PVD: Aortic. PAD Flashcards

1
Q

Most common site for thoracic Ao aneurysm?

A

Desc thoracic Ao

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2
Q

Timing of Ascending TAA repair

A

> 5.5cm for most patients

>4.5cm for bicuspid AV, Marfans or Ehlers-Danlos

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3
Q

Timing of descending TAA repair

A

> 6.5cm

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4
Q

Can you do endovascular repair for an ascending Ao aneurysm?

A

No

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5
Q

Surgical morbidity for descending TAA repair

A

Paraplegia

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6
Q

Is open surgery or endovascular preferred for AAA repair?

A

Endovascular

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7
Q

What is difference in mortality b/w endovascular or open AAA repair? Morbidity?

A

None

Lower morbidity with endovascular

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8
Q

Timing of repair of AAA

A

> 5.5cm

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9
Q

What to do with pt with AAA 4-5.4cm?

A

U/S or CT every 6-12 months

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10
Q

What to do for pt with AAA <4cm?

A

U/S every 2-3 yrs

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11
Q

When do you repair a AAA regardless of diameter?

A

sxs

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12
Q

Guidelines for management of AAA

A

4cm- U/S every 2-3 yrs
4-5.4cm- U/S or CT every 6-12months
5.5cm- repair

Any sxs = repair

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13
Q

USPSTF recs for AAA screening

A

Screen any man age 65-75 who ever smoked

No routine screening for women (even with family hx)

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14
Q

When can you screen a person for AAA if they have a first degree relative with AAA?

A

When it is a MAN 60 yrs old or older (not women)

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15
Q

When do you intervene on a lower ext aneurysm?

A

> 2cm

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16
Q

Where are lower ext aneurysms most commonly found?

A

Popliteal 80%

Iliac 20%

17
Q

50% rule for lower ext. aneurysms

A

50% bilateral
50% assoc. w/ AAA (should screen)
50% asymptomatic

18
Q

What to do if a pt has lower ext aneurysm?

A

Imaging of contralateral ext and AAA screen
If lesion >2cm, repair
If lesion <2cm, annual imaging

19
Q

Which medication increases functional capacity in claudication?

A

Cilostazol

20
Q

How to calculate ABI

A

Take ipsilateral Highest ankle pressure. Divide it by HIGHEST brachial pressure on EITHER side.

21
Q

What is a normal ABI?

A

.91-1.3

22
Q

What is an abnormal ABI?

A

< .9

23
Q

ADA rec for screening diabetics for PAD

A

Do ABI in diabetics > 50 y/o, if normal, repeat in 5yr

24
Q

What med can you use for an asymptomatic pt with PAD?

A

Aspirin

25
Q

Class I recs for patients with PAD

A

ASA
Antihypertensives, DM, smoking cessation
High dose statins

26
Q

Do you use DAPT for PAD?

A

No. Single therapy.

27
Q

When do you use Plavix in PAD?

A

As alternate to ASA

28
Q

What is the most high yield Rx for pt’s with PAD and intermittent claudication?

A

Home exercise

29
Q

What is the blackboard warning for cilostazol

A

Do not give in CHF

30
Q

What is the class of recommendation for prophylactic endovascular intervention on an asymptomatic pt with lower ext PAD?

A

III

31
Q

When can you do intervention on PAD?

A

Sxs are LIFESTYLE limiting AND inadequate response to exercise and meds and favorable risk of procedure.

32
Q

Can you put a stent in femoral, popliteal, tibial arteries?

A

No

33
Q

If pt has CLI, which lesion should you fix first?

A

Inflow (Ao, femoral or iliac)

34
Q

What diameter Ao is considered a AAA?

A

> 3cm or 50% inc in size c/w prox segment