Discussing the risk factors causing Gangrene, and the development of Peripheral Vascular Disease. Role of non surgical Vascular Interventions and Hyperbaric Oxygen treatment in treating Peripheral Arterial disease.
It is estimated that 20% of American women and 7% of American men suffer from venous disease. Venous disease results in symptoms such as aching, fatigue, swelling, and pain in the legs which can interfere with daily living.Cosmetic issues may affect quality of life.
At least 20% of patients with venous disease will develop leg ulcers. This presentation outlines the normal anatomy and physiology of venous drainage of the extremities as well as the common venous disorders such as varicose veins and deep vein thrombosis.
Deep vein thrombosis is a blood clot that forms in the deep veins, usually in the legs. It can cause complications like pulmonary embolism. Risk factors include age over 60, obesity, immobility, surgery, and inherited or acquired hypercoagulable states. Diagnosis is made using ultrasound, CT, or MRI imaging to detect clots. Treatment involves blood thinners like heparin and warfarin to prevent clot growth and reduce risk of embolism. Prophylaxis with compression stockings or blood thinners is important for high risk patients like those having surgery.
The document discusses the anatomy and pathophysiology of the venous system in the lower extremities. It describes the deep and superficial venous systems, including the great and small saphenous veins, and the perforating veins that connect them. It explains how the musculovenous pump and one-way valves work to pump blood out of the legs, and how valve dysfunction or reflux can lead to varicose veins. Doppler exams are used to detect normal versus refluxing blood flow.
1. Stroke occurs when the blood supply to the brain is reduced or blocked, preventing brain tissue from receiving oxygen and nutrients.
2. Strokes are classified as either ischemic (caused by blockage of arteries) or hemorrhagic (caused by bleeding in or around the brain).
3. Common symptoms of stroke include sudden weakness or numbness on one side of the body, difficulty speaking, confusion, and severe headache. Early recognition and treatment are important to reduce long-term disability.
This document summarizes common venous disorders, including varicose veins, superficial thrombophlebitis, deep vein thrombosis (DVT), and their causes, risk factors, symptoms, diagnosis, and treatment. Some key points:
- Varicose veins are abnormally dilated and tortuous veins caused by increased pressure and valve incompetence. Risk factors include family history, pregnancy, and obesity. Treatment includes compression stockings, sclerotherapy, and surgery.
- DVT occurs when blood clots form in the deep veins, usually in the legs. It can cause leg swelling/pain and potentially fatal pulmonary embolism. Risk increases with age, surgery, trauma, cancer, and genetic factors. Ul
Deep vein thrombosis is the formation of a blood clot in the deep veins, usually in the legs. It is caused by Virchow's triad of endothelial injury, hypercoagulability, and venous stasis. Common risk factors include immobilization, surgery, cancer, and family history. Ultrasound is the investigation of choice and treatment involves anticoagulants like heparin, low molecular weight heparin, or warfarin to prevent pulmonary embolism, a potentially fatal complication.
Deep vein thrombosis (DVT), is the formation of a blood clot in a deep vein, most commonly the legs.[2][a] Symptoms may include pain, swelling, redness, or warmth of the affected area. About half of cases have no symptoms. Complications may include pulmonary embolism, as a result of detachment of a clot which travels to the lungs, and post-thrombotic syndrome.[2][3]
Risk factors include recent surgery, cancer, trauma, lack of movement, obesity, smoking, hormonal birth control, pregnancy and the period following birth, antiphospholipid syndrome, and certain genetic conditions. Genetic factors include deficiencies of antithrombin, protein C, and protein S, and factor V Leiden mutation. The underlying mechanism typically involves some combination of decreased blood flow rate, increased tendency to clot, and injury to the blood vessel wall.
This document defines peripheral artery disease and describes its causes and presentation. PAD is caused by a reduction of blood flow in the arteries due to stenosis or occlusion. Major causes include atherosclerosis, Buerger's disease, vasospastic disorders like Raynaud's, and vasculitis. Clinical features include trophic skin changes, absent pulses, and symptoms ranging from intermittent claudication to critical limb ischemia. Diagnosis involves imaging like Doppler and angiography. Treatment options include conservative management, endovascular procedures like angioplasty, and open surgeries like bypass grafts and amputation.
It is estimated that 20% of American women and 7% of American men suffer from venous disease. Venous disease results in symptoms such as aching, fatigue, swelling, and pain in the legs which can interfere with daily living.Cosmetic issues may affect quality of life.
At least 20% of patients with venous disease will develop leg ulcers. This presentation outlines the normal anatomy and physiology of venous drainage of the extremities as well as the common venous disorders such as varicose veins and deep vein thrombosis.
Deep vein thrombosis is a blood clot that forms in the deep veins, usually in the legs. It can cause complications like pulmonary embolism. Risk factors include age over 60, obesity, immobility, surgery, and inherited or acquired hypercoagulable states. Diagnosis is made using ultrasound, CT, or MRI imaging to detect clots. Treatment involves blood thinners like heparin and warfarin to prevent clot growth and reduce risk of embolism. Prophylaxis with compression stockings or blood thinners is important for high risk patients like those having surgery.
The document discusses the anatomy and pathophysiology of the venous system in the lower extremities. It describes the deep and superficial venous systems, including the great and small saphenous veins, and the perforating veins that connect them. It explains how the musculovenous pump and one-way valves work to pump blood out of the legs, and how valve dysfunction or reflux can lead to varicose veins. Doppler exams are used to detect normal versus refluxing blood flow.
1. Stroke occurs when the blood supply to the brain is reduced or blocked, preventing brain tissue from receiving oxygen and nutrients.
2. Strokes are classified as either ischemic (caused by blockage of arteries) or hemorrhagic (caused by bleeding in or around the brain).
3. Common symptoms of stroke include sudden weakness or numbness on one side of the body, difficulty speaking, confusion, and severe headache. Early recognition and treatment are important to reduce long-term disability.
This document summarizes common venous disorders, including varicose veins, superficial thrombophlebitis, deep vein thrombosis (DVT), and their causes, risk factors, symptoms, diagnosis, and treatment. Some key points:
- Varicose veins are abnormally dilated and tortuous veins caused by increased pressure and valve incompetence. Risk factors include family history, pregnancy, and obesity. Treatment includes compression stockings, sclerotherapy, and surgery.
- DVT occurs when blood clots form in the deep veins, usually in the legs. It can cause leg swelling/pain and potentially fatal pulmonary embolism. Risk increases with age, surgery, trauma, cancer, and genetic factors. Ul
Deep vein thrombosis is the formation of a blood clot in the deep veins, usually in the legs. It is caused by Virchow's triad of endothelial injury, hypercoagulability, and venous stasis. Common risk factors include immobilization, surgery, cancer, and family history. Ultrasound is the investigation of choice and treatment involves anticoagulants like heparin, low molecular weight heparin, or warfarin to prevent pulmonary embolism, a potentially fatal complication.
Deep vein thrombosis (DVT), is the formation of a blood clot in a deep vein, most commonly the legs.[2][a] Symptoms may include pain, swelling, redness, or warmth of the affected area. About half of cases have no symptoms. Complications may include pulmonary embolism, as a result of detachment of a clot which travels to the lungs, and post-thrombotic syndrome.[2][3]
Risk factors include recent surgery, cancer, trauma, lack of movement, obesity, smoking, hormonal birth control, pregnancy and the period following birth, antiphospholipid syndrome, and certain genetic conditions. Genetic factors include deficiencies of antithrombin, protein C, and protein S, and factor V Leiden mutation. The underlying mechanism typically involves some combination of decreased blood flow rate, increased tendency to clot, and injury to the blood vessel wall.
This document defines peripheral artery disease and describes its causes and presentation. PAD is caused by a reduction of blood flow in the arteries due to stenosis or occlusion. Major causes include atherosclerosis, Buerger's disease, vasospastic disorders like Raynaud's, and vasculitis. Clinical features include trophic skin changes, absent pulses, and symptoms ranging from intermittent claudication to critical limb ischemia. Diagnosis involves imaging like Doppler and angiography. Treatment options include conservative management, endovascular procedures like angioplasty, and open surgeries like bypass grafts and amputation.
This document discusses pulmonary embolism (PE), which occurs when a blood clot breaks off and travels to the lungs. It defines PE and classifies the severity. Risk factors include prolonged bed rest, surgery, cancer, and inherited or acquired hypercoagulable states. Symptoms are often nonspecific but include chest pain and difficulty breathing. PE is caused by deep vein thrombosis (DVT) in the legs traveling to the lungs. The diagnosis is challenging due to vague symptoms but is important because untreated PE can be fatal.
Deep Vein Thrombosis in stroke patientsAhmed Mohamed
Deep vein thrombosis is a serious complication in stroke patients that can lead to pulmonary embolism. The risk of DVT is highest in the first 2 weeks after stroke and ranges from 10-75% depending on diagnostic method. Major risk factors include advanced age, immobility, atrial fibrillation, and prior history of DVT. Ultrasound is the initial test of choice to diagnose DVT. Treatment involves anticoagulation to prevent pulmonary embolism, while risks of anticoagulation must be weighed for patients with hemorrhagic stroke. Prophylaxis recommendations include early mobilization, low molecular weight heparin, pneumatic compression devices, and the Caprini risk assessment score to determine
1) Acute limb ischemia is a sudden decrease in blood flow to a limb that threatens viability and requires urgent treatment. It has an incidence of about 1.5 cases per 10,000 people per year.
2) Causes include arterial embolism (from cardiac or arterial sources), native arterial thrombosis, arterial thrombosis after intervention, and arterial injury.
3) Diagnosis involves history, physical exam assessing pain and function, and imaging tests like Doppler ultrasound and angiography.
4) Treatment depends on viability of the limb and includes oxygen, fluids, anticoagulation, analgesia, and revascularization through catheter-directed thrombolysis, open surgery, or bypass if other options fail. Comp
1) PAD is associated with increased risk of myocardial infarction and ischemic stroke due to shared risk factors of atherosclerosis.
2) Clinical features of PAD range from asymptomatic to intermittent claudication to critical limb ischemia manifested by rest pain, ulcers or gangrene.
3) Diagnosis involves assessment of symptoms and risk factors as well as tests such as ankle-brachial index, duplex ultrasound and angiography. Treatment depends on severity and may include lifestyle modification, medication, angioplasty or bypass surgery.
whom that have sx of swelling leg, painful when walking and raise up leg, redness of leg skin, have history of accident or long journey u are suspected had deep vein thrombosis.
1) Deep vein thrombosis is a blood clot that forms in the deep veins, usually of the legs. It can break off and travel to the lungs, blocking blood flow (pulmonary embolism).
2) Risk factors include prolonged bed rest, surgery, cancer, and inherited or acquired hypercoagulable states. Symptoms include leg pain, swelling, warmth, and redness. Diagnosis involves a clinical evaluation along with D-dimer testing and ultrasound imaging of the legs.
3) Treatment focuses on blood thinners to prevent clot growth and reduce the risk of embolism. Left untreated, a DVT can lead to long-term leg damage or potentially fatal blockages in
This document discusses deep vein thrombosis (DVT), including its anatomy, pathophysiology, risk factors, clinical presentation, diagnosis, complications, and treatment. DVT is a blood clot that forms in the deep veins, usually in the legs. It is caused by Virchow's triad of venous stasis, endothelial injury, and hypercoagulability. Common risk factors include immobilization, surgery, pregnancy, and genetic thrombophilias. Ultrasound is the primary diagnostic tool. Complications can include pulmonary embolism. Initial treatment involves anticoagulants like low molecular weight heparin or warfarin to prevent clot propagation and embolism.
Deep vein thrombosis is a blood clot that forms in the deep veins, usually of the legs. It can dislodge and travel to the lungs, causing a pulmonary embolism. Risk factors include surgery, trauma, cancer, and prolonged immobility. Symptoms may include leg pain, swelling, redness, and warmth. Diagnosis involves assessing risk factors and testing such as ultrasound, venography, MRI, or D-dimer blood test. Treatment focuses on blood thinners to prevent clot growth and embolism.
Pulmonary embolism is a blockage in the pulmonary artery or its branches, usually caused by blood clots from deep vein thrombosis. It occurs in over 600,000 patients annually in the US and contributes to 50,000-200,000 deaths per year. Common signs and symptoms include dyspnea, chest pain, tachycardia, and hypoxia. Diagnostic tests include chest x-rays, CT scans, D-dimer tests, V/Q scans, and blood gas analysis. Treatment involves anticoagulant therapy, thrombolytic therapy, bed rest, and in severe cases, surgical embolectomy.
Chronic Venous Insufficiency (CVI) is a common progressive disorder affecting the legs that is caused by chronic venous hypertension. It is estimated to affect 5-15% of the adult population. CVI has major health and economic impacts, consuming 1-2% of European healthcare budgets and costing over 1 billion Euros annually in some countries. The hallmark of CVI is distal venous hypertension leading to valvular incompetence, reflux, and venous obstruction over time.
Deep vein thrombosis (DVT) is a blood clot that forms in the deep veins, usually in the legs. Virchow's triad of venous stasis, hypercoagulability, and endothelial injury can lead to thrombus formation. Risk factors include age, immobilization, surgery, cancer, and genetic factors. Patients may experience pain, swelling, warmth, and tenderness. Diagnosis involves a Wells score, D-dimer test, ultrasound or venography. Treatment is anticoagulation with heparin, low molecular weight heparin, fondaparinux, or warfarin to prevent pulmonary embolism. Long-term anticoagulation and compression stockings can help prevent
This document discusses pulmonary embolism (PE), including its definition, epidemiology, pathophysiology, risk factors, diagnosis, and treatment. PE refers to obstruction of the pulmonary artery or its branches by material originating elsewhere in the body. It affects around 5 million people annually worldwide and can be life-threatening. Diagnosis involves evaluating risk factors, symptoms, imaging tests like CT scans, and blood tests like D-dimer. Timely diagnosis and treatment are important to prevent right heart failure or death from PE.
This document discusses classification and treatment of venous disorders of the extremities. It classifies diseases by location such as the superior and inferior vena cava, describes conditions like thrombophlebitis, varicose veins and post-thrombophlebitic syndrome. Diagnostic tests and stages of chronic venous insufficiency are outlined. Conservative treatments include compression therapy, medications and anticoagulants. Surgical options are described for eliminating reflux and removing varicose veins.
Venous insufficiency dvt - final year mbbs lectureMr Adeel Abbas
This document discusses deep vein thrombosis (DVT), including its causes, risk factors, diagnosis, and treatment. It notes that DVT occurs when blood clots form in the deep veins, most commonly in the legs. It describes Virchow's triad, the three factors that contribute to DVT risk: venous stasis, hypercoagulability, and endothelial injury. Common signs of DVT include calf pain and swelling; diagnosis involves tests like ultrasound, MRI, or blood tests. Treatment aims to prevent clots from growing (prophylaxis) such as with blood thinners, compression stockings, or devices, as well as definitive treatments like continued anticoagulation or thrombolysis for severe cases.
Deep Vein Thrombosis (DVT) is a blood clot that forms in the deep veins of the legs, thighs, pelvis or arms. Risk factors for DVT include immobilization, recent surgery or trauma, certain medications, and inherited or acquired hypercoagulability. Symptoms include leg pain, tenderness, swelling, warmth, and skin discoloration of one leg. Diagnosis is made through Doppler ultrasound, CT venography, or MRI imaging along with blood tests. Treatment involves anticoagulant drugs like heparin or warfarin to prevent pulmonary embolism and further clots.
This document discusses venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE). It covers the pathophysiology of VTE involving Virchow's triad of venous stasis, endothelial injury, and hypercoagulability. Evaluation and diagnostic methods are described, including clinical assessment, d-dimer testing, ultrasound, CT, lung scanning, and angiography. Management includes anticoagulation with unfractionated heparin, low molecular weight heparin, fondaparinux, vitamin K antagonists, and direct thrombin inhibitors. Outcomes of both DVT and PE such as post-thrombotic syndrome and mortality are addressed
This document provides information on hemorrhage (excessive blood loss). It defines hemorrhage and describes the natural process of clotting to stop bleeding. Causes of hemorrhage include wounds, fractures, surgery, and accidents. Stages and classifications of hemorrhage severity are presented. Signs and symptoms ranging from mild pallor to life-threatening shock are outlined. First aid treatments and nursing management of hemorrhage are discussed.
Nursing Care of Clients with Peripheral Vascular Disorders Part 2 of 3 Carmela Domocmat
Nursing Care of Clients with Peripheral Vascular Disorders Part 2 of 3: Arterial disorders such as Arterial occlusive disease, Arterial embolism, Arterial thrombosis, Thromboangiitis obliterans (Buerger’s disease), Aortitis, Aortoiliac disease, Aneurysms, Raynaud’s disease, and Thoracic outlet syndrome
This document discusses pulmonary embolism (PE), which occurs when a blood clot breaks off and travels to the lungs. It defines PE and classifies the severity. Risk factors include prolonged bed rest, surgery, cancer, and inherited or acquired hypercoagulable states. Symptoms are often nonspecific but include chest pain and difficulty breathing. PE is caused by deep vein thrombosis (DVT) in the legs traveling to the lungs. The diagnosis is challenging due to vague symptoms but is important because untreated PE can be fatal.
Deep Vein Thrombosis in stroke patientsAhmed Mohamed
Deep vein thrombosis is a serious complication in stroke patients that can lead to pulmonary embolism. The risk of DVT is highest in the first 2 weeks after stroke and ranges from 10-75% depending on diagnostic method. Major risk factors include advanced age, immobility, atrial fibrillation, and prior history of DVT. Ultrasound is the initial test of choice to diagnose DVT. Treatment involves anticoagulation to prevent pulmonary embolism, while risks of anticoagulation must be weighed for patients with hemorrhagic stroke. Prophylaxis recommendations include early mobilization, low molecular weight heparin, pneumatic compression devices, and the Caprini risk assessment score to determine
1) Acute limb ischemia is a sudden decrease in blood flow to a limb that threatens viability and requires urgent treatment. It has an incidence of about 1.5 cases per 10,000 people per year.
2) Causes include arterial embolism (from cardiac or arterial sources), native arterial thrombosis, arterial thrombosis after intervention, and arterial injury.
3) Diagnosis involves history, physical exam assessing pain and function, and imaging tests like Doppler ultrasound and angiography.
4) Treatment depends on viability of the limb and includes oxygen, fluids, anticoagulation, analgesia, and revascularization through catheter-directed thrombolysis, open surgery, or bypass if other options fail. Comp
1) PAD is associated with increased risk of myocardial infarction and ischemic stroke due to shared risk factors of atherosclerosis.
2) Clinical features of PAD range from asymptomatic to intermittent claudication to critical limb ischemia manifested by rest pain, ulcers or gangrene.
3) Diagnosis involves assessment of symptoms and risk factors as well as tests such as ankle-brachial index, duplex ultrasound and angiography. Treatment depends on severity and may include lifestyle modification, medication, angioplasty or bypass surgery.
whom that have sx of swelling leg, painful when walking and raise up leg, redness of leg skin, have history of accident or long journey u are suspected had deep vein thrombosis.
1) Deep vein thrombosis is a blood clot that forms in the deep veins, usually of the legs. It can break off and travel to the lungs, blocking blood flow (pulmonary embolism).
2) Risk factors include prolonged bed rest, surgery, cancer, and inherited or acquired hypercoagulable states. Symptoms include leg pain, swelling, warmth, and redness. Diagnosis involves a clinical evaluation along with D-dimer testing and ultrasound imaging of the legs.
3) Treatment focuses on blood thinners to prevent clot growth and reduce the risk of embolism. Left untreated, a DVT can lead to long-term leg damage or potentially fatal blockages in
This document discusses deep vein thrombosis (DVT), including its anatomy, pathophysiology, risk factors, clinical presentation, diagnosis, complications, and treatment. DVT is a blood clot that forms in the deep veins, usually in the legs. It is caused by Virchow's triad of venous stasis, endothelial injury, and hypercoagulability. Common risk factors include immobilization, surgery, pregnancy, and genetic thrombophilias. Ultrasound is the primary diagnostic tool. Complications can include pulmonary embolism. Initial treatment involves anticoagulants like low molecular weight heparin or warfarin to prevent clot propagation and embolism.
Deep vein thrombosis is a blood clot that forms in the deep veins, usually of the legs. It can dislodge and travel to the lungs, causing a pulmonary embolism. Risk factors include surgery, trauma, cancer, and prolonged immobility. Symptoms may include leg pain, swelling, redness, and warmth. Diagnosis involves assessing risk factors and testing such as ultrasound, venography, MRI, or D-dimer blood test. Treatment focuses on blood thinners to prevent clot growth and embolism.
Pulmonary embolism is a blockage in the pulmonary artery or its branches, usually caused by blood clots from deep vein thrombosis. It occurs in over 600,000 patients annually in the US and contributes to 50,000-200,000 deaths per year. Common signs and symptoms include dyspnea, chest pain, tachycardia, and hypoxia. Diagnostic tests include chest x-rays, CT scans, D-dimer tests, V/Q scans, and blood gas analysis. Treatment involves anticoagulant therapy, thrombolytic therapy, bed rest, and in severe cases, surgical embolectomy.
Chronic Venous Insufficiency (CVI) is a common progressive disorder affecting the legs that is caused by chronic venous hypertension. It is estimated to affect 5-15% of the adult population. CVI has major health and economic impacts, consuming 1-2% of European healthcare budgets and costing over 1 billion Euros annually in some countries. The hallmark of CVI is distal venous hypertension leading to valvular incompetence, reflux, and venous obstruction over time.
Deep vein thrombosis (DVT) is a blood clot that forms in the deep veins, usually in the legs. Virchow's triad of venous stasis, hypercoagulability, and endothelial injury can lead to thrombus formation. Risk factors include age, immobilization, surgery, cancer, and genetic factors. Patients may experience pain, swelling, warmth, and tenderness. Diagnosis involves a Wells score, D-dimer test, ultrasound or venography. Treatment is anticoagulation with heparin, low molecular weight heparin, fondaparinux, or warfarin to prevent pulmonary embolism. Long-term anticoagulation and compression stockings can help prevent
This document discusses pulmonary embolism (PE), including its definition, epidemiology, pathophysiology, risk factors, diagnosis, and treatment. PE refers to obstruction of the pulmonary artery or its branches by material originating elsewhere in the body. It affects around 5 million people annually worldwide and can be life-threatening. Diagnosis involves evaluating risk factors, symptoms, imaging tests like CT scans, and blood tests like D-dimer. Timely diagnosis and treatment are important to prevent right heart failure or death from PE.
This document discusses classification and treatment of venous disorders of the extremities. It classifies diseases by location such as the superior and inferior vena cava, describes conditions like thrombophlebitis, varicose veins and post-thrombophlebitic syndrome. Diagnostic tests and stages of chronic venous insufficiency are outlined. Conservative treatments include compression therapy, medications and anticoagulants. Surgical options are described for eliminating reflux and removing varicose veins.
Venous insufficiency dvt - final year mbbs lectureMr Adeel Abbas
This document discusses deep vein thrombosis (DVT), including its causes, risk factors, diagnosis, and treatment. It notes that DVT occurs when blood clots form in the deep veins, most commonly in the legs. It describes Virchow's triad, the three factors that contribute to DVT risk: venous stasis, hypercoagulability, and endothelial injury. Common signs of DVT include calf pain and swelling; diagnosis involves tests like ultrasound, MRI, or blood tests. Treatment aims to prevent clots from growing (prophylaxis) such as with blood thinners, compression stockings, or devices, as well as definitive treatments like continued anticoagulation or thrombolysis for severe cases.
Deep Vein Thrombosis (DVT) is a blood clot that forms in the deep veins of the legs, thighs, pelvis or arms. Risk factors for DVT include immobilization, recent surgery or trauma, certain medications, and inherited or acquired hypercoagulability. Symptoms include leg pain, tenderness, swelling, warmth, and skin discoloration of one leg. Diagnosis is made through Doppler ultrasound, CT venography, or MRI imaging along with blood tests. Treatment involves anticoagulant drugs like heparin or warfarin to prevent pulmonary embolism and further clots.
This document discusses venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE). It covers the pathophysiology of VTE involving Virchow's triad of venous stasis, endothelial injury, and hypercoagulability. Evaluation and diagnostic methods are described, including clinical assessment, d-dimer testing, ultrasound, CT, lung scanning, and angiography. Management includes anticoagulation with unfractionated heparin, low molecular weight heparin, fondaparinux, vitamin K antagonists, and direct thrombin inhibitors. Outcomes of both DVT and PE such as post-thrombotic syndrome and mortality are addressed
This document provides information on hemorrhage (excessive blood loss). It defines hemorrhage and describes the natural process of clotting to stop bleeding. Causes of hemorrhage include wounds, fractures, surgery, and accidents. Stages and classifications of hemorrhage severity are presented. Signs and symptoms ranging from mild pallor to life-threatening shock are outlined. First aid treatments and nursing management of hemorrhage are discussed.
Nursing Care of Clients with Peripheral Vascular Disorders Part 2 of 3 Carmela Domocmat
Nursing Care of Clients with Peripheral Vascular Disorders Part 2 of 3: Arterial disorders such as Arterial occlusive disease, Arterial embolism, Arterial thrombosis, Thromboangiitis obliterans (Buerger’s disease), Aortitis, Aortoiliac disease, Aneurysms, Raynaud’s disease, and Thoracic outlet syndrome
Peripheral vascular disease (PVD) is caused by a buildup of plaque in the arteries that reduces blood flow. It most commonly affects arteries in the legs. PVD is usually caused by atherosclerosis and is associated with risk factors like smoking, diabetes, and hypertension. Symptoms include leg pain when walking or at rest. Diagnosis involves tests like the ankle-brachial index. Treatment focuses on risk factor modification through exercise, medication, and lifestyle changes. More severe cases may require procedures like angioplasty, stents, or surgery to improve blood flow.
This document discusses peripheral artery disease (PAD), including:
- PAD affects over 200 million people worldwide and causes intermittent claudication in 5% of men and 2.5% of women.
- Patients at highest risk include those over 65, males, diabetics, smokers, and those with an ankle-brachial index over 0.9.
- Diagnosis involves history, physical exam including pulse checks, ankle-brachial index, and tests like duplex ultrasound, angiography.
- Treatment involves risk factor modification, exercise, medications like cilostazol, and referral for revascularization for severe or critical limb ischemia.
This document provides information on diabetic foot, including its definition, epidemiology, pathophysiology, risk factors, patient evaluation, classification, and treatment modalities. Some key points include:
- Diabetic foot is defined as foot pathology resulting from diabetes or its complications and affects around 15% of diabetics in their lifetime.
- Risk factors for diabetic foot include peripheral neuropathy, peripheral arterial disease, foot deformities, and poor glycemic control.
- Pathophysiology involves diabetic angiopathy reducing blood supply, neuropathy damaging sensation, and osteoarthropathy causing deformities - all of which can lead to foot ulcers and infection.
- Patient evaluation includes assessment of dermatological features, musculoskeletal structure
La rivascolarizzazione degli arti inferiori nel paziente anziano: rischi e va...ASMaD
Presentazione a cura del Professor Angelo Cioppa - XII° Congresso Nazionale FIMeG 2018 - The Silver Tsunami: l'anziano fra appropriatezza e farmaeconomia
This document discusses peripheral arterial diseases of the extremities. It notes that the prevalence increases with age and risk factors like atherosclerosis. Peripheral arterial disease is defined as an ankle-brachial index of less than 0.9. Risk factors include atherosclerosis, smoking, diabetes, and hypertension. Symptoms range from intermittent claudication to critical limb ischemia with ulcers or gangrene. Diagnosis involves medical history, physical exam, and tests like ABI. Treatment focuses on risk factor modification and revascularization for severe symptoms.
PHYSIOTHERAPY IN COMMON VASCULAR CONDITIONS.pptxKunjalPardeshi1
Vascular disease includes any condition that affects your circulatory system, or system of blood vessels. This ranges from diseases of your arteries, veins and lymph vessels to blood disorders that affect circulation.
Blood vessels are elastic-like tubes that carry blood to every part of your body. Blood vessels include:
Arteries that carry blood away from your heart.
Veins that return blood back to your heart.
Capillaries, your tiniest blood vessels, which link your small veins and arteries, deliver oxygen and nutrients to your tissues and take away their waste.
The document discusses varicose veins and venous thrombosis. It defines varicose veins as dilated, elongated veins caused by venous hypertension. Valves in the veins and factors like muscle contraction help venous return. Varicose veins are caused by prolonged standing, family history, pregnancy, aging and other factors. Symptoms include leg pain, swelling and heaviness. Treatment involves leg elevation, compression stockings, sclerotherapy and surgery. Venous thrombosis occurs when blood clots form in the veins. Risk factors include immobility, surgery and genetic factors. Symptoms are pain, swelling and fever. Treatment aims to prevent further clots and embolisms with anticoagulants, compression and exercise. Nursing
This document provides information on deep vein thrombosis (DVT), including:
- DVT occurs when a blood clot forms in a deep vein, most often in the leg. Part of the clot can break off and cause a pulmonary embolism.
- Risk factors include pregnancy and immobilization. Ultrasound is the main imaging method used to diagnose DVT.
- Ultrasound findings of DVT include non-compressible veins, lack of flow, and visualization of thrombus within the vein. Differential diagnoses when DVT is ruled out include muscle injuries, hernias, cysts, and arterial diseases. Proper patient positioning and knowledge of anatomy are important for accurate ultrasound evaluation.
Deep vein thrombosis is a blood clot that forms in the deep veins, usually of the legs. Risk factors include prolonged bed rest, surgery, trauma, cancer, and genetic hypercoagulable states. Symptoms include leg pain, swelling, and shortness of breath. Ultrasound is commonly used for diagnosis. Treatment involves anticoagulation with heparin or warfarin to prevent pulmonary embolism complications.
Buerger's disease is a progressive inflammatory disease that causes blockages in small and medium blood vessels, most commonly in the lower limbs of young and middle-aged male smokers. It presents with symptoms like intermittent claudication pain, rest pain, ulceration, and gangrene. Investigations show decreased or absent pulses distal to blockages. Angiography reveals blockages, corkscrew collaterals, and poor distal blood flow in advanced cases. Treatment focuses on quitting smoking and medications to reduce inflammation and promote collateral circulation. Surgery may be needed for severe cases involving amputation or revascularization procedures like omentoplasty.
The document discusses the stepwise management of hemoptysis. It defines hemoptysis and massive hemoptysis. The most common causes in Egypt are discussed. Steps in diagnosis include history, exams, labs, imaging like CXR, CT, bronchoscopy. Treatment depends on localization and cause but may include bronchoscopic interventions, bronchial artery embolization, or surgery. Disease-specific approaches are also outlined. Three case studies are presented to demonstrate tailored management of hemoptysis.
Thoraco Abdominal Aortic Aneurysm technique for present ok.pptxPeter Flash
1) The document discusses various techniques for organ protection during surgery for thoracoabdominal aortic aneurysm (TAAA), including spinal cord, renal, and visceral protection.
2) For spinal cord protection, techniques discussed include maintaining adequate blood pressure and cerebrospinal fluid drainage to decrease pressure on the spinal cord. Renal protection methods include intermittent cold crystalloid perfusion or localized hypothermia to protect the kidneys from ischemia.
3) The document also discusses maintaining perfusion to other organs like the brain and heart, as well as distal perfusion techniques using left heart bypass or fem-fem bypass to maintain lower body blood flow during aortic clamping.
Peripheral arterial disease (PAD) is a circulatory condition where narrowed arteries reduce blood flow to the limbs, typically causing leg pain with walking. Exercise and lifestyle changes can help manage PAD symptoms and prevent progression. A study found that arm ergometry exercise alone significantly improved walking ability and time to onset of pain in PAD patients over 12 weeks compared to baseline. Specific yoga poses and breathing techniques may also help PAD symptoms.
VASCULITIS INTRODUCTION.
TYPES OF VASCULITIS
DIAGNOSING CRIERIA
TREATMENT AND GUIDELINES
DRUGS USED IN BURGER'S DISEASE
A CASE ON VASCULITIS
APPROACH OF TREATMENT
PATIENT COUNSELLING FOR THE PARTICULAR PATIENT
Fat embolism syndrome is a condition where fat particles travel through the bloodstream and lodge in blood vessels, potentially causing organ dysfunction. It most commonly occurs after long bone fractures or pelvic fractures. While fat emboli occur in most patients with these injuries, less than 10% exhibit clinical symptoms. Symptoms usually begin 1-3 days after injury and involve the lungs, brain, and skin. Diagnosis is clinical and treatment is supportive, focusing on oxygenation, ventilation, circulation, and early surgical fixation of fractures when possible. Prognosis is generally good, though neurological deficits can occasionally persist long-term.
This document discusses investigations and management of arterial diseases. Non-invasive testing includes segmental limb pressure tests, exercise testing, photoplethysmography, and duplex scanning to confirm, localize, and follow arterial disease. Invasive angiography provides diagnostic and therapeutic guidance and can be done via catheter, CT, or MR angiography. Endovascular procedures include balloon angioplasty, stenting, and atherectomy to treat aortoiliac and femoropopliteal lesions. Surgical options are recommended for more complex lesions and include aortobifemoral, axillobifemoral, and femoropopliteal bypasses using autografts or prosthetic grafts to revascular
Peripheral vascular disease is the disease that involves narrowing of blood vessels including artery , vein and lymphatic vessels. Here introduction, definition and Types of peripheral vascular
disease are well classified in flowchart. Types of arterial , venous and lymphatic disease described . All the diseases are explained with their definition, risk factors, causes, sign and symptoms,diagnostic evaluation,medical management, surgical management with diagramatic presentation, nursing management is explained. Youtube link of procedures is also available in ppt. Nursing diagnosis of PVD is included .
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Preventing gangrene and amputation by Vascular Interventions
1. Preventing Gangrene
and Saving Legs from
Amputation
DR SHOAIB F PADARIA
Interventional Cardiologist
Director, Department of Vascular
Sciences, Jaslok Hospital, Mumbai
5. Risk factors for PAD
Murabito JM et al. Circulation 1997;96:44–49; Laurila A et al. Arterioscler Throm Vasc Biol 1997;17:2910–2913;
Malinow MR et al. Circulation 1989;79:1180–1188; Brigden ML. Postgrad Med 1997;101:249–262.
Gender (male)
Age
Smoking
Hypertension
Diabetes
Hyperlipidaemia
Fibrinogen
Homocysteinaemia
PAD
Ischaemic
stroke
Myocardial
infarction
Atherosclerosis Atherothrombosis
6. Peripheral Arterial Diseases in
Diabetics has a Poor Prognosis
PAOD is 20 times more common in diabetics than non diabeticsLower limb amputation is 15 times more common in diabetics
Ten year incidence of lower limb amputation is 5.4% in type I
diabetes and 7.3% in type II
10% of diabetics will eventually get an ulcer ,
45% of ulcers are ischemic with associated neuropathy, infection,
biomechanical abnormalities and Charcot deformity
8. How dangerous is Peripheral Arterial Disease ?
Depends on the severity of Symptoms
Criqui MH et al. N Engl J Med 1992;326:381–
386.
Time (years)
0 2 4 6 8 10 12
0.00
0.25
0.50
0.75
1.00
Survival
Severe symptomatic
Symptomatic
Asymptomatic
Normal
10 year
Survival
Rates
9. PAD is a Dangerous Disease
5-year mortality rates
1American Cancer Society. Cancer Facts and Figures – 1997.
2Kampozinski RF, Bernhard VM. In: Vascular Surgery (Rutherford RB, ed). Philadelphia, PA: WB Saunders: 1989;chap
53.
15 18
28
38
86
0
10
20
30
40
50
60
70
80
90
100
Breast cancer1 Hodgkin's
disease1
PAD2 Colon and
rectal cancer1
Lung cancer1
Patients(%)
10. Main Symptom of Peripheral artery
disease
Claudication
Claudication is pain, tired or weak feeling that
occurs in the legs, usually during activity like
walking, and goes away a short time after rest
Complete relief of symptoms should occur
within 5 to 10 minutes.
It should not be necessary for the patient to sit
to obtain relief
14. Progression of Peripheral Arterial Disease
Critical Limb Ischemia leading to
Gangrene and Amputation
Initial Symptoms are usually Claudication Pain
Later Pain occurs even at rest
Skin changes, loss of hair, loss of nails, ulcer
23. In most patients,
regular exercise
helps to increase
the distance they
can walk before
they develop
claudication
pain.
This is because
of gradual
development of
new blood
vessels –
Collateral
circulation
24. Pharmacologic Treatment
• Pentoxiphylline
• Cilostazole
Only Two
Drugs have US
FDA approval
for Intermittent
Claudication
• Aspirin
• Clopidogrel
• Rivoroxaban
Other drugs
which are
commonly used
include :
Some Other Drugs which can be
used
• Naftidrofuryl
• Levocarnitine
Changes in
tissue
Metobolism
• L-Arginine
Enhanced
Nitric Oxide
Production
• Statins
• Prostaglandins
• ACE Inhibitors
Vasodilatory
Effects
30. Drug Coated Balloons and Stents
Decrease the Restenosis Rate
Use of Drugs like Sirolimus and Paclitaxel
31. When the Obstructive tissue is very large for Angioplasty
Debulking Technologies
Rotablator
Excimer Laser
Excisional Atherectomy
Orbital Atherectomy
Pathway Atherectomy
34. Aortic Occlusive Disease
68 year old female : Diabetes, Hypertension, Impaired Renal function
Severe Rest Pain in Both lower limbs, with both femoral arteries very feeble
Initially diagnosed as “Slipped Disc” and treated for one month
43. Superficial Femoral Artery
Most common site of Peripheral arterial disease
Most common cause of Claudication Pain
Total occlusive disease of SFA is 3 times more common than stenosis
Usually calcification is seen in the diseased segment of SFA
SFA disease tends to be bilateral and “mirrored” in the other leg
Profunda artery collaterals are usually present, and rate of critical limb
ischemia is 2-3% per year
49. Below Knee Disease
Most common in diabetic patients
Usually all three vessels, the Anterior
Tibial, Posterior Tibial and the
Peroneal artery are involved
Opening of even one of these
arteries is enough to salvage the leg
from amputation
50. Results of Treatment of Below knee Disease in Critical Limb Ischemia
71% clinical improvement at 19 months
• ( Cardiovasc Interv Rad 1992 ; 15 : 211 - 216 )
97% clinical improvement when restoration of straight line pulsatile flow to
foot ( Bakat et al )
Prevention of amputation :
: 88% Shwarten (Radiology 1988 ; 169 : 71 - 74 )
: 85% Buckhenham (Eur Jr Vasc Surg 1993 : 7: 21 - 25)
55. What about those patients
suffering from PAD whose
disease is not suitable for
either angioplasty or surgery ?
56. 42 year old diabetic
War injury to right leg resulting
in amputation
Non healing of infected stump
for 3 months
Advised amputation at hip
joint
INFECTED WOUND
57. 54 year old male smoker
Has developed gangrene of
the toes
Has been advised above
knee amputation
ARTERIAL WOUND
58. Treatment of Problem Wounds
• Add Hyperbaric Oxygen treatment
when needed
Infected wounds –
Proper surgical
debridement, antibiotics,
skin grafting if
necessary.
• Add Hyperbaric Oxygen treatment
when needed
Arterial wounds –
Restore arterial blood
flow by angioplasty or
vascular surgery
60. What is Hyperbaric Oxygen Therapy (HBOT)
HBOT is delivery of 100%
oxygen which is inhaled by
patients , while they are
inside a special hyperbaric
chamber which has a raised
pressure
62. Hyperbaric Oxygen Treatment
100% oxygen
About 1100 cubic feet of oxygen
treatment for a treatment time of
60 to90 minutes
About 5 to 7 patients can be
treated per chamber per day
Each patient may need
between 5 to 15 treatments
Outpatient Treatment
63. • By breathing 100%
oxygen at 1 atmospheric
pressure, hemoglobin gets
100% saturated.
• (Only 3% increase)
Effect on
Hemoglobin:
When you
normally breath
air at sea level –
1 atmosphere
( 760 mm Hg),
hemoglobin is
97% saturated
64. HBO mainly increases the dissolved oxygen
in plasma
Oxygen solubility in plasma is proportional to the
partial pressure of oxygen pO2.
Breathing air at 1 atm , gives 0.31 vol%
Breathing 100% oxygen at 1 atm, gives 2.1 vol%
Breathing 100% oxygen at 3 atm, gives 6.8 vol %
Breathing 100% oxygen at 3 atm, increases plasma
oxygen solubility 21 times
65. HBOT increases Oxygen diffusion into tissue
At 1 ata on air, capillary pO2 of about 100 mm Hg diffuses about 64
microns from functioning capillary
As pO2 increases, oxygen diffusion distance also increases
At pO2 of about 2000 mm Hg, oxygen diffusion distance increases about 4
fold.
3 atm2 atm1 atm
Capillary Tissue
66. How does HBOT lead to Wound Healing ?
Establishment of a gradient of Oxygen level
between the healthy tissue and the wound,
stimulates release of various vaso-active factors
which promote the formation of newer capillaries.
Multiple exposures to HBOT treatment are
necessary to establish this formation. Especially
useful in severe peripheral vascular disease
Neovascularisation – New Blood Vessel Formation
67. How does HBOT lead to Wound Healing ?
• Increases Leukocyte phagocytosis
• Improves bacterial killing by neutrophil-generated
high energy oxygen radicals
• Effect on Clostridium Perfringens (gas gangrene)
• Alpha toxin ceases at pO2 >250 mm Hg
• Bactericidal when pO2>1500 mm Hg
1: Leukocyte
Oxidative Killing
2: Converts anaerobic wounds with low pH to aerobic
wounds with normal pH – so kills anaerobic bacteria
Anti Bacterial Effect
68. How does HBOT lead to Wound Healing ?
Anti Bacterial Effect
3: Some antibiotics do not
work well in acidic pH –
HBOT converts to tissue to
normal pH
• Tobramycin and HBOT best
eradicates Pseudomonas aeroginosa
from infected bone (Mader JT et al ,
1987)
4: Adjunctive
role of HBOT:
69. How does HBOT lead to Wound Healing
?
By decreasing the
Tissue Edema
This decreases the
compression the blood
vessels, leading to
increased arterial flow, and
better return of blood by
the veins
The decreased edema
also allows for better
oxygen diffusion up to
the area of tissue which
needs more of oxygen
71. Conclusion
With use of currently
available technology, it is
possible to treat severely
diseased lower limb
arteries, including the
distal vessels of the foot
with angioplasty procedure
Early diagnosis and
treatment of PAOD
prevents progression
to critical limb
ischemia and gangrene
Prevention of
amputation and
maintaining mobility
in patients is the
greatest gift we can
give to our patients.
72. Thank
you
Vascular OPD at Jaslok Hospital
Monday, Wednesday and Friday
10 am to 11 am
Online Video
Consultations
8080802665 8010918000