Fiser Ch 27: Vascular Flashcards
most common acquired hypcoagulable disorder
smoking
1st branch off internal carotid artery?
ophthalmic aa
1st brach off external carotid artery?
superior thyroid aa
indications for CEA?
- Asymptomatic with >70% stenosis
2. Symptomatic with >50% stenosis
what part of vessel do you remove in CEA?
intima and part of media
why do 20% of ppl get hypertensive after CEA?
injury to carotid body, tx w nipride
what are the three aortic arch vessels?
- innominate aa (branches to right subclavian and right common carotid)
- left common carotid
- left subclavian
whats DeBakey Classification for AAAs?
Type I: ascending and descending
Type II: Ascending only
Type III: Descending only
where do dissections normally occur? (layer)
medial layer of blood vessel wall
how do you get paraplegia after a thoracic AAA repair? how can you prevent it?
- spinal cord ischemia due to occlusion of intercostal arteries and artery of Adamkiewicz
- reimplant intercostal arteries afte T8
most likely location of rupture of abdominal AAA?
left lateral wall 2-4cm below renals
when do you reimplant the IMA? indications (4)
- If backpressure <40mmHg
- Previous colonic surgery
- Stenosis at the SMA
- Flow to colon appears inadquate
1 causes of acute and late death after AAA repair?
acute: MI
late: renal failure
5 types of endoleaks
Type I: Proximal or distal attachment sits
Type II: Collaterals (observe)
Type III: Overlap sites of multiple grafts (secondary endograft to cover)
Type IV: Graft wall porosity or suture holes (observe)
Type V: expansion of aneurysm without evidence of leak (back to OR)
top 2 organisms that cause mycotic aneurysms and tx
- Staph
- Salmonella
extra-anatomic bypass (ax fem) and resection of infected aorta
top 2 organisms that cause aortic graft infections
- staph
2. E. Coli
whats leriche syndrome? tx?
- aortoiliac occlusive disease causing:
1. no femoral pulses
2. Buttock o thigh claudication
3. impotence
tx: aorto-bifem bypass
ABI: claudication
0.7-0.9
ABI: rest pain
0.5