Vascular Surgery Flashcards
When is AAA screening performed?
Single US scan at 65
How does size determine management of asymptomatic AAA?
<3cm: Normal
3-4.4: Re-scan every 12 months
4.5-5.4: Re-scan every 3 months
>=5.5: 2 week referral to vascular
How do you manage a symptomatic AAA?
Two week referral
How do you decide between elective endo-vascular repair and open?
EVAR first, Open if this fails
How do you tell if an AAA has ruptured? how is this managed
Severe central abdo pain radiating to back
Shock/collapse
ABCDE + CT if stable; theatre if not
Differentiate aortic dissection from AAA?
AAA: central abdominal pain radiating to back
AD: Tearing chest/back pain, pulse deficit
What 3 groups tend to get AAA?
Arteriopaths
Smokers
CTDs
How do you manage peripheral arterial disease?
Meds: Statin, clopidogrel
Lifestyle: Excercise
If severe: endovascular if <10cm, open if >10cm/multifocal or common femoral
What is the line of investigations in PAD?
Check pulses and ABPI
1st: Duplex
MRA to confirm
Differentiate venous, arterial and neuropathic ulcers based on... Pain Site Appearance ABPI Associated
Venous // arterial // neuropathic
Painful // painful // painless
Medial malleolus // supramalleolar, trauma // tips
Large, shallow // Small, deep // variable
0.8-1.0 // <0.8 // <0.8
Warm, pulses // cold, no pulses // Warm no pulses
What is a marjolin’s ulcer?
Arterio-venous ulcer, form of squamous cell carcinoma
How do you differentiate critical vs acute limb ischaemia
CLI // ALI
claudicant history // acute
Reduced pulses in opposite limb // normal pulses
How do you manage limb ischaemia
ABCDE + heparin IV
Review for surgery
Aching, throbbing or itching superficially visible veins suggests what and how do you manage?
Varicose veins, compression stockings
What do you need to check for in superficial thrombophlebitis? What else do you do for the condition
DVT via US
if long saphenous: LMWH IV 3- days/ 8-12 days NSAIDs if CId
