Podcast
Questions and Answers
What is the preferred treatment for symptomatic infected (mycotic) EVAR in elderly and high-risk patients?
What is the preferred treatment for symptomatic infected (mycotic) EVAR in elderly and high-risk patients?
- Aorto-bifemoral repair
- Medical therapy
- Open surgery
- Endovascular repair (correct)
What is the recommended size threshold for delaying repair in high-risk, non-symptomatic patients?
What is the recommended size threshold for delaying repair in high-risk, non-symptomatic patients?
- 5.5 cm (correct)
- 4.0 cm
- 3.0 cm
- 6.0 cm
Which artery should be reimplanted during the technical aspects of repair?
Which artery should be reimplanted during the technical aspects of repair?
- Superior mesenteric artery
- Internal iliac artery
- Lumbar arteries
- Inferior mesenteric artery (correct)
What should aorto-bifemoral repair ensure to avoid complications?
What should aorto-bifemoral repair ensure to avoid complications?
What are the major complications of aortic aneurysm repair?
What are the major complications of aortic aneurysm repair?
What may diarrhea after AAA repair indicate?
What may diarrhea after AAA repair indicate?
What is a common cause of aortic graft infections?
What is a common cause of aortic graft infections?
Which condition can lead to hyperkalemia, myoglobinemia, myoglobinuria, and renal failure?
Which condition can lead to hyperkalemia, myoglobinemia, myoglobinuria, and renal failure?
What is the most likely cause of blue toe syndrome?
What is the most likely cause of blue toe syndrome?
What is the most common site of peripheral obstruction from emboli?
What is the most common site of peripheral obstruction from emboli?
Which condition presents with symptoms such as intermittent claudication and changes in symptoms with knee flexion/extension?
Which condition presents with symptoms such as intermittent claudication and changes in symptoms with knee flexion/extension?
What is the most common cause of extremity ischemia evolution?
What is the most common cause of extremity ischemia evolution?
What is the recommended treatment for threatened limb due to acute arterial thrombosis?
What is the recommended treatment for threatened limb due to acute arterial thrombosis?
Which condition can result in renovascular hypertension characterized by bruits, diastolic blood pressure > 115, and resistance to drug therapy?
Which condition can result in renovascular hypertension characterized by bruits, diastolic blood pressure > 115, and resistance to drug therapy?
What is the most common indication for nephrectomy in cases of renal hypertension?
What is the most common indication for nephrectomy in cases of renal hypertension?
Which procedure is recommended for treating renal artery stenosis due to fibromuscular dysplasia?
Which procedure is recommended for treating renal artery stenosis due to fibromuscular dysplasia?
What is the most common cause of abdominal aortic aneurysms?
What is the most common cause of abdominal aortic aneurysms?
What is the leading cause of death without an operation in cases of abdominal aortic aneurysm rupture?
What is the leading cause of death without an operation in cases of abdominal aortic aneurysm rupture?
What are the symptoms that may indicate a ruptured abdominal aortic aneurysm?
What are the symptoms that may indicate a ruptured abdominal aortic aneurysm?
What is the emergency management approach for ruptured abdominal aortic aneurysm before proximal control?
What is the emergency management approach for ruptured abdominal aortic aneurysm before proximal control?
At what size does duplex ultrasound surveillance become necessary for abdominal aortic aneurysms?
At what size does duplex ultrasound surveillance become necessary for abdominal aortic aneurysms?
For which patients is repair indicated at a size of ≥5.5 cm for abdominal aortic aneurysms?
For which patients is repair indicated at a size of ≥5.5 cm for abdominal aortic aneurysms?
What is the best predictor of long-term patency in lower extremity bypasses?
What is the best predictor of long-term patency in lower extremity bypasses?
What is the most common site for atherosclerotic occlusion in the lower extremities?
What is the most common site for atherosclerotic occlusion in the lower extremities?
What is the treatment for Leriche syndrome?
What is the treatment for Leriche syndrome?
What is used to assess Peripheral Arterial Disease (PAD)?
What is used to assess Peripheral Arterial Disease (PAD)?
What can give falsely elevated Ankle-brachial index (ABI) in diabetics?
What can give falsely elevated Ankle-brachial index (ABI) in diabetics?
What are the surgical indications for PAD?
What are the surgical indications for PAD?
What is involved in postnatal angiogenesis?
What is involved in postnatal angiogenesis?
Study Notes
Peripheral Arterial Disease (PAD) and Vascular Surgery
- Leriche syndrome is characterized by absent femoral pulses, buttock or thigh claudication, and impotence due to decreased blood flow in the internal iliac arteries.
- Aorto-bifemoral bypass graft is the treatment for Leriche syndrome.
- Hunter's canal is the most common site for atherosclerotic occlusion in the lower extremities, covered by the sartorius muscle.
- Collateral circulation forms from abnormal pressure gradients, such as from circumflex iliacs to subcostal and circumflex femoral arteries to gluteal arteries.
- Postnatal angiogenesis involves budding from preexisting vessels, with angiogenin playing a role.
- Ankle-brachial index (ABI) is used to assess PAD, with values below 0.9 indicating claudication, below 0.5 indicating rest pain, and below 0.3 leading to tissue loss.
- Noncompressible vessels, often in diabetics, can give falsely elevated ABIs, requiring the use of toe pressures or Doppler waveforms.
- Diabetics tend to have disease of trifurcation vessels and feet microvasculature, limiting intervention options.
- Surgical indications for PAD include rest pain, ulceration, gangrene, and severe lifestyle limitations despite medical therapy.
- Vein quality is the best predictor of long-term patency in lower extremity bypasses.
- Duplex ultrasound is the best technique for graft surveillance.
- Complications of reperfusion of ischemic tissue include compartment syndrome, lactic acidosis, hyperkalemia, myoglobinuria, and technical problems with grafts.
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Description
Test your knowledge about Leriche syndrome, a condition characterized by absence of femoral pulses, buttock or thigh claudication, and impotence due to reduced flow in the internal iliac arteries. Explore the most common atherosclerotic occlusion in lower extremities and collateral circulation pathways.
