Fiser Ch 27: Vascular Flashcards Preview

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Flashcards in Fiser Ch 27: Vascular Deck (48)
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1

most common acquired hypcoagulable disorder

smoking

2

1st branch off internal carotid artery?

ophthalmic aa

3

1st brach off external carotid artery?

superior thyroid aa

4

indications for CEA?

1. Asymptomatic with >70% stenosis
2. Symptomatic with >50% stenosis

5

what part of vessel do you remove in CEA?

intima and part of media

6

why do 20% of ppl get hypertensive after CEA?

injury to carotid body, tx w nipride

7

what are the three aortic arch vessels?

1. innominate aa (branches to right subclavian and right common carotid)
2. left common carotid
3. left subclavian

8

whats DeBakey Classification for AAAs?

Type I: ascending and descending
Type II: Ascending only
Type III: Descending only

9

where do dissections normally occur? (layer)

medial layer of blood vessel wall

10

how do you get paraplegia after a thoracic AAA repair? how can you prevent it?

- spinal cord ischemia due to occlusion of intercostal arteries and artery of Adamkiewicz
- reimplant intercostal arteries afte T8

11

most likely location of rupture of abdominal AAA?

left lateral wall 2-4cm below renals

12

when do you reimplant the IMA? indications (4)

1. If backpressure <40mmHg
2. Previous colonic surgery
3. Stenosis at the SMA
4. Flow to colon appears inadquate

13

#1 causes of acute and late death after AAA repair?

acute: MI
late: renal failure

14

5 types of endoleaks

Type I: Proximal or distal attachment sits
Type II: Collaterals (observe)
Type III: Overlap sites of multiple grafts (secondary endograft to cover)
Type IV: Graft wall porosity or suture holes (observe)
Type V: expansion of aneurysm without evidence of leak (back to OR)

15

top 2 organisms that cause mycotic aneurysms and tx

1. Staph
2. Salmonella
extra-anatomic bypass (ax fem) and resection of infected aorta

16

top 2 organisms that cause aortic graft infections

1. staph
2. E. Coli

17

whats leriche syndrome? tx?

- aortoiliac occlusive disease causing:
1. no femoral pulses
2. Buttock o thigh claudication
3. impotence
tx: aorto-bifem bypass

18

ABI: claudication

0.7-0.9

19

ABI: rest pain

0.5

20

ABI: ulcers

0.4

21

ABI gangrene

<0.3

22

when to use gortex (PTFE) vs saphenous v.

PTFE above the knee
saphenous below the knee bypasses

23

when do you use dacron graft?

aorta or large vessels

24

when do you use PTA?

percutaneous transluminal angioplasty, use:
- common iliac artery stenosis
- short stenoses

25

diagnosis of compartment syndrome

pressures >20-30mmHg

26

diagnosis of popliteal entrapment syndrome? tx?

loss of pulses with plantarflexion
tx: resection of head of gastroc

27

what arteries are used in CABG?

arterial autografts:
radial aa
IMA

28

most common site of peripheral obstruction from emboli

common femoral artery

29

management of acute arterial embolus

embolectomy

30

most common site of atheroma embolism

renals