Peripheral Artery Disease Flashcards
PAD etiology
Most commonly AS
PAD risk factors
SMOKING Diabetes HTN Hypercholesterolemia Hyperhomocysteinemia CRP
Individuals “at risk”
Under 50 with diabetes and 1 additional
50-69 with hx of smoking or diabetes
OVer 70
Leg sx with exertion or ishcemic rest pain
Abnormal LE pulse
Known AS dz
Higher risk fo ____ with PAD
MI and stroke
CLI after tx outcomes
45% alive w/o amp
35% alive w/
20% dead
Exam for PAD
Manifestations fo DM/HTN
Vasc dz in other beds (bruits)
Pulses, signs of chronic or acute ischemia
CHronic - loss of hair, dec sensation, wounds on the feet
Acute ischemia sx
Acute pain and loss of fxn
5Ps
Pain, pallor, pulseless, paralysis/paresthesias, poikilothermia
ABI
Classiification of PAD
0 - asx
1- mild calud
2- mod claud
3 - sever claud
4 - rest apin
5- ischemic ulceraiton not exceeding ulcer of digits of foot
6- severe ulcer/gangrene
Tx modalities
Smoking cessation
Walking program
Diet
Aspirin
Statins
ACEI
Cilostazol (PDE-3 inhibitor)
Tx modalities cont
Revas - for crticial limb ischemia or lifestyle limiting
CLaud - coal to revasc to reduce sx and reduce need fr repeat procedure…met for iliac but worse for infrainguinal
CLI - goal is to relieve rest pain and allow wound healing
Class 1
individuals at risk of PAD should undergo vascular reivew of sx
Also pulse examinatio nand feet inspection
Take home points
PAD=ABI
PAD risk factors
SMOKING Diabetes HTN Hypercholesterolemia Hyperhomocysteinemia CRP
Individuals “at risk”
Under 50 with diabetes and 1 additional
50-69 with hx of smoking or diabetes
OVer 70
Leg sx with exertion or ishcemic rest pain
Abnormal LE pulse
Known AS dz
