peripheral vascular disease

Question 1

Define

Answer 1

Atherosclerosis process of vessels in the limbs which cause stenosing of arteries and eventually ischaemia

Question 2

Different types?

Answer 2

Acute
Acute on chronic
Chronic

Question 3

Causes? (4)

Answer 3

Thrombosis in situ (50%)
Embolism (30%)
Trauma
Aortic dissection

Question 4

Different types of ischaemia?

Answer 4

Complete
Incomplete
Irreversible» need amputation

Question 5

What is the fate of pt w/ irreversible ischaemia?

Answer 5

Needs amputation

Question 6

What type of ischaemia is caused by thrombosis in situ and embolism?

Answer 6

Embolism= complete because the emboli moves and lodges in femoral bifurcation and cuts blood supply to whole of leg below the site
Thrombosis in situ= incomplete

Question 7

Presentation of peripheral vascular disease?

PPPPPP

Answer 7

Limb is PPPPPP
Pale
Pulseless
Perishingly cold
Painful
Paraesthesia
Paralysis

Question 8

App Ix (3)

Answer 8

Bloods» fbc, u&e
duplex doppler of leg
CXR

Question 9

Mx (3)

Answer 9

General» NBM, Rehydration (IV), morphine w/metoclopramide, ABx if there is infection, Heparin IV

Angiography» only if incomplete ischaemia. Use it to visualise the artery during distal bypass

Embolectomy» wire fed through artery and balloon inflated and the embolus will be removed w/ the wire.
After that do on table angiography to see if artery is sorted