Acute ARTERIAL OCCLUSION Flashcards
Cause of ACUTE ARTERIAL OCCLUSION
Embolism
Causes:
Atrial Fibrillation
6Ps of ACUTE ARTERIAL OCCLUSION
Pain
Pallor
Paresis
Paresthesia (Complete loss of sensation)
Poikilothermia
Pulselessness (LATE Sign)
🩺 IOC of ACUTE ARTERIAL OCCLUSION
Duplex Scan
Duplex finding in NORMAL VESSELS
Triphasic Flow
💊💉 MANAGEMENT of ACUTE ARTERIAL OCCLUSION
⭐ EARLY presentation (within 6-8hrs)
⭐ THROMBOLYSIS
⭐ EMBOLECTOMY: FOGARTY’S BALLON
Identify
FOGARTY’S BALLON
⬇️
For EMBOLECTOMY
Why FASCIOTOMY should be done with EMBOLECTOMY?
Done to prevent COMPARTMENT SYNDROME
Reperfusion
⬇️
Excess Free Radicles
⬇️
Swelling of Muscles
⬇️
Compartment syndrome
Ps of COMPARTMENT Syndrome
Pain (excessive)
Pain on passive stretch
Pulsations can be ➕
Adequate FASCIOTOMY
Incise till DEEP FASCIA
💊💉 MANAGEMENT of ACUTE ARTERIAL OCCLUSION
⭐ LATE presentation (> 6-8hrs)
Amputation
DISTAL RUN-OFF seen in?
Chronic ARTERIAL OCCLUSION
⬇️
DUE TO: Development of COLLATERALS
🧑🏻⚕️ Clinical Features of CHRONIC ARTERIAL OCCLUSION
- Intermittent CLAUDICATION Pain
- REST Pain (severe disease)
- Sensations ➕
- Temperature maintainance ➕
- Arterial ulcer
REST PAIN in CHRONIC ARTERIAL OCCLUSION
⭐ Worse AT NIGHT
⭐ Patient feels RELIEF when the Leg is HUNG DOWN
As the Block (THROMBUS) ⬆️, CLAUDICATION distance
⬇️ ⬇️
BOYD CLASSIFICATION USED FOR
Intermittent CLAUDICATION
BOYD CLASSIFICATION
- Pain on walking, but Pain reduces as patient continues to walk
- Pain on walking ➕ Continues to walk despite pain
- Pain forces patient to stop
- Pain at REST
Why: Pain on walking, but Pain reduces as patient continues to walk
Dilution of Substance P
Classifications used for INTERMITTENT CLAUDICATION
- Boyd classification
- Fontaine classification
- Rutherford classification
DIFFERENCE BETWEEN INTERMITTENT CLAUDICATION, NEUROGENIC CLAUDICATION & OSTEOARTHRITIS
NEUROGENIC CLAUDICATION seen in
Lumbar Canal Stenosis
Which CLAUDICATION is relieved when patient BENDS forward
NEUROGENIC CLAUDICATION
Site of PAIN in CHRONIC ARTERIAL OCCLUSION
🧠⚡Pain is felt in the muscle group, distal to the block ⚡
⚡⚡ MOST COMMON SITE OF PAIN IN CHRONIC ARTERIAL OCCLUSION
Calf
DUE TO:
⚡⚡ MOST COMMON ARTERY involved: FEMORAL ARTERY
LERICHE SYNDROME
Aortoiliac ARTERIAL OCCLUSION
⭐ Femoral & Distal pulses absent in BOTH LIMBS
⭐ BRUIT over Aorto-iliac region
⭐ IMPOTENCE
EARLIEST SYMPTOM OF LERICHE SYNDROME
CLAUDICATION in GLUTEAL REGION (Buttocks, Thigh)
Features of ARTERIAL ULCER
- Absent Pulsations
- Shiny Skin
- Loss of Hair
- Punched out ulcer
Identify
Arterial ulcer
🩺 IOC for CHRONIC ARTERIAL OCCLUSION
Duplex scan
Handheld doppler scan