[16] Surgery for PVD Flashcards
Most Common Location of an Aneurysm
Abdominal Aorta
Growth Rate of an AAA
3.3-4mm/year
Good Cheap Diagnostic Test for Aneurysms
Ultrasound
Do you operate on all aneurysms?
Risk of rupture is 1%
Risk of major surgery 1-2%
Up to you DJ Villeza
Gold Standard for Diagnosing Carotid Artery Stenosis
Contrast Angiography
Define: Claudication
Pain experienced in a functional muscle unit, usually when blood flow is insufficient during activity
How to Relieve Claudication
Rest
Formula: Ankle-Brachial Index
ABI = Ankle Systolic Pressure / Brachial Artery Systolic Pressure
[Example: Ankle-Brachial Index]
Right Arm: 150 mmHg
Right Ant Tib: 68
Right Post Tib: 75
Left Arm: 143
Left Ant Tib: 120
Left Post Tib: 100
ABI = 75/150 = 0.50
ABI = 120/150 = 0.80
ABI is important for diagnosing?
What is its diagnostic value?
How sensitive is it? How specific is it?
Peripheral Arterial Diseases
ABI <= 90
95% Sensitivity and 99% Specificity
Indications for Intervention with Chronic Limb Ischemia
Rest Pain
Tissue Loss
Severe, life-limiting Claudication
Cause of Sudden Onset of Limb Ischemia
Embolism
Embolus vs. Thrombus in an Angiogram
Embolus blockage would cause no collateral circulation to flow either
[T/F] Soft plaques are more prone to embolization
T
Higher chance of chipping off if plaques are soft
Important clinical clue in diagnosing renovascular hypertension
Onset before 30y/o without any risk factors (hypertension in the young)