Vascular Flashcards
When is stent placement, aortobifemoral bypass, and axillobifemoral bypass used for vascular disease?
short-segment stenosis in the common iliac artery = angioplasty and/or stent placement
long-segment stenosis and good risk patient treatment options = aortobifemoral bypass
long-segment stenosis and HIGH risk/poor general condition = axillobifemoral bypass
An aneurysm should be repaired, regardless of symptomology, if it is what size in the following locations?
abdominal:
iliac:
splenic:
abdominal: >5cm
iliac: >4cm
splenic: >2cm
The first investigation
with patients where colonic ischemia is suspected is to perform
sigmoidoscopy
An endarterectomy is performed if there is __% carotid stenosis in an asymptomatic patient.
> 60%
What is thromboangiitis obliterans? What is the pattern of involvement?
Buerger’s disease
Panvasculitis affecting artery, vein, and nerve. Involvement of superficial veins early in course of disease (migratory superficial phlebitis) and involves peripheral arteries (beyond popliteal/distal to forearm). Most important aspect of treatment is cessation of smoking!
On examination, the popliteal, dorsalis pedis, and posterior tibial pulses are normal; but they disappear on dorsiflexion of the foot. What is the most likely diagnosis?
popliteal artery entrapment syndrome (abnormal relation of that artery to the muscles, usually the medial head of the gastrocnemius muscle). Angiography to establish diagnosis.
What is the treatment for phlegmasia cerulae dolens?
venous thrombectomy (esp if impending gangrene noted)> Standard treatment for post-op thrombosis is anticoagulation and bed rest.
What are the two most important steps in managing varicose veins of the lower extremity?
A through clinical evaluation followed by a venous duplex examination. Will help the valvular incompetence and guide the extent of surgical intervention if needed
What is effort thrombosis, also called Paget-von
Schroetter syndrome? What is the treatment?
The development of thrombosis of the axillary-subclavian vein as a result of injury or compression. Treatment is thrombolytic therapy (followed by cervical rib resection if it is due to thoracic outlet syndrome)
Blue, red, or purple nodules with satellite lesions in the arm of a patient who has previously undergone radical mastectomy:
Lymphangiosarcoma (Stewart-Treves syndrome), a rare complication of long-standing lymphedema. Early metastasis (mainly to lung) may develop if it is not recognized early and widely excised.
Popliteal aneurysms are usually arteriosclerotic and are bilateral in __% of cases.
50%
A popliteal artery aneurysm >__cm should be repaired to avoid thrombosis or embolism.
> 2cm
Nonocclusive ischemic disease is characterized by spasm of the major mesenteric arterial vessels, with a characteristic beading effect. Early recognition can lead to treatment with ______________, avoiding operative intervention.
papaverine (a vasodilator)
How is renal vascular fibromuscular dysplasia treated?
percutaneous transluminal angioplasty
Which is the most common site at which an arterial embolus lodges?
Just proximal to bifurcation at the common femoral artery