Ischaeia And DVT Flashcards
What causes pain at rest and tissue loss but with palpable pulses?
Critical limb ischaemia
What is the cause of arterial embolism?
Secondary to aneurysms like thromboembolism from plaques
What type of embolism is atrial fibrillation assoicated with?
Cardiac embolism
How does thrombosis present?
Chronic or subacute presentation with no clear border of ischaemia.
There may be features of peripheral vascular disease sch as ulcers and hair loss.
What are the visual features of venous ulcers?
surrounding skin changes, such as oedema, hyperpigmentation, and lipodermatosclerosis
Shallow and irregularly shaped. Cause pain or itching
Which ulcers are found on lately aspect of food?
Arterial
Which ulcer causes pain on exertion?
Venous
How does an embolism related cause fo acute limb ischaemia present?
ACUTE compared to thrombosis
Well demarcated area with mottled appearance
Other limb is normal
What is a key risk with treatment of acute limb ischaemia?
Reperfusion injury:
Ischaemia causes tissue death. When perfusion is restored to the limb, potassium and hydrogen ions can be released, resulting in hyperkalaemia and acidosis.
Hyperkalaemia can result in weakness and cardiac arrhythmias and myoglobin causes AKI.
What is the MOST common cause of acute limb ischaemia?
Thrombosis, from rupture of atherosclerotic plaques
What are the findings in Class 1 Rutherford?
No findings
What are the findings in Class 2a Rutherford?
Minimal sensory impairment
What are the findings in Class 2b Rutherford?
Mild to moderate motor impairment
Absent arterial Doppler
Sensory impairment of forefoot
What are the findings in Class 3 Rutherford?
Absent arterial and venous Doppler
No sensation
Severe motor repair
Are the pulses palpable in compartment syndrome?
YES
-> Sweling with lower leg
What is the management of chronic leg ischaemia?2
Supervised exercise for 3 months for 2 hours a week
Antiplatelet therapy
High dose stain 80mg
Management of BP and diabetes
What is the antiplatelet therapy of choice in chronic limb ischaemia?
Clopidogrel 75mg
What can be used to relieve pain in PAD?
Naftidrofuryl oxalate
What causes weak peripheral pulses and atrophic nails and cool foot?
Chronic limb ischaemia affecting iliac and femoral artery
How are single segment diseases of arteries managed?
Percutaneous transluminla angioplasty, which is widening vessel with balloon
What is Leriche syndrome?
Aortoiliac obstruction causes claudication pain in the buttocks and thighs, absent femoral pulses and impotence.
When is surgical reconstruction indicated?
Surgical reconstruction uses bypass grafts in patients with extensive disease. the patient’s quality of life, or if the disease is limb-threatening.
When are vasoactive drugs reccomended for management?
When exercise fails to improve symptoms
