Peripheral Vascular Disease
Acteral Asterial disease
>
Peripheral
-
-
Venous
-
Mixed
Piterial Disorders
Aunte limb ischemia
sudden block of blood to muscle
-
rapid , supply a
Chronic limb Ischemis
muscle
-gradual block of blood supply to a
-takes time ,
disease
slower .
characted reduction in
*
by blood flow
reduced or through peripheral vessels
anairobir metabolism
late andncumulation
as
&
.
pain
when the need the tissues for 02 exceeds the of Eschemia st mersons. turme death
.
supply
*
of > areas -
-
Hunte Limb istemia
Embolus thrombus
- -
clot formed develops over a
somewhere else
pre-inithug
-
O
atme to
plaque
Embolus Thrombus
-
originates carhine
somewhere else -
previous plaque
-
previous history transforms
features
-previous
PAD
Y
distal
possible from amyuhers
-
as
.
-
heart. -
diffuse long
-
areas of bifurcation segment
(commonly seen
-
small
segment
-
Grades
I .
limb vorable
not regent
la]
>
threatened
-
b > urgent
III-dead turne
Treatment
Conservative
*
management - systemic
-
thrombolytes (nokinase , streptokinase) > entheles
F chirected
-
Cat [ 2 Ia
> Endovenous > steut used .
Interventional
*
>
Bypass .
Leat [b) -Open Surgical
-Encasterectomy
.
Debridement
> removal of dead of necrole Issue
-
3lat I
*
Amputation
.
Chronic Limb Schemi
weeks
-symptoms than more I .
-gradual formation of plaque
recued blood flow
define mechanis
-collateral formation
X duration
long
central
j
O
himb ischaemia
zhology
=
* Atherosclerosis
disease
*
Buerger's TAO
# Artists
Risk factors
· A
>Age chance of
developing atherosclerosis higher in old
age
disease
40-50
yes
> more
-
prone for Benga's .
>
younger Raynaud's
·
B <
hypertension (BP) 6
o C >
Ligaratta smoking
·
D >
Dyslipidemia > Altered Spid profile .
·
E > Emotional stress.
Symptomatology
* Claudication air
P
like
O
~
samp pan
-
releived rest
by
-
.
-reproducible (pam
O
comes back)
Alternal
stypes >
-
-
Venous
Neurological
Asterial Venous Neurological
due to Lee
pain increase compression of
·
rea as o
blood flow 28 to
day
nerves
progresses
· rest - pain lumbar canal
reduces .
stenosis
reduces
· on
down
.
lying Ou
pantonal
aggravated by (immediately)
· ·
immediate
activity
-
Boyd's grading Claudication
of
F-Continues to walk down lacter vasodilatation
>
pain settle as a washed off >
walking >
-
... -
It Continues to walk with
pain > even
-
after vasodilation
> .
pain
to take rest > narrowing after vasodilation
III-
Compelled even severe > even
#. Rest
pain , even at rest
very painful .
level of oclusion and symptoms
actoiliac
G
1 in the buttocks
austa
.
>
par
thugh calf claudication
O
common lar 2 . The
thugh calf >
-
3
fenepopliteal
.
calf -
>
enternal love
sophtal calf and foot
O
Mfx)
o
>
4
.
- .
~
Olive
internal la internal char enternal
genitalia -impotency
o G 6
5.
-
>
-
common
Jerusal
↓ protical actory zeiche syndrome .
ferusal
↓,
popliteal
tibial artees
-
peroncal actones
* Rest
pain activities
.
-even at rest without ,
G
doing
-
blood vessels
supplying nerve-rasa neworm
unable to survive
compromised ,
cry of dying neve
-
night gravity lost.
6
the blood flow reduced to
during hangings
.
·
manimum effect of as
compared
sympatheter tone hanges > rechuced
supply
-
as beit
temperature reduces biches
-
> vasocons
.
reduced disturbance other distractions
* Fal
Ca limb schemica
in disease leads to gangrene
.
-any progress
-persistence of rest pain > 2 weeks is
persistence of rest pains z weeks
needing analgesics .
-
Ankle Brachial pressure inden 10 3
. .
lower ABPI more chsease
advanced the .
0 9
.
>
-
Normal
0 5-0
.
.
9 - wild .
0 3-0.
.
5 -> moderate
20 3 .
>
-
chronic limb ischema
20 05 .
- > true death
.
-
ankle
systolic, pressure 750mmtly
toe somet a 20 angle
I
Other signs of symptoms
skin
-
day
-
hair loss
-
brittle waits
guttering of veins/prominent veins vei involved
acterial
supply reduced Smellings
↓ loss of subcutaneous tissue
low venous return
↓
guttering
-
absent pulses .
Atherosclerosis vs Buerger's
Shinoyo's enterior >
Burger's
·
smoke
450 enset
age years
·
vessels.
·
inrapopliteal < more distal because medium/small
limb involvement
·
phlebits migrams upper
risk atherosclerosis
.
oAbsence of other factors of
Bewarea I
Atheroscleros
purely actres
actual
-
-medium small cateries
thmin intere
ely
-
