Flashcards in Fiser Ch 27: Vascular Deck (48)
most common acquired hypcoagulable disorder
1st branch off internal carotid artery?
1st brach off external carotid artery?
superior thyroid aa
indications for CEA?
1. Asymptomatic with >70% stenosis
2. Symptomatic with >50% stenosis
what part of vessel do you remove in CEA?
intima and part of media
why do 20% of ppl get hypertensive after CEA?
injury to carotid body, tx w nipride
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
whats DeBakey Classification for AAAs?
Type I: ascending and descending
Type II: Ascending only
Type III: Descending only
where do dissections normally occur? (layer)
medial layer of blood vessel wall
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
most likely location of rupture of abdominal AAA?
left lateral wall 2-4cm below renals
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
#1 causes of acute and late death after AAA repair?
late: renal failure
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)
top 2 organisms that cause mycotic aneurysms and tx
extra-anatomic bypass (ax fem) and resection of infected aorta
top 2 organisms that cause aortic graft infections
2. E. Coli
whats leriche syndrome? tx?
- aortoiliac occlusive disease causing:
1. no femoral pulses
2. Buttock o thigh claudication
tx: aorto-bifem bypass
ABI: rest pain
when to use gortex (PTFE) vs saphenous v.
PTFE above the knee
saphenous below the knee bypasses
when do you use dacron graft?
aorta or large vessels
when do you use PTA?
percutaneous transluminal angioplasty, use:
- common iliac artery stenosis
- short stenoses
diagnosis of compartment syndrome
diagnosis of popliteal entrapment syndrome? tx?
loss of pulses with plantarflexion
tx: resection of head of gastroc
what arteries are used in CABG?
most common site of peripheral obstruction from emboli
common femoral artery
management of acute arterial embolus