Tibioperoneal Disease

Question 1

When is intervention warented for tibioperonial disease

Answer 1

ischemic rest pain, non healing soft tissue ulcer, gangrene

Question 2

At what ankle pressure indicates the patient is unlikely to heal foot wounds

Answer 2

50mm Hg

Question 3

What are 2 interventions that acutely threatened limbs may benefit from

Answer 3

heparinization or thrombolytic tx prior to going to OR or IR

Question 4

For tibeoperoneal bypasses what is the order of desired auto-grafts

Answer 4

greater saphenous vein, lesser saphenous vein, arm vein, PTFE or graft

Question 5

What 2 muscles are identified when the posterior compartment is incised

Answer 5

gastrocnemius and soleus

Question 6

What is the MC intervention for tibioperoneal ds

Answer 6

balloon angioplasty -most successful for segments less than 1 cm

Question 7

Post op tx after bypass for tibioperoneal ds

Answer 7

ASA, ADP-receptor inhibitor, statin

Question 8

Surveillance of patients after bypass for tibioperoneal ds

Answer 8

duplex US at 1, 3, 6months and 1 year

Question 9

What ABI findings should trigger an angio (suggest early graft failure)

Answer 9

decreased ABI greater than 0.15 or increased velocity

Question 10

Where does the profunda femoris originate (femoral bifurcation)

Answer 10

3-5cm below the inguinal ligament

Question 11

Tx of isolated profunda disease

Answer 11

profundaplasty or bypass with distal profundaplasty (best tx)