17. Peripheral Arterial Disease Flashcards
What is peripheral arterial disease?
Atherosclerosis in the arteries supplying the lower extremities
What are the symptoms of peripheral arterial disease?
Claudication and atypical lower extremity pain
Rest pain
Ulceration
Gangrene
What does rest pain refer to?
A continuous burning pain, brought on when elevating the limb and relieved when the limb is lowered
What kind of necrosis is dry gangrene?
Coagulative
What is intermittent claudication?
Reproducible discomfort of a group of muscles, induced by exercise and relieved by rest
Describe an arterial ulcer
'Punched out' appearance Intensely painful Grey/yellow fibrotic base Shiny skin and no hair Pulses not palpable
How is a diagnosis of peripheral arterial disease made?
History and examination
Ankle-brachial index combined with duplex ultrasoundography
Angiogram
What ABI range will claudication be present?
0.9-0.5
What ABI range will rest pain be present?
<0.5
What is the first line treatment for peripheral vascular disease?
Supervised exercise program and cilostazol (phosphodiesterase inhibitor)
Then percutaneous angioplasty and stents
What surgeries are used in the treatment of peripheral vascular disease?
Reconstructive vascular surgery
Amputation
What are the causes of acute limb ischaemia?
Embolus, thrombus or trauma
What are the signs and symptoms of acute limb ischaemia?
Pain Pallor Pulseless Paraesthesia Perishing cold Paralysis
What are the treatment options for acute limb ischaemia?
Thromolectomy/bypass
Thrombolysis
