Peripheral Vascular Disease

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Information about Peripheral Vascular Disease
Health & Medicine

Published on February 4, 2009

Author: stierney

Source: slideshare.net

Adelaide & Meath National Children’s Hospital, Tallaght Sean Tierney, Consultant Vascular Surgeon

Issues in PAOD Presentation and differential diagnosis Assessment/management of cardiovascular risk Managing symptoms Prevention of limb loss

Presentation and differential diagnosis

Assessment/management of cardiovascular risk

Managing symptoms

Prevention of limb loss

Presentation & differential diagnosis

Presentation of atherosclerotic plaque

Peripheral Arterial Occlusive Disease Limitation on exercise (QOL) Risk of limb loss Global Health risk Claudicants – concerns ?

Limitation on exercise (QOL)

Risk of limb loss

Global Health risk

PAOD secondary prevention

PAOD – predictor of CVS disease Tasc; EJVS; 2000

PAOD outcome Tasc; EJVS; 2000

PAOD Real risks Limitation on exercise (QOL) Risk of limb loss Global Health risk Patients Concerns Death from MI/CVA Limitation on exercise Risk of limb loss Relative risk

Limitation on exercise (QOL)

Risk of limb loss

Global Health risk

Death from MI/CVA

Limitation on exercise

Risk of limb loss

PAOD Tx reduce global risk Measures Stop smoking Optimum therapy underlying disease (DM, HTN, etc.) Antiplatelet (? Clopidogrel) CAPRIE Statin (? even if normal XOL) ASCOT

Measures

Stop smoking

Optimum therapy underlying disease (DM, HTN, etc.)

Antiplatelet (? Clopidogrel) CAPRIE

Statin (? even if normal XOL) ASCOT

PAOD – symptom relief

PAOD – symptomatic treatment Measures Stop smoking Exercise Drug therapy Surgery approx doubling walking distance approx doubling walking distance ?

Measures

Stop smoking

Exercise

Drug therapy

Surgery

PAOD – symptomatic treatment

PAOD – symptomatic treatment Endovascular Open surgery

PAOD – non-critical ischaemia surgery vs conservative treatment

PAOD – critical ischaemia

PAOD – limb salvage

PAOD – limb salvage Peripheral angioplasty image 10 9 8 6 5 4 1 No. at risk Pop distal bypass Kalbassi et al. IJMS 1999

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