peripheral arterial disease
DESCRIPTION
Peripheral Arterial Disease. CST teaching Wissam Al-Jundi ST3 Vascular Surgery 01/12/2009. PAD Symptoms. Intermitted Claudication Distance walked before onset of pain/has to stop Location calf, thigh, buttock Ischaemic rest pain: Severe, unremitting affects toes and MTs - PowerPoint PPT PresentationTRANSCRIPT
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Peripheral Arterial Disease
CST teaching
Wissam Al-JundiST3 Vascular Surgery
01/12/2009
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PAD Symptoms
• Intermitted Claudication– Distance walked before onset of pain/has to stop– Location
• calf, thigh, buttock
• Ischaemic rest pain:• Severe, unremitting affects toes and MTs• Eased by dependency• Pain experienced on lying flat• Patient usually sleeps in a chair
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PAD - Risk factor modification
• To alleviate disability• To prevent major amputation• To reduce the secondary morbidity – Cardiac– Stroke
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PAD - Risk factor modification
• Smoking cessation1
• Treatment of Hyperlipidaemia2
• Diabetic control3
• Control of Hypertension4
• Anti-platelet therapy5
• Diet – Fish oils6
• Exercise programmes7
• Others: hyperhomocysteinaemia8
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Risk factor modification – smoking cessation
• 70% of POAD patients continue to smoke• Improvement in claudication in 3-6 months• Reduced risk of critical ischaemia• Reduced MI and mortality• 5-10 years future cardiovascular risk
approaches non-smokers
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Risk factor modification - hyperlipidaemia
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Risk factor modification – anti-platelet therapy
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Risk factor modification - Clopidogrel
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Risk factor modification: Exercise
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Critical limb ischaemia - definition
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Angioplasty
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Angioplasty + stenting
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Indications for intervention
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Acute limb ischaemia
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Acute limb ischaemia