{"id":5109,"date":"2011-07-14T20:23:31","date_gmt":"2011-07-14T20:23:31","guid":{"rendered":"http:\/\/crashtext.org\/misc\/5109.htm\/"},"modified":"2013-01-01T14:37:00","modified_gmt":"2013-01-01T19:37:00","slug":"peripheral-vascular-disease","status":"publish","type":"post","link":"https:\/\/crashingpatient.com\/medical-surgical\/peripheral-vascular-disease.htm\/","title":{"rendered":"Peripheral Vascular Disease"},"content":{"rendered":"<h2>Acute arterial occlusion<\/h2>\n<p><a href=\"https:\/\/crashingpatient.com\/wp-content\/uploads\/2011\/07\/rutherford-limb-ischemia.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-9023\" alt=\"rutherford-limb-ischemia\" src=\"https:\/\/crashingpatient.com\/wp-content\/uploads\/2011\/07\/rutherford-limb-ischemia-600x96.jpg\" width=\"600\" height=\"96\" srcset=\"https:\/\/crashingpatient.com\/wp-content\/uploads\/2011\/07\/rutherford-limb-ischemia-600x96.jpg 600w, https:\/\/crashingpatient.com\/wp-content\/uploads\/2011\/07\/rutherford-limb-ischemia-1024x164.jpg 1024w, https:\/\/crashingpatient.com\/wp-content\/uploads\/2011\/07\/rutherford-limb-ischemia.jpg 1201w\" sizes=\"(max-width: 600px) 100vw, 600px\" \/><\/a><\/p>\n<ul>\n<li>Usually thrombotic occlusions are class I or IIA and are treated with intra-arterial thrombolysis if symptom duration &lt;14 days (especially if bypass graft occlusion) and if patient has significant co-morbidities\/high operative risk.<\/li>\n<li>Usually embolic occlusions are class IIB or III.\u00a0 They usually require surgery as thrombolytics take effect too slowly.<\/li>\n<\/ul>\n<p>Pain, pallor, pulselessness, paresthesias, paralysis<\/p>\n<p>Venous ulcers-prox to or at ankle, especially medial malleolus<\/p>\n<p>Buerger\u0092s disease-hands and feet, 20 y\/o men who smoke<\/p>\n<p>Arterial Embolism-4-6 hours for limb salvage. Heparin (80,18)<\/p>\n<p>Ulnar artery aneurysm-hypothenar hammer syndrome\u00a0 (using hand to bang)<\/p>\n<p>Mycotic aneurysm-from endocarditis<\/p>\n<p>Vasculitides<\/p>\n<p><a href=\"#_Chapter_17-Headache\">Temporal arteritis<\/a><\/p>\n<p>Henoch-Schonlein purpura-palpable purpura, abd pain, arthritis<\/p>\n<p>&nbsp;<\/p>\n<p>Thoracic Outlet syndrome-test c EAST (elevated arm stress test)-arms abducted at 90, elbows flexed 90.\u00a0 Open and close fists for 3 minutes.\u00a0 Numbness or limb heaviness is positive<\/p>\n<p>HD catheters which get obstructed-try urokinase (5000 u)<\/p>\n<p>Use venous side of fistula or graft for blood draw.<\/p>\n<p>&nbsp;<\/p>\n<p>|\u00a0\u00a0 \u00a0\u00a0 |\u00a0\u00a0 \u00a0\u00a0 |<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Array<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[8],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.6 - 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