Vascular Flashcards
How urgently should someone with an AAA >5.5cm/rapidly enlarging/symptomatic see a vascular surgeon?
Within 2 weeks
Should someone with an AAA <5.5cm need to see a vascular surgeon?
Yes, within 12 weeks
What age AAA screening?
Single ultrasound at 65 years
What are the two types of acute limb ischaemia?
Embolic or thrombotic
How can you tell the difference between these two types?
Factors suggesting embolus..
No history of previous claudication
Obvious source of embolus e.g. AF or recent MI
NO evidence of PAD - other limb normal
How can you manage acute limb ischaemia?
ABC approach, analgesia, urgent vascular review
Definitive - depends on cause.
If Thrombus - thrombolysis/angioplasty/bypass surgery
if embolus - embolectomy
How can you manage chronic PAD?
Stop smoking
Manage any co-morbidities
Everyone should be on a statin and clopidogrel
What is the difference between a true and a false aneurysm?
A false aneurysm is when there is a collection of blood around a blood vessel
Why do varicose veins occur?
Due to retrograde flow due to incompetent valves in veins
What is dry vs. wet gangrene?
Dry gangrene is due to ischaemia
No signs of infection, well-demarcated
Wet gangrene is due to infection
Due to nec fasc
Poorly demarcated
Will be systemic symptoms
EVAR vs. open AAA repair?
EVAR - less scarring, quicker recovery. needs more follow up. Not all aneurysms can be managed with EVAR
What is the most important risk factor for aortic dissection? What are other risk factors?
Main RF = Hypertension
Others= Marfan's syndrome Ehlers-Danlos Turner's syndrome Coarctation of the aorta Truama
How does aortic dissection present?
Severe tearing chest pain which radiates to the back
Weak/absent pulses
Aortic regurgitation - Early diastolic murmur with rumbling character
Can be ST elevation
What is the most common cause of an AAA?
Arterial disease - HTN, diabetes, smoking
When should a patient with an AAA stop driving? When does the DVLA need to be informed?
Inform DVLA at 6cm
Stop driving at 6.5cm
