Acute Limb Ischemia Etiology Quiz

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Questions and Answers

What is the clinical manifestation of Atherosclerosis at the legs?

Peripheral Arterial Disease (correct)

Coronary Disease

Cerebrovascular Disease

Renovascular Disease

What is the relative risk factor associated with PAD?

0.25

0.75 (correct)

1.50

1.25

What percentage of patients with PAD have typical symptoms of Intermittent Claudication?

Three in ten patients

One in ten patients (correct)

One in five patients

Three in five patients

What are the common risk factors for PAD?

Smoking and diabetes Signup and view all the answers

What is the survival percentage of patients with severe PAD over 10 years?

25% Signup and view all the answers

What is the ABI interpretation for mild PAD?

ABI 0.71 – 0.90 Signup and view all the answers

Which of the following is a symptom of critical ischemia?

Rest pain (night) Signup and view all the answers

What is the recommended ankle pressure threshold for diagnosing critical ischemia in non-diabetic patients?

Ankle pressure < 50mmHg Signup and view all the answers

Which of the following arteries is responsible for 80-90% of symptoms in PAD patients?

Femoro-Popliteal arteries Signup and view all the answers

What should the toe pressure be in non-diabetic patients to diagnose critical ischemia?

Toe pressure < 50mmHg Signup and view all the answers

What is the definition of acute limb ischemia?

The sudden decrease in limb perfusion that threatens the viability of the limb Signup and view all the answers

What are some manifestations of peripheral artery disease (PAD)?

Asymptomatic, intermittent claudication, critical limb-threatening ischemia Signup and view all the answers

What are the recommended interventions for debilitating claudication or in CLTI due to PAD?

Endarterectomy, Bypass Surgery, Balloon Angioplasty, Stenting Signup and view all the answers

What are the common risk factors associated with PAD?

Smoking, hypertension, hyperlipidemia, diabetes Signup and view all the answers

In what condition can PAD be asymptomatic or cause intermittent claudication?

It can be asymptomatic or cause intermittent claudication Signup and view all the answers

What is the preferred treatment for patients with advanced intermittent claudication and chronic limb-threatening ischemia (CLTI)?

Endovascular techniques Signup and view all the answers

In what scenario is open surgery with a good quality saphenous vein conduit considered better than endovascular techniques?

For patients with extensive disease and low surgical risk Signup and view all the answers

What type of conduit is considered far superior in terms of patency rates compared to prosthetic grafts in open surgery?

Autologous venous conduit Signup and view all the answers

What is the preferred treatment for patients with small ulcers, shorter lesions, and high risk for restenosis?

PTA with drug eluting stents Signup and view all the answers

What is the most suitable treatment for long complex lesions after failed drug coated balloon?

Covered self-expanding stents Signup and view all the answers

What is the most common cause of embolic acute limb ischemia?

Cardiogenic emboli Signup and view all the answers

What is the most common risk factor for Abdominal Aortic Aneurysm (AAA)?

Smoking Signup and view all the answers

Where do peripheral arterial emboli predominantly lodge?

Femoral bifurcation Signup and view all the answers

What is the epidemiological difference in the prevalence of AAA between males and females in the age group 45-54?

Males have a 1.3% prevalence, while females have 0% Signup and view all the answers

What is the predominant cause of native arterial thrombosis in acute limb ischemia?

Atherosclerosis Signup and view all the answers

What is the definition of Abdominal Aortic Aneurysm (AAA)?

Aortic diameter >3cm Signup and view all the answers

What is the primary surgical modality for the treatment of acute limb ischemia?

Primary operative revascularization Signup and view all the answers

What are the 5Ps used to describe a condition related to Vascular Diseases?

Pulselessness, Paleness, Paralysis, Palor, Pain Signup and view all the answers

In the context of acute limb ischemia, what does ALI stand for?

Acute Limb Inflammation Signup and view all the answers

What is the significance of 'Time is tissue' in the context of Vascular Diseases?

It emphasizes the importance of rapid diagnosis and intervention to prevent tissue damage Signup and view all the answers

What is the prevalence of Cerebrovascular Disease in the U.S. expected to be in 2030?

3.9% Signup and view all the answers

What does the acronym 'ICA' stand for in the given context?

Internal Carotid Artery Signup and view all the answers

What is the primary cause of cardiovascular death in the U.S.?

Cerebrovascular Disease Signup and view all the answers

In the case scenario, what was the MRI result related to?

Acute Infarct of the Left Middle Cerebral Artery Territory Signup and view all the answers

What treatment was initiated for the patient admitted to the Stroke Unit?

Aspirin and statin Signup and view all the answers

What is the significance of the left carotid bruit mentioned in the case scenario?

Indicates a critical stenosis of the left internal carotid artery Signup and view all the answers

What does the acronym 'PAD' stand for in the context of vascular diseases?

Peripheral Arterial Disease Signup and view all the answers

Which condition is indicated by venous insufficiency- varicose veins?

Deep vein thrombosis Signup and view all the answers

Study Notes

Clinical Manifestations of Atherosclerosis in the Legs

Peripheral artery disease (PAD) can cause pain, numbness, or weakness in the legs, particularly during physical activity, known as intermittent claudication.

Risk Factors and Symptomatology

Relative risk for PAD is significantly influenced by factors such as smoking, diabetes, hypertension, and hyperlipidemia.
Approximately 10-30% of patients with PAD exhibit typical symptoms of intermittent claudication.
Common risk factors for PAD include smoking, diabetes, hypertension, and increasing age.

Survival and Diagnostic Thresholds

The survival rate for patients with severe PAD over a 10-year period is around 50%.
Ankle-brachial index (ABI) interpretation for mild PAD typically ranges from 0.9 to 0.7.
Recommended ankle pressure threshold for diagnosing critical ischemia in non-diabetic patients is <50 mmHg.

Arterial Involvement and Toe Pressure

The superficial femoral artery accounts for 80-90% of symptoms in PAD patients.
A toe pressure of 30 mmHg or lower in non-diabetic patients indicates critical ischemia.

Definitions and Parameters

Acute limb ischemia is defined as a sudden decrease in blood flow to the extremities, leading to the potential loss of limb.
Common manifestations of PAD include leg pain, especially during exercise, and non-healing wounds.

Interventions and Treatments

Recommended interventions for debilitating claudication or chronic limb-threatening ischemia (CLTI) include revascularization procedures and supervised exercise therapy.
Preferred treatment for advanced intermittent claudication and CLTI is either endovascular revascularization or surgical bypass depending on the patient's condition.

Surgical Techniques and Grafts

Open surgery with a high-quality saphenous vein conduit is preferred over endovascular techniques for specific patients, particularly with longer lesions.
Saphenous vein grafts are superior in patency rates compared to prosthetic grafts in open surgery.

Ulcer Treatment and Embolic Events

Small ulcers and shorter lesions at high risk for restenosis are often best treated with endovascular interventions.
The most suitable treatment for long, complex lesions after failed drug-coated balloon procedures may involve bypass surgery or other advanced techniques.
The most common cause of embolic acute limb ischemia is cardiac embolism, often from atrial fibrillation.

Aneurysm and Epidemiology

The most prevalent risk factor for abdominal aortic aneurysm (AAA) is advanced age, particularly in males.
Peripheral arterial emboli predominantly lodge in the distal arteries of the legs.
The prevalence of AAA varies significantly between genders; males aged 45-54 have a higher incidence than females.

Thrombosis and Terminology

Native arterial thrombosis in acute limb ischemia is predominantly due to atherosclerosis.
AAA is defined as an abnormal dilation of the aorta, typically measuring over 3 cm.

Surgical Treatment and Vascular Conditions

Primary surgical modality for acute limb ischemia is emergency bypass surgery or thrombectomy.
The "5Ps" used to describe conditions regarding vascular diseases include Pain, Pulselessness, Pallor, Paresthesia, and Paralysis.
"Time is tissue" emphasizes the critical importance of rapid intervention to prevent tissue loss in vascular emergencies.

Future Considerations

The prevalence of cerebrovascular disease in the U.S. is expected to rise by 2030.
The acronym ICA stands for internal carotid artery, which is significant in cerebrovascular events.

Cardiovascular Health and Clinical Scenarios

Leading cause of cardiovascular death in the U.S. remains coronary artery disease.
Notable MRI findings can provide insight into vascular issues during stroke evaluations.
Initiation of antiplatelet therapy or thrombolysis treatment is common for patients in the Stroke Unit presenting with ischemic symptoms.
The presence of a left carotid bruit can indicate significant carotid artery stenosis.

Vascular Diseases Overview

PAD stands for peripheral artery disease, a key condition involved in vascular health challenges.
Venous insufficiency, as seen in varicose veins, is often characterized by poor venous return and swelling.

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Description

Test your knowledge on the etiology of acute limb ischemia, including factors such as embolism, thrombosis, bypass graft occlusion, and native artery occlusion. Explore the different sites of peripheral embolization and their prevalence in the body.