Medical Articles

Vascular Surgery - The Basics

Definition – Peripheral vascular disease

Vascular occlusive disease of the arterial supply distal to the coronary arteries resulting in insufficient arterial supply to end organs.

Basic arterial anatomy

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Presentation

Rutherford Classification:

  • Mild claudication
  • Moderate claudication
  • Severe claudication
  • Rest pain
  • Minor tissue loss
  • Major tissue loss
  • Same as for Atherosclerosis
    • Smoking
    • Dyslipidemia
    • Diabetes
    • Hereditary
    • Hypertension

Workup

  • Only performed in cases where intervention is envisaged
    • Clinical evaluation
      • General
      • Focused on the arterial supply of
        the limb
    • General workup
      • Heart/Lungs/kidneys
    • Arterial workup
      • Delineate level of obstruction
      • ABI/Arteriogram/CTA/MRA

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Treatment

  • Conservative
    • Modification of risks
    • Exercise
    • Asprin/Clopidogrel
  • Interventional
    • PTA
    • Stenting
  • Open surgery
    • Endarterectomy
    • Bypass (Vein/prosthetic/combiation)
  • Combination

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