Peripheral arterial disease Flashcards
2 types of classification scheme for peripheral arterial disease
Fontaine classification
Rutherford classification
Imaging tests to do for peripheral arterial disease? (give order)
- Duplex USS
2. CT/MR angiogram
Bedside investigation for peripheral arterial disease?
Ankle Brachial Pressure Index
What is the ABPI score associated with intermittent claudication?
ABPI < 0.8
What is the ABPI score associated with Critical Limb Ischaemia
ABPI < 0.3
6 P’s associated with Acute limb Ischaemia
Pain Perishingly cold Paraesthesia Paralysis Pulseless Pallor
2 examples of tissue loss in Critical limb ischamia
Ulceration
Gangrene
Normal ABPI range?
0.9 - 1.1
Risk factors for chronic lower limb ischaemia
Smoking
Hypertension
Hyperlipidaemia
Diabetes Mellitus
SSx of chronic limb ischaemia (intermittent claudication)
Severe cramp which resolves on stopping walking Cold lower limbs Dry skin Hairless Absent or diminished peripheral pulses
SSx of critical limb ischaemia
Ischemic rubor Dependency rubor (When raising feet in Bueger’s test, colour is white and placing feet back on the ground turns red again)
Rest pain
Tissue loss –> ulceration/gangrene
Criteria for critical limb ischaemia
Fulfil just 1 criterion:
Rest pain
Requiring opiate analgesia and/or tissue loss (ulceration or gangrene) present for more 2 weeks
ABPI < 0.5 or ankle systolic pressure < 50mmHg
1st line imaging for peripheral arterial disease?
Duplex USS (CT/MR angiogram if stenosis higher up)
Preventive Mx for PAD?
Clopidogrel 75mg OD (1st line)
Aspirin 75mg OD (2nd line)
Symptomatic Mx for PAD?
Naftidrofuryl oxalate (1st line) Cilostazol (2nd line)
IV Iloprost used if patient unsuitable for surgery
