a type of arteriosclerosis

involves the formation of plaque within the arterial wall and is the leading risk factor of CVD

• a white, glistening, fibrous elevation that covers a lipid core in the inflamed vessel.
• when it ruptures, thrombosis and vessel constriction obstruct the lumen, causing inadequate perfusion to distal tissues.

• has a liquid lipid core
• it is elevated enough to partially or completely reduce or block the blood flow of an artery
• causes more severe damage than stable plaque.
• after the rupture occurs, the exposed underlying tissue causes platelet adhesion and rapid thrombus formation. the thrombus may suddenly block a blood vessel, resulting in ischemia and infarction.

an elevation of serum lipid levels.

the liver makes excessive cholesterol and other fats.

• a turbulent, swishing sound, which can be soft or loud in pitch. It is heard as a result of blood trying to pass through a narrowed artery
• considered abnormal, but it does not indicate the severity of disease
• often occur in the carotid, aortic, femoral, and popliteal arteries

• Low HDL-C
• High LDL-C
• Increased triglycerides
• genetic predisposition
• diabetes mellitus
• obesity
• sedentary lifestyle
• smoking
• stress
• african american or hispanic

• a sulfur-containing amino acid derived from dietary protein
• there MAY be a positive correlation between increased homocysteine levels and the development of PVD, CAD, stro, and venous thrombosis.

a severe type of elevated blood pressure that rapidly progresses.

systolic BP > 200mm Hg

diastolic BP > 150mm Hg

• No known cause
• associated risk factors:
• family hx of HTN
• high Na intake
• excessive calorie consumption
• physical inactivity
• excessive alcohol intake
• low K intake

• an elevation in BP related to specific disease states and drugs
• causes
• renal vascular and renal parenchymal disease
• primary aldosteronism
• pheochromocytoma
• cushing's disease
• coarctation or the aorta
• brain tumors
• encephalitis
• psychiatric disturbances
• pregnancy
• Drugs:
• estrogen
• glucocorticoids
• mineralocorticoids
• sympathomimetics

• includes disorders that change the natural flow of blood through the arteries and veins of the peripheral circulation. It affects the legs much more frequently than the arms.
• generally implies arterial disease rather than venous involvement.
• result of systemic atherosclerosis

• a characteristic leg pain experienced by patients with chronic peripheral arterial disease
• typically, patients can walk only a certain distance before a cramping muscle pain forces them to stop.
• as the disease progresses, the patient can walk only shorter and shorter distances before the pain recurs.
• ultimately, pain my occur even at rest

• burning or cramping in the calves, ankles, feet, and toes.
• instep or foot discomfort indicates an obstruction below the politeal artery

• painful and develop on the toes, between the toes, or on the upper aspect of the foot
• the ulcer is small and round with a "punched out" appearance and well-defined borders.

a ratio of the ankle pressure with the brachial pressure

the value can be derived by dividing the ankle blood pressure by the brachial blood pressure

an ABI of less than 0.9 in either leg is diagnostic of PAD

• nonsurgical but invasive method of improveing arterial flow
• one or more arteries are dilated with a balloon catheter advanced through a cannula, which is inserted into or above an occluded or stenosed artery
• it opens the vessel and improves arterial blood flow

wirelike devices

used along with the PTA to help keep the vessel open

• a laser probe is advanced through a cannula similar to that used for PTA.
• laser-assisted angioplasy is usually reserved for smaller occlusions in the distal superficial femora, proximal politeal, and common iliac arteries
• heat from the laser vaporizes the arteriosclerotic plaque to open the occluded or stenosed artery.

• a technique used to improve blood flow to ischemic limbs in people with PAD with a mechanical rotational abrasive method.
• the rotational atherectomy device (rotablator) is a high-speed rotary metal burr ranging in sizes.
• it results in fine-particle destruction of tissue.

piece of clot that travels and lodges in a new area

the most common cause of peripheral occlusions

• surgical opening into the tissues
• may be necessary to prevent further injury and save the limb in an event of complications caused by reperufusing the artery after thrombectomy or embolectomy

• account for most aneurysms and are commonly asymptomatic
• mostly located between the renal arteries and the aortic bifurcation

• not as common and frequently misdiagnosed
• commonly develop between the origin of the left subclavian artery and the diaphragm

• most common surgical procedure for AAA
• resection or repair of the aneurysm

• the repair of an AAA using a stent made of flexible material
• the stent is inserted through a skin incision into the femoral artery by way of a catheter-based system

Buerger's Disease

(thromboangiitis obliterans)

• an uncommon occlusive disase limited to the medium and small arteries and veins
• usually identified in young adult men who smoke

occurs in te upper extremities as a result of a subclavian artery occlusion or stenosis

the result is altered blood flow and ischemia in the arm

• a compression of the subclavian artery at the thoracic outlet by anatomic structures such as a rib or muscle
• the arterial wall may be damaged, producing thrombosis or embolization to distal arteries of the arms

• caused by vasospasm of the arterioles and arteries of the upper and lower extremities, usually unilaterally
• as a result of vasospasm, the superficial skin vessels are constricted and blanching of the extremity occurs, followed by cyanosis

Thrombus formation has been associated with:

1. stasis of blood flow
2. endothelial injury
3. hypercoagulability