peripheral vascular disease Flashcards
what are the complications of plaques?
- stenosis - plaque increases in size - either moves outwards or inwards blocking the lumen
- stenosis progresses to occlusion
- haemorrhage
- plaque rupture
- overlying thrombosis and embolism
- dissection
- aneurysm
which parts of the body are most likely to get atherosclerosis?
the parts furthest away from the heart
what are the symptoms of critical leg ischaemia?
pain at REST
ulceration
gangrene
(only need one of these for diagnosis)
what are the SIGNS of acute limb ischaemia?
pale pain paralysis paraesthesia perishing cold pulseless don't need all of these, depends on how acute and severe the ischaemia is
what are the different types of peripheral vascular disease?
intermittent claudication critical leg ischaemia acute limb ischaemia carotid artery disease eg stroke, TIA, amaurosis fugax abdominal aortic aneurysm
what is intermittent claudication?
moderate ischaemia
pain in the large muscles of the leg as oxygen demand exceeds supply
this causes lactic acid to form which accumulates and leads to pain
pain on exertion
pain distal to the site of atheroma (as this is the area that is getting cut off)
classically affects the calf muscles
resolves on resting
what is critical leg ischaemia?
the blood supply to the lower limb is insufficient for basal metabolism ie too low to sustain life
commonly happens at night when the HR and resp rate are reduced and wakes people from sleep
the leg is red as it is massively vasodilated to increase blood supply
risk of infarction and infection
How do we treat peripheral vascular disease?
risk factor modification for atherosclerosis
revascularisation after having done a risk benefit analysis
what are the components of risk factor modification for treatment of peripheral vascular disease?
exercise and weight reduction reduce hypertension reduce hyperlipidaemia diabetes antiplatelet therapy smoking cessation
What interventions can be done for peripheral vascular disease?
femorodistal vein bypass percutaneous balloon angioplasty amputation carotid endarterectomy open aneurysm repair endovascular repair of aneurysm
