PVD Flashcards
Risk of pvd
Smoking
DM
HTN
Hld
ABI
Exercise drop of 25% is abnormal
Incidence of pvd
Men more often than woman
Blacks more often than non blacks
Presentation
50% asymptomatic
33% atypical
Mortality
Biphasic very low abi and abi over 1.4
Deaths
75% cardiac
25% non cardiac
Categories
Viable
Threatened viability
Nonviable
Indications
Class 1 Exertional leg pain Non healing wound Age greater than 65 Age more than 50smoking and DM
AAA
65-75 smokers Family history AAA Abd pain If AAA found 3.0-3.9 check every 2-3 yrs 4-5.4 every 6 mos
Pvd
Aortoiliac
CTA or MRI
Mra coukd be done without contrast
For endo leaks
CTA is the best test
Treatment
Class 1 Anti platelet in symptomatic pvd Asa Plavix is am alternative 2a Abi less than 0.9 Class 3 Coumadin
Statin class 1
Cilostazol class one don’t use in CHF
Don’t use pentoxifyllim
Need for pvd revascularization
Life limiting claudication despite therapy Critical limb ischemia Rest pain Non healing ulcer Gangrene
Aorto iliac angioplasty
Success 90% Long term 70%at 5 years Poor out come Long segment Multiple lesions Eccentric Poor run off
Aortofem f bypass
90%patent
Popliteal aneurysm
More than 2 cm can occlude Class 1surgery class1 Pci class 2
Mesentric ischemia
High mortality
Thrombus
Embolism
Carotid therapy
Asa
Or pkavix
Or persantine Asa combo
Renal revascularization
Class 1 unexplained pulm edema
Accelerated HTN
Bowel infarction
70-90% mortality
Takayasu
Giant cell
Pulse less
Young Asian
Burger
Smoker cork screw angio
Amputation 19%
Carotid endarterectomy
Do it in 2 weeks after stroke
After Tia 25% adverse events by 90 days
CEA
Asymptomatic 70%by us or >50% by catheter
Clas 2a documented by us
CEA with embolic protection
In peopke with >80% blockage with stroke symptoms with in 6 Mos
