Chapter 104 - lower extremity occlusive disease introduction Flashcards
Percentage of PAD that have CLTI
10%
Progression from IC to CLTI
20%
Prevalence of PAD
5% in age < 50 20% in age > 80
Prevalence of PAD in male vs female
M = F F > M in low SES
Risk factors for PAD
1) Age 2) smoking 2x-4x 3) DM 2x-4x 4) HTN 5) dyslipidemia 6) obesity 7) inflammation 8) homocysteine 9) SES (stress, nutrition, health literacy)
Disease pattern for different risk factors and symptoms
Smoking: AI and FP DM/ESRD: FP and TBP I.C. = single level CLTI = multi level
Asymptomatic PAD cardiovascular risks
2.7x increase mortality 5.6 x increase CAD-related death
Progression from asymptomatic to IC in 5 years
7%
Standard 5 mm treadmill protocol
2 mph with 12% incline
Limb loss risk in IC
< 1%
Typical values for ischemic rest pain
AP < 40 TP < 30 In tissue loss AP < 50 TP < 40
CLI 1 year mortality and amputation risk
22% for amp 22% for mortality
Risk factors for mortality and major amputation in PAD
1) Age > 75 2) CKD 3) CAD 4) CHF 5) DM 6) CVD 7) tissue loss 8) BMI 9) dementia 10) functional state
Bollinger score
Assess severity of arterial disease –> each segment gets its own score
SVS lower extremity threatened limb class system
WIFI
WIFI is associated with…
1) limb amputation 2) wound healing
Target screening PAD
1) Age > 70 with DM or high risk
2016 AHA/ACC screen for PAD
1) ABI in people > 65 yr 2) ABI if 50-64 with risk factors 3) Any vascular disease in other vascular beds
SVS guideline for IC
follow up annually with ABI
Follow up for vein bypass
Duplex annually
Stages of chronic limb ischemia
Summary of risk prediction models for patients with CLTI who have revasc
WIFI classification
