peripheral arterial disease Flashcards
what arteries in the lower limb provide an alternative route when we flex a joint?
genicular arteries
also collateral circulation can form is occlusions are slow enough
what is acute limb ischaemia?
can a collateral circulation develop?
what can cause this?
what are the 6 Ps of leg ischaemia?
why is it important to compare both limbs?
how to treat?
occlusion that occurs acutely (minutes to days)
no they cant as its speeeeedy
trauma and embolism - AF, aneurysm, rupture of plaque
pain, pallor, perishing with cold, pulseless, parathaesia, paralysis/redued power
the signs may be subtle
refer to vascular surgeon - imaging, thrombectomy, thrombolysis, amputation :(((
what is chronic peripheral arterial disease?
what is a common symptom?
when does the pain go away?
management?
narrowing of artery over time caused by atherosclerosis
intermitent claudication - similar to stable angina
on rest - worst on exercise
stop smokinnn, exercise, anticoagulant drugs, angioplasty, bypass
what test identifys peripheral arterial disease?
why does it measure?
what value does it have to be for PAD?
ankle-brachial index (ABI)
ankle systolic and briachial systolic - ankle divided by arm
less than 0.9
what is the common cause of claudication?
is untreated what can develop?
what does the stenosis location determine?
atheroma/atherosclerosis of superficial femoral artery
critical ischaemia
where the claudcation is and which pulses can be palpated
what is critical limb ischaemia?
what is a classic sign?
what happens if untreated?
what treatment?
progression of chronic peripheral vascular disease - extreme ischaemia
pain on rest - like unstable angina and relief when hand leg off bed (gravity)
gengrene, ulceration
strong pain relief, vascular surgery referal, imaging, thrombectomy, thrombolysis, ampuation
where are the 4 places to palpate a pulse in legs?
what can you use ultrasound to identify?
what does it meausre?
to see where stenosis is in an artery - peripheral arterial disease
flow and velocity
velocity through a stenosed area is higher = high frequncy and pitch of echo
