Vascular conditions

Question 1

What are the cardinal features of critical limb ischaemia?

Answer 1

Ulceration, gangrene, foot pain at rest relieved by hanging leg over bed

Question 2

What are the 6 Ps of acute limb ischaemia?

Answer 2

Pallor, pulselessness, pain, paralysis, parasthesia, perishingly cold

Question 3

What ABPI results are seen in peripheral arterial disease?

Answer 3

Normal: 1-1.2
P.A.D: 0.5-0.9
Critical ischaemia: <0.5

Question 4

Define abdominal aortic aneurysm?

Answer 4

A permanent and irreversible dilatation of the abdominal aorta by more than 50% of its normal diameter

Question 5

Where do most AAAs occur?

Answer 5

90% occur below renal arteries

Question 6

What differentiates true aneurysms from false aneurysms?

Answer 6

True: involves all layers of the arterial wall

False (pseudoaneurysm): collection of blood in the adventitia only which communicates with the lumen

Question 7

Symptoms of AAA?

Answer 7

Most are aymptomatic, as it expands it may cause epigastric pain radiating to back, pulsating sensations in abdomen, pain in chest, lower back or scrotum (due to pressure on adjacent structures)

Question 8

At what size is surgery indicated for AAAs, as opposed to conservative management?

Answer 8

> 5.5cm

Also, if ruptured, rapid expansion or sinister onset

Question 9

How do varicose veins arise?

Answer 9

Incompetent venous valves leading to venous HTN and dilatation of superficial veins

Question 10

How are varicose veins managed?

Answer 10

Education: avoid prolonged standing, support stockings, lose weight, regular walks
Endovascular Rx: radiofrequency ablation, endovascular laser ablation, injection scleropathy
Surgery: very effective long term