidence of neurologic complications DECREASE as the clamp is positioned higher on the aorta.
FALSE
