Peripheral Vascular Disease Flashcards
What is intermittent claudication?
Pain in the back of the calves during exertion
What causes intermittent claudication?
Atherosclerosis of the femoral artery
What classification/staging is used to grade claudication?
Fontaine staging
Name two non-invasive investigations for lower limb ischaemia?
Ankle brachial pressure index (ABPI)
Duplex ultrasound scan
Name the main invasive investigation for lower limb ischaemia?
Angiography
How is ABPI measured?
Ankle pressure / brachial pressure (mm Hg)
What range for ABPI would indicate claudication?
0.4-0.85
Name 4 non-invasive therapies for intermittent claudication?
Stop smoking
Increase exercise
Antiplatelet drugs (cilostazol)
Statins
Treatment for worsening limb ischaemia?
Angioplasty
What is endarterectomy?
Cutting out the inside of an artery to remove plaque
Describe critical limb ischaemia + main treatment?
Resting toe and foot pain worse at night with ulcers and gangrene + amputation
What are some typical features of a ruptured AAA?
Epigastric pain that radiates to the back
Pulsatile mass
Typical patient with AAA?
Male, smoker and hypertensive
What 2 non-invasive investigations are done for AAA (+ 1st line) ?
Ultrasound (1st line)
CT scan
What can a CT scan tell us about an AAA?
Whether it is ruptured or not
2 criteria for an optional AAA repair?
> 5.5 cm or increasing > 1 cm a year
2 surgical options for AAA + which has less mortality/faster recovery?
Open repair and EVAR (better)
What is the main superifical vein of the leg?
Saphenous
How do varicose veins arise?
Increased venous pressure causes incompetent valves and pooling of blood
What do secondary varicose veins arise from?
DVT
What is thrombophlebitis?
Inflammation of veins caused by a clot
Name a non-interventional management of varicose veins + CI?
Compression stockings + low ABPI
Name 2 interventional management of venous insufficiency?
Foam sclerotherapy or ablation
Diabetic foot sepsis is a … problem?
Pressure
Biggest factor for limb loss?
Diabetes
How do diabetics get foot sepsis?
Ulcers get infected and cause necrosis and gangrene
Treatment for diabetic foot sepsis?
Urgent surgery and abx
Cause of acute lower limb ischaemia?
Acute occlusion by embolism, rupture etc.
0-4 hours occlusion with pallor?
Salveagable
4-12 hours occlusion with mottling?
Partly reversible
> 12 hours occlusion with redness and paralysis?
Non-salveagable
Smoking decreases chance of limb amputation by?
10%
Treatment for persistent DVTs?
IVC filter
