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Peripheral Vascular Diseases

Peripheral Vascular Diseases

Terminology Acute: 1.3: Arteriosclerosis Resting ABPI is normally about 1.0; values below 0.9 indicate some degree of arterial obstruction (claudication), less than 0.5 suggests rest pain and less than 0.3 indicates imminent necrosis.Even normal values may present with intermittent claudicationBailey & Love 26th/e

Sabistons 19th ed

Site of blockageClinical featuresAortoiliac Leriche syndrome, buttock-thigh-calf claudicationCommon femoral Thigh & calf claudicationSuperficial femoralCalfPopliteal CalfCrural Calf

Atherosclerosis vs BuergersAtherosclerosis Buergers (OLIN criteria-2000)Old ageHypercholesterolemiaSmoking (4x)Diabetes mellitus (3-5x)Hypertension Pvs history of thromboembolic phenomena (stroke/ TIA/ amaurois fugax, DVT etc.)Large & medium sized elastic & muscular vessels20 mm Hg differenceFallacy: Well formed collaterals and multilevel obstructionDigital pressure: normal: 20-40 mm Hg below ankleTBI =0.7Absolute digit pressure>50 mmHgTCpO2: for selection of amputation sites

Management: risk factor modificationSmoking cessationDiabetes control: 1% rise HbA1C= 28% rise in PAD riskTarget HbA1C< 7%Hypertension:


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