Peripheral Vascular DiseaseJoel Arudchelvam

Peripheral arteriesArteries outside of chest and abdomenDiseases Occlusive [OAD]AneurysmalInflamatoryOthers

OADCausesAtheromatousRisk Factors SmokingDiabetesHypertensionHyperlipidemiaAdvanced ageInflammatoryTrauma

PresentationClaudicationRest painUlcerGangrene

ExaminationVascular - pulse status

Pulse strength0 - no pulse1 - faint pulse2 - diminished than normal3 - normal 4 - bounding

ExaminationAnkle Brachial Pressure index - ankle perssure/ Brachial pressureNormal – 0.9 to 1.3

Lower limb arteries

Pulse status and possible sites of occlusion

Pulse status and possible sites of occlusionAorto iliac disease

Pulse status and possible sites of occlusionFem-pop disease

Pulse status and possible sites of occlusion

Investigations General FBC,SCR,SE,FBS,LIPID PROFILETo localise and to plan intervention USS + DOPPLER CT/MR ANGIOGRAPHY

ManagementMedicalGraded exercisesAspirin Lipid lowering drugsCilostazolPentoxifyllineFoot careAggressive control of co-morbid diseases

ManagementIndications for intervention1. Disabling claudication2. Rest pain3. Tissue loss

ManagementEndovascular1.angioplasty and/2.stentingSurgical1.Bypass2.EndarterctomyAmputation

Bypass

Conduits1. Autogenous saphenous vein2. Synthetic PTFE DACRON(polyester)

OutcomeMajor cause of mortality in PVD is cardiac and cerebrovascular disease

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