Peripheral Vascular Disease Flashcards
What characteristics an Abdominal Aortic Aneurysm?
50% increase in the diameter of the aorta
What are the risk factors of AAA?
male family history age smoking peripheral vascular disease Hypertension Raised lipids Obesity
How are asymptomatic AAA found?
imaging for other things and screening
75% are asymptomatic
What proportion of patients with a ruptured AAA make it to hospital?
25%-50%
What are the 2 main imaging investigations are useful for AAA?
Ultrasound and CT scan
What can a CT scan with IV contrast find about the AAA?
The anuerysm morphology …
What are the reasons for elective aneurysm operation?
Prophylactic reasons - reducing the risk of rupture
What are the reasons for emergency aneurysm operation?
Therapeutic - to save the patients life
Management of elective anuerysm?
actively watch
Actively intervene through EVAR or Open oractively decide not to intervene
EVAR - endo
exclude AAA from inside th
What is an open repair?
Laparotomy
Clamp aorta and the iliacs
do a Dacron graft
Decide between a tube or bifurcated graft
What can you tell about a AAA from a ultrasound?
The diameter of it and whether the iliac arteries are involved
What moves the blood out of the legs?
A vessel, valves to create a one-way system
A pump - muscle to deliver energy to the system
What are varicose veins?
Dilated, tortuous superficial veins, due to the abnormal transmission of deep vein pressure
What conditions increase the deep veins pressure?
deep vein obstruction
deep valve incompetence
What are the risk factors for varicose veins?
Age
pregnancy
obesity
family history
What are the clinical signs of varicose veins?
Worse on standing
arise in the groin and behind the knees
What are the complications of varicose veins?
….
What is thrombophlebitis?
Inflammation of a vein caused by a blood clot
sore
significant
scarring
What is lipodermatosclerosis?
…
Investigations used for varicose veins?
dulex scans
What does a duplex scan look at?
The state of the deep veins, are there occlusions or incompetence
The saphenofemoral or saphenopopliteal incompetence
What is the non-invasive management of varicose veins?
Graduated compression
4 layer bandaging foe ulcer
and stockings for ulcer prevention and symptomatic relief
do not use for arterial disease
How are compression stockings used?
They are fitted
worn when up and about
No extra benefit of being over the knee
What is the invasive intervention for varicose veins?
Duplex guided endovenous - either foan sclerotherapy (chemical) or endovenous ablation - mechanical (physical) laser (thermal) or radiofrequency (radio wave)
Surgical intervention - High tie or distal foam ablation
