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Peripheral Arterial Disease

Peripheral Arterial Disease. CST teaching Wissam Al-Jundi ST3 Vascular Surgery 01/12/2009. PAD Symptoms. Intermitted Claudication Distance walked before onset of pain/has to stop Location calf, thigh, buttock Ischaemic rest pain: Severe, unremitting affects toes and MTs

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Peripheral Arterial Disease

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  1. Peripheral Arterial Disease CST teaching Wissam Al-Jundi ST3 Vascular Surgery 01/12/2009

  2. PAD Symptoms • Intermitted Claudication • Distance walked before onset of pain/has to stop • Location • calf, thigh, buttock • Ischaemic rest pain: • Severe, unremitting affects toes and MTs • Eased by dependency • Pain experienced on lying flat • Patient usually sleeps in a chair

  3. PAD - Risk factor modification • To alleviate disability • To prevent major amputation • To reduce the secondary morbidity • Cardiac • Stroke

  4. PAD - Risk factor modification • Smoking cessation1 • Treatment of Hyperlipidaemia2 • Diabetic control3 • Control of Hypertension4 • Anti-platelet therapy5 • Diet – Fish oils6 • Exercise programmes7 • Others: hyperhomocysteinaemia8

  5. Risk factor modification – smoking cessation • 70% of POAD patients continue to smoke • Improvement in claudication in 3-6 months • Reduced risk of critical ischaemia • Reduced MI and mortality • 5-10 years future cardiovascular risk approaches non-smokers

  6. Risk factor modification - hyperlipidaemia

  7. Risk factor modification – anti-platelet therapy

  8. Risk factor modification - Clopidogrel

  9. Risk factor modification: Exercise

  10. Critical limb ischaemia - definition

  11. Angioplasty

  12. Angioplasty + stenting

  13. Indications for intervention

  14. Acute limb ischaemia

  15. Acute limb ischaemia

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