19 Arterial Occlusion Flashcards
Most important risk factors for peripheral arterial disease
Smoking
Diabetes
Most frequently diseased arteries leading to limb ischemia (in order of occurence)
- Femoropopliteal
- Tibial
- Aortoiliac
- Brachiocephalic vessels
Number of hours before peripheral nerves and skeletal muscle suffer irreversible changes
4 to 6 hours
Six Ps of acute limb ischemia
Pain
Pallor
Pulselessness
Paralysis
Paresthesias
Poikothermia
Cutoff time perior for “acute limb ischemia”
2 weeks
Define Rutherford Criteria I (Viable)
Sensory loss: none
Muscle weakness: none
Audible doppler signals
72/M came in as a case of ALI. Upon PE, noted with sensory loss of the entire dorsum of the feet, with moderate muscle weakness. Doppler studies showed inaudible arterial signals but with audible venous signal. What is the rutherford criteria?
Rutherford II (Threatened), type B (Immediately threatened)
Define Rutherford criteria II (Threatened), type B
Sensory loss: more than toes, associated with rest pain
Muscle weakness: mild to moderate
Doppler studies:
Arterial - inaudible
Venous - audible
Define Rutherford Criteria II, Marginally threatened (type A)
Sensory loss: minimal (toes) or none
Muscle weakness: none
Inaudible arterial signals
Audible venous signals
Rutherford Criteria III (Irreversible) definition
Sensory loss: profound; anesthetic
Muscle weakness: paralysis profound
Inaudible ARTERIAL AND VENOUS
Definition of claudication
Cramp-like pain, ache, or tiredness that is brought on by exercise and relieved by rest (same with angina in the heart)
Difference of claudication and acute limb ischemia
Pain of ALI is not relieved with rest, not well localized and can present as marked worsening of chronic pain
How do you measure Ankle-Brachial Index?
Ratio of systolic blood pressure with the cuff just above the malleolus to the highest brachial pressure in either arm
Cut-off ABI in patients with CHRONIC peripheral arterial disease?
<0.9
Cut off Ankle Brachial Index value for severe disease?
<0.4
