Vascualr Flashcards
Anatomical location of the SFJ
2 finger breaths below and lateral to the pubic tubercule
Definition of a varicose vien
Torturous dilated vien of the superficial venous system
Cause of varicose veins
Primary/idiopathic - RF: prolanged standing, OCP, pregnancy obesity Secondary 5% - valve destruction: DVT, thrombophlebitis - obstruction: pelvis mass, DVT - Avm - klippel - trenaunary - weber - parkes - weber syndrome
Klippel- trenaunary - weber syndrome
Abnormality of the deep venous syndrome causing
- varicose vein
- port wine stain
- bony and soft tissue hypetrophy of the limbs
Parkes-weber syndrome
Multiple AVM with limb hypetrophy
AVM can lead to highout out heart failure
Types of minimally invasive therapies for varicose viens
Injection sclerotherapy - 1% Na tetradecyl sulphate
Endovenous laser or radio frequency abalation
Indication for minimally invasive therapy for varicose veins
Small below knee varicosities not involving the Great saphenous vien or short saphenous vien
Indications for surgical management of varicose viens
SFJ Incompetence
Major perforator incompetence
Symptomatic: ulceration, skin changes, pain
Surgical intervention for varicose veins
Trendelenburg: saphenofemoral ligation
SSV Ligation: in the popliteal fossa
LSV STRIPPING - No longer performed
Multiple adulation
Cockett’s operation: perforator ligation
SEPS: subfascial endoscopic perforator surgery
Complications of varicose viens
Early: heamatoma, wound sepsis, nerve damage Late - superficial thrombophlebitis - DVT - reoccurrence: 10% at 15years
Cause of chronic venous insufficiency
Reflux following DVT - 90%
Obstruction following DVT - 10%
Surgical management of chronic venous insufficiency
Reflux
- trahere transplantation: axillary vein transplant
- kistner operation: valvuloplasty of damaged valve
Obstruction
- Palma operation
Leriche syndrome
Buttock claudication and wasting
Erictile dysfunction
Absent femoral pulses
Risk factor for peripheral vascular disease
Modifiable: smoking, BP, DM control, Hyperlipidemia, decreased exercise
Non-modifable: FHx, PMH, Male, increased age, ethnicity
Fontaine classification for chronic limb ischemia
- Asymptomatic - 0.8-1
2. Claudication - a (>200m) b(
Doppler sounds
Normal - triphasic
Mild stenosis - biphasic
Severe stenosis - Monophasic
Increased risk of AAA rupture
High BP
Smoker
Strong FH
Female
Defintion of AAA
Abnormal dilatation of the abdominal aorta to >50% of its normal diameter = >3cm
Indication for AAA operation
Symptomatic/evidence of complication Rupture Asymptomatic - greater or equal to 5.5cm - expanding greater than 1cm a year
Complication of AAA
Death MI Renal failure Spinal or mesenteric ischemia Distal trash from thromboembolism Anastomotic leak Graft infection Aortoenteric fistula
Signs of chronic venous insufficiency
HAS LEGS haemosiderosis Atrophie Blanche Swelling Lipodermatosclerosis Eczema Gaiters ulcers Stars - venous
