Pestana- 7. Vascular Surgery Flashcards
Where is the plaque located in subclavian steal syndrome?
at the origin of the subclavian (before the take-off of the vertebral)
When will a patient with subclavian steal syndrome become symptomatic?
during exercise
What happens when someone with subclavian steal syndrome exercises?
the arm sucks blood away from the brain by reversing the flow in the vertebral artery
What are the signs of subclavian steal syndrome?
- Claudication of the arm (coldness, tingling, muscle pain)
- Posterior neurologic signs (visual symptoms, equilibrium problems)
How do you diagnose subclavian steal syndrome?
duplex scanning showing reversal of flow
How do you cure subclavian steal syndrome?
bypass
At what sizes can you observe a AAA?
= 4 cm
What are the indications for surgery for a AAA?
- 5-6 cm
- Rate of growth >1cm/year
- tender AAA
- excruciating back pain (retroperitoneal hematoma forming from leaking aneurysm)
What is the most durable surgical option in PAD?
saphenous vein bypass
What will people with rest pain typically present with?
pain in the calf that prevents them from falling asleep
What signs clue you in that you have an arterial embolus?
- Pain
- Pale
- Pulseless
- Paresthetic
- Paralytic
- Poikilothermic
How long do you have to fix an arterial embolus?
6 hours
How do you treat arterial embolus?
- Thrombolytics (if early and incomplete)
- Embolectomy with Fogarty catheter (if complete)
What should you always remember to do if several hours have passed before a patient gets treated for arterial embolus?
do fasciotomy
What is the best option for diagnosis of aortic dissection?
spiral CT (CT angiogram)
