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Surgery > Peripheral Arterial Disease (PAD) > Flashcards

Peripheral Arterial Disease (PAD) Flashcards

1
Q

PAD

A

atherosclerosis of arteries in limbs

it is body wide!!!

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2
Q

stenosis becomes significant at

A

75% occlusion

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3
Q

Risk Factors for PAD

A 
smoking 
HTN 
DM 
hypercholesterolemia 
family history
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4
Q

Acute Arterial Occlusion

A

emergent condition that may result in irreversible ischemia

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5
Q

six P’s

A 
pain
pulseless 
paralysis 
paresthesia
pallor 
poikilothermia
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6
Q

MC site of acute arterial occlusion

A

Common femoral artery

peripheral nerves affected first (peroneal n)–> decreased sensation in 1st TM, unable to dorsiflex great toe

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7
Q

MC cause of acute arterial occlusion

A

Cardiac emboli (AFIB)

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8
Q

Treatment of Acute Arterial Occlusion

A

emergent angiogram
IV heparin
embolectomy

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9
Q

Chronic Arterial Occlusion

A

intermittent claudication associated with exercise and relieved by rest

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10
Q

Rest pain

A

associated w/ significant/advanced PAD

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11
Q

Pt w/ advanced ischemia

A

pain w/ legs elevated

improved when legs dangle

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12
Q

MC site for chronic arterial occlusion

A

superficial femoral artery at hunter’s canal (Adductor canal)
distal medial thigh

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13
Q

Dependent Rubor

A

bright red coloration of feet when feet are dangled

seen in pt w/ advanced PAD

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14
Q

Non-invasive testing for PAD

A

ABI (ankle/brachial index)

PVR (pulse volume recording)

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15
Q

ABI

A

ratio of ankle to brachial pulse
normal = 1.0-1.1
claudication = 0.5–0.6
severe PAD w. risk of limb loss = 0.3

ABIs will drop after exercise in pt w/ PAD

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16
Q

When are ABIs not reliable

A

in DM
arteries become calcified and difficult to compress

can measure toe pressure in these cases

17
Q

Aortoiliac Disease

A

intermittent claudication of butt, thighs, calves

18
Q

Leriche’s Syndrome

A

claudication, impotence, diminished femoral pulses

19
Q

Blue Toe Syndrome

A

seen w/ pt w/ aortoiliac disease

distal embolization derby from atherosclerotic plaques

20
Q

Management of PAD

A 
baseline ABIs
antiplatelet therapy 
walking regimen (promote collaterals) 
Pletal 
control HTN 
control BS
lower cholesterol
21
Q

Surgery if…

A

toe ulcers, restpain, worsening ABI

22
Q

Pletal

A

reversibly inhibits platelets
helps lower tris, inc HDL
mild vasodilator
100 mg PO, BID on an empty stomach

23
Q

Surgical Intervention w/ PAD

A

Fem-Pop bypass
above knee: prosthetic graft
below knee: vein

Surgery (8 decks)

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