1 / 38

Peripheral Arterial Disease

What is Peripheral Arterial Disease?. PAD=POAD=PVDArteriosclerotic occlusive disease of aortoiliac and/or femoropopliteal arterial system. What are the risk factors for PAD?. Non-Modifiable Risk Factors: Male gender Advanced age Family history. Modifiable Risk Factors: Major

lavonne
Download Presentation

Peripheral Arterial Disease

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

    1. Peripheral Arterial Disease Mohammed Al-Omran, MD, MSc, FRCSC Assistant Professor & Consultant Vascular Surgery King Saud University

    2. What is Peripheral Arterial Disease? PAD=POAD=PVD Arteriosclerotic occlusive disease of aortoiliac and/or femoropopliteal arterial system

    3. What are the risk factors for PAD?

    4. Pathogenesis

    5. Pathogenesis

    6. How do patients with PAD present?

    7. How do patients with PAD present?

    8. How do we diagnose PAD?

    9. How do we diagnose PAD?

    10. Ankle Brachial Index

    11. Ankle Brachial Index

    12. Investigations

    13. Investigations

    14. Why it is important to recognize patients with PAD? PAD is a marker of systemic atherosclerosis Patients with either symptomatic or asymptomatic PAD generally have widespread arterial disease

    15. Why it is important to recognize patients with PAD? Coexisting vascular Disease: CAD-- 35 % to 92% CVD-- 25 % to 50%

    16. Why it is important to recognize patients with PAD? Cause of death: CAD– 40%-60% CVD– 10%-20% Non-cardiovascular causes--Only 20% to 30 % Patients with PAD have a 6 fold increased risk of cardiovascular disease mortality compared to patients without PAD

    17. Natural History

    18. Natural History Annual risk : - Mortality 6.8% - MI 2.0% - Intervention 1.0% - Amputation 0.4%

    19. Worldwide Causes of Death

    20. Goals of treating patients with PAD Relief symptoms Improve quality of life Limb salvage Prolong survival

    26. Acute Limb Ischemia

    27. What is an Acute Limb Ischemia? Sudden decrease or worsening in the limb perfusion causing a potential threat to the limb viability resulting from a sudden obstruction of the arterial system

    28. What are the causes of acute arterial occlusion ? Embolus Thrombosis Others Trauma Iatrogenic Arterial dissection

    29. What is the possible source for an embolus?

    30. What are the common sites for embolus lodgment in the arterial tree?

    31. How do patients with acute limb ischemia present? Sudden onset of diffuse and poorly localized leg pain 6 Ps Paresthesias Pain Poikilothermia (coolness) Pallor Pulselessness Paralysis

    32. Investigations Acute Limb Ischemia is a CLINICAL DIAGNOSIS If time allows, especially if atherosclerotic thrombosis is suggested, preoperative angiography is often wise

    33. Goal of treating patients with Acute Limb Ischemia Rapid restoration of adequate arterial perfusion without the development of morbid local or systemic complications

    34. Treatment EMEGENCY (Golden time is 6 hours) ABC IV Heparin (anticoagulation) Rapid surgical thromboembolectomy +/ - surgical bypass +/- thrombolytic therapy +/- primary amputation

    35. Surgical Thrmboemblectomy Procedure

    36. Thrombolysis

    37. What do we worry about after revascularization? Reperfusion Injury Local Compartment Syndrome Systemic Hyperkalemia Acidosis Myoglobulinuria

    38. Compartment Syndrome

    39. Thank You Mohammed Al-Omran, MD, MSc, FRCSC Assistant Professor & Consultant Vascular Surgery King Saud University

More Related