peripheral ertery disease

Question 1

what is peripheral artery disease

Answer 1

atherosclerosis affecting the lower-extremity arteries

Question 2

risk factors for PAD

Answer 2

modifiable:
smoking, diabetes, elevated blood presssure
dyslipidemia
non-modifiable: dvances age, male sex, non-caucasian race

Question 3

clinical features of asymptomatic or intermittant claudication

Answer 3

many patients are asymptomatic, typical claudication occurs in 50%
asymptomatic PAD and intermittnt claudication have favourable limb prognosis nd rarely progress to require revascularisation or amputation

Question 4

conservtive therapy for asymptomatic PAD or with intermittant claudication

Answer 4

graduated walking program: pain induced by walking does not represent worsening of the disease
ensure foot care - comorbid diabetes and diabetic foot ulcer is common
smoking cessation
manage CVD risk
give antithrombotic therpay

Question 5

antithrombotic therapy for asymptomatic or intermittant claudication PAD

Answer 5

antiplatelets eg. aspirin, clopidogrel

Question 6

chronic limb-threatening ischaemia

Answer 6

most severe type of lower-limb peripheral artery disease
characterised by pain at rest, extensive necrosis, lower limb ulceration of longer than 2 weeks duration
frequently progresses and has a high risk of tissue loss unless revascularisation is performed

Question 7

management of chronic limb-threatening ischameia

Answer 7

refer to vascular specialist for early consideration of angiography and revascularisation
vascular reconstruction (bypass grafting, endarterectomy, endoluminal techniques) is the treatment of choice
primary amputation may be the only way to control complications and pain

Question 8

pain in chronic limb thretening ischaemia

Answer 8

often severe, opoiods may be required
pressure area care and pressure offloading bandages are important
elevating the head of the bed may reduce severity of nocturnal rest pain

Question 9

VTE prophylaxis in chronic limb threatening ischaemia

Answer 9

patients who are admitted to hospital have an increased risk of VTE event, prticulalry if they are immobile
use VTE prophylaxis
do not use grduated compression stockings or pneumatic ocmpression devices