Arterial Occlusive Disease Flashcards
Give examples of 3 types of arterial occlusive diseases
ACUTE LIMB ISCHAEMIA (ALI)
CHRONIC LIMB THREATENING ISCHAEMIA (CLTI)
SYMPTOMATIC CAROTID STENOSIS
Describe common symptoms of acute ischaemia (the 6P’s)
(ALSO PRESENT IN CLTI)
- Pain
- Pallor
- Pulseless
- Perishingly cold
(LATE SIGNS)
- Paraesthesia
- Paralysis
Describe common symptoms of critical limb threatening ischaemia (CLTI)
Outline options for INITIAL management of critical limb threatening ischaemia
TEST FROM PATIENT
~ Full blood count (FBC)
~ Urea and electrolytes (U&Es)
~ Coagulation
~ G&S (incase blood transfusion required
ECG
CT ANGIOGRAM
DRUGS
~ Antiplatelet, statin
~ Analgesia
~ DVT prophylaxis
~ +/- Antibiotics
Outline the surgical management of symptomatic carotid stenosis
CAROTID ENDARTERECTOMY (CEA)
Describe appropriate secondary prevention interventions for patients with peripheral arterial disease
Risk factors of acute limb ischaemia
Atrial Fibrillation
thrombophilias
Obesity
Cancer
If thrombotic, risks as for atherosclerosis
Risk factors of critical limb threatening ischaemia
- Smoking
- Hypertension
- Diabetes
- Hypercholesterolaemia
Give an account of the pathophysiology of acute limb ischaemia
- Sudden blockage to blood flow in a normal artery
- Ischaemia
- Cell death (necrosis)
Give an account of the pathophysiology of critical limb threatening ischaemia
- Progressive atherosclerosis causes severe narrowing or complete occlusion in arteries
- Without gravity, supply cannot match demand even at rest
- Anaerobic metabolites released = pain
- Patients keep leg(s) hanging down
- causes oedema
- skin breakdown/ulceration which doesnt heal
Outline options for OPERATIVE management of critical limb threatening ischaemia
Conservative / Palliative
Endovascular intervention
Open surgery
HYBRID PROCEDURE
= endovascular intervention and open surgery
