Pathology of Peripheral Vascular Disease Flashcards
PVD mainly affects
Large elastic arteries: Aorta, carotids and iliacs
Medum Muscular arteries: Coronary, cerebral and popliteal
The consequences of atherosclerotic disease are
- Myocardial Infarction
- PVD
- Cerebral infarction
Gangrene - wet and dry
Coagulative necrosis (dry gangrene) in multiple planes due to inadequate perfusion. If bacterial infection is superimposed liquefactive necrosis occurs (wet gangrene)
Clinical consequences of atherosclerosis
- Critical stenosis or occlusion by plaque
- Plaque rupture and occlusion by thrombus
- Aneurysm development and vessel rupture
Diabetic Macrovascular Disease involves
Accelerated atherosclerotic disease involving greater severity, earlier onset and more distal disease.
Diabetes causes
Ulceration due to arterial insufficiency
Gangrene in extremities (100x more common in diabetics)
Neuropathy due to microangiopathy
Claudication
Leg pain on exertion due to insufficient oxygen supply - Occurs in 15-40% of PVD patients
Critical Limb Ischemia
Ischemic pain at rest due to terminal lack of supply to leg - mortality 25%
Helloooo Jacob
Heart failure :)
Buerger’s disease
Recurring progressive inflammation and thrombosis of small/medium arteries/veins.
Strongly associated with smoking, 20-40 yrs, male.
Corkscrew arteries with tree root collaterals
What is May-Thurner syndrome
DVT of iliofemoral vein caused by compression of left common iliac vein by overlying right common iliac artery
What is Volkmann’s contracture
Permanent flexion contracture of hand and wrist- claw hand
Commonly caused by supracondylar fracture of the humerus.
Ischaemia/necrosis of flexor digitorum profundus and flexor pollicus longus
What is a paradoxical embolism
Embolus, whilst passing through the heart, passed through a VSD or ASD. Gives embolitic CVA