chronic limb ischaemia

Question 1

what is chronic limb ischaemia?

Answer 1

1. peripheral arterial disease that results in symptomatic reduced blood supply to the limbs
2. caused by atherosclerosis

Question 2

RF

Answer 2

1. smoking
2. hypertension
3. hyperlipidaemia
4. diabetes

Question 3

what are the stages of PVD?

Answer 3

1. assymptomatic
2. intermittent claudication
3. ischaemic rest pain
4. gangrene

Question 4

buerger’s test

Answer 4

1. lying the patient supine and raising their legs until they go pale
2. angle at which limb goes pale is named buerger’s angle
3. <20 degree indicates severe ischaemia

Question 5

intermittent claudication

Answer 5

1. pain occurs on exercise
2. absolute claudication distance - distance of walking before the pain starts
3. progress to limb ischaemia
4. peripheries are cold/buerger’s positive

Question 6

critical limb ischaemia

Answer 6

1. rest pain for >2 weeks
2. ABPI < 0.5
3. presence of gangrene

Question 7

Ix of PVD?

Answer 7

1. ABPI
   - normal > 0.9
   - mild (0.8 -0.9)
   - critical limb ischaemia < 0.5

Question 8

First line Ix

Answer 8

1. doppler US

2. CT angiography

Question 9

medical mx

Answer 9

1. lifestyle - smoking cessation/weight reduction
2. statin - 80 mg Atovastatin
3. antiplatelet - 75 mg of clopidogrel

Question 10

surgical mx

Answer 10

1. angioplasty w/wo stenting

2. bypass grafting - multilevel disease/long occlusions

Question 11

disease in aortoilliac

Answer 11

1. bilateral loss of
   - femoral
   - popliteal
   - foot pulses

Leriche’s syndrome - buttock pain and impotence

Question 12

disease in common illiac

Answer 12

unilateral loss of
femoral, popliteal and foot pulses

buttock, thigh, calf and foot

Question 13

disease in superficial demoral

Answer 13

unilateraly loss of popliteal and foot pulses

calf only