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Understanding Peripheral Arterial Disease

Sep 23, 2024

Peripheral Arterial Disease (PAD) and Peripheral Bypass Graft

Peripheral Arterial Disease (PAD)

Definition

  • Inadequate blood flow to the extremities
  • Caused by atherosclerosis, leading to occluded blood vessels
  • Different from peripheral venous disease (blood return issues)

Risk Factors

  • Hypertension
  • Diabetes
  • Smoking
  • Obesity
  • Hyperlipidemia

Signs and Symptoms

  • Intermittent Claudication: Leg pain worsens with exertion, improves when legs are in a dependent position
  • Delayed Capillary Refill
  • Decreased Pedal Pulses
  • Lack of Hair on Calves: Skin appears cool and shiny
  • Pallor on Elevation, Dependent Rubor: Legs turn pale when elevated and red when dependent
  • Wounds: Typically on toes, dry and necrotic, filled with eschar
  • Delayed Wound Healing: Due to impaired blood flow

Diagnosis

  • Ankle Brachial Index (ABI): Comparison of ankle and arm blood pressure
  • Doppler Ultrasound: To assess blood flow

Treatment

  • Medications: Statins and antiplatelets
  • Surgical Procedures: Angioplasty, Peripheral Bypass Graft

Patient Teaching

  • Rest during pain from walking, then continue
  • Avoid restrictive clothing and leg crossing
  • Maintain warmth, use socks
  • Avoid nicotine and caffeine

Peripheral Bypass Graft

Definition

  • Surgery to reroute blood flow around an occluded artery

Post-Surgery Monitoring

  • Monitor pedal pulses, capillary refill, skin color, and temperature
  • Keep legs straight for 24 hours post-procedure

Complications

  • Graft Occlusion: Indicated by pallor, decreased pedal pulses, decreased temperature, sudden increase in pain
  • Compartment Syndrome: Increased pressure in muscle compartment, symptoms include numbness, severe pain with passive movement, edema, taut skin

Quiz Questions

  1. A patient with PAD will have decreased pain when their extremity is elevated.
    • Answer: False, pain decreases when in a dependent position
  2. Pallor with elevation and dependent rubor are indicative of PAD.
    • Answer: True
  3. Edema, taut skin, numbness, and severe pain are indicative of what complication?
    • Answer: Compartment Syndrome

Conclusion

  • Review flashcards for better retention
  • Encouragement to like, comment, and share the video with classmates and friends.

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