Term
| arch or associated vessels forms a compression around the trachea or esophagus |
|
Definition
|
|
Term
| types of aortic arch anomalies |
|
Definition
| left, right, or double aortic arch |
|
|
Term
| most common vascular anomaly |
|
Definition
|
|
Term
| narrowig of the aortic wall and lumen, generates extensive intercostal artery collaterals |
|
Definition
|
|
Term
| risk factors for aortic aneurysm |
|
Definition
| advanced age, HTN, smoking, ateriosclerosis, aortic dissection, thoracic aorta |
|
|
Term
| who is often considered for aortic aneurysm at an earlier stage then normal? |
|
Definition
| Marfan patients, and pts who are predisposed to dissection and rupture |
|
|
Term
| the mass effect of large anuerysms can cause |
|
Definition
| hoarseness, dyspnea, pulmonary HTN, and dysphagia |
|
|
Term
| what aneurysms are considered for surgical repair? |
|
Definition
| greater than or equal to 5cm OR with rapid enlargement |
|
|
Term
| connective tissue disorder, tall pts with long limbs and long fingernails, associated with heart problems |
|
Definition
|
|
Term
| a tear in the intima allows blood to escape from the true lumen of the aorta, dissects the aortic layers, and reroutes blood through it's false channel |
|
Definition
|
|
Term
| risk factors for aortic dissection |
|
Definition
| HTN, connective tissue disorders, Turner syndrome, Ehlers Danlos syndrome, Polycystic Kidney Disease |
|
|
Term
| short stature, webbed neck, females only, defect in X chromosome, low set ears, congenital haert disease |
|
Definition
|
|
Term
| abrupt excrutiating pain, chest pain in 2/3 of pts, back pain when condition occurs distal to the aortic arch |
|
Definition
|
|
Term
| treatment of aortic dissection in the acute phase |
|
Definition
| antihypertensives, arterial line placement |
|
|
Term
| management of an acute aortic aneurysm in the chronic phase |
|
Definition
| survivors undergo serial imaging at 6wks, 3m, 6m, 12m, and yearly thereafter. chronic antihypertensive therapy, aneurysmal dilation will require surgical graft replacement when the max diameter reaches 5-6cm to prevent rupture |
|
|
Term
| repair of an ascending aorta aneurysm/dissection |
|
Definition
| prosthetic valve or graft replacement or both |
|
|
Term
| repair of an aortic arch aneurysm/dissection |
|
Definition
| aortic arch replacement or open distal anastomosis |
|
|
Term
| repair of a chronic dissection |
|
Definition
| partition between the true and false lumen is opened |
|
|
Term
| repair of an acute dissection |
|
Definition
| false lumen is obliterated by sewing together the dissected walls and the graft is sutured to the proximal aortic arch |
|
|
Term
| repair of a descending or thoracoabdominal aorta |
|
Definition
| great care is taken to protect the spinal cord in order to lower the incidence of neurologic defecit |
|
|
Term
| any acute brain injury that results in a neurologic deficit of 24 hrs or more |
|
Definition
|
|
Term
|
Definition
|
|
Term
| the primary indication for performing cerebrovascular surgery is |
|
Definition
|
|
Term
| where do most intracranial hemorrhages occur? |
|
Definition
|
|
Term
| least common type of stroke |
|
Definition
|
|
Term
| most common cause of ischemic stroke in the US is |
|
Definition
| ASHD at the bifurcation of the common carotid artery, extending into the internal and external carotids |
|
|
Term
| what is characteristic of carotid bifurcation disease? |
|
Definition
|
|
Term
| most widely used test for the cervical carotid arteries |
|
Definition
|
|
Term
| what test for carotid artery disease has an increased risk of stroke? |
|
Definition
|
|
Term
| reliable low-risk means of evaluating the carotids |
|
Definition
|
|
Term
| carotid artery imaging technique that is risky in pts with compromised renal function |
|
Definition
| computed tomography angiography |
|
|
Term
| most frequently performed vascular operation in the United States |
|
Definition
| carotid endarterectomy (CEA) |
|
|
Term
| indications for cartoid artery surgery |
|
Definition
sxs with 50% diameter reduction
asx with > 80% diameter reduction |
|
|
Term
| when is surgery not indicated in carotid artery disease? |
|
Definition
| when the artery is 100% blocked |
|
|
Term
| carotid artery surgery complications |
|
Definition
| stroke, cranial nerve injury, cerebral hypoperfusion syndrome, intracerebral hemorrhage, vein patch rupture, postoperative hematoma, infection |
|
|
Term
| permanent or irreversible localized dilation of a blood vessel |
|
Definition
|
|
Term
| aneurysm with dilation < 50% of the normal |
|
Definition
|
|
Term
|
Definition
| in the aorta, iliac arteries, popliteal arteries, femoral arteries |
|
|
Term
| anuerysm with all 3 layers of the vessel wall involved |
|
Definition
|
|
Term
| aneurysm that doesn't have all 3 layers of a vessel wall involved. |
|
Definition
|
|
Term
| spindle shaped aneurysm, symmetrical enlargement involving the whole circumfrenece of the artery |
|
Definition
|
|
Term
| aneurysm that affects part of the arterial circumfrence, has a higher risk for rupture |
|
Definition
| saccular (berry) aneurysm |
|
|
Term
|
Definition
| age, male gender, caucasian race, tobacco use, FHx of aneurysmal disease |
|
|
Term
| 2 diseases that increase the rupture rate of AAA |
|
Definition
|
|
Term
|
Definition
sudden onset mid abdominal/flank pain
shock
presence of a pulsatile abd mass |
|
|
Term
|
Definition
| abd or L spine xray = calcification, ultrasound = structural detail, CT = MOST PRECISE, CTA, MRA |
|
|
Term
| most precise test for AAA |
|
Definition
|
|
Term
| how do you manage low risk AAA |
|
Definition
|
|
Term
| surgical indications for repair of a AAA |
|
Definition
| >5.5cm in men, > 4.5-5cm in women, anerysms that expand > 5mm in 6m, symptomatic aneurysms, atypical aneurysms |
|
|
Term
| other common locations of aneurysms |
|
Definition
| iliac artery, femoral artery, politeal artery, upper extremity, splenic artery, renal artery, intracranial |
|
|
Term
| open repair of AAA, perioperative complications |
|
Definition
| cardiac/pulm problems, incisional herna, sexual dysfunction, lower extremity paralysis, death |
|
|
Term
| risk factors for peripheral artery occlusive disease (PAD) |
|
Definition
| hypercholesterolemia, HTN, cigarette smoking, DM |
|
|
Term
|
Definition
normal = 0.9
mild obstruction = .70-.90
mod obstruction = .41-.70
severe obstruction = -.4 |
|
|
Term
|
Definition
| surgical bypass grafting, percutaneous angioplasty, stenting, thrombolytic therapy |
|
|
Term
| acute lower extremity edema resulting from thromboembolic disease may lead to ______ |
|
Definition
|
|
Term
| 5 P's of thromboembolic disease |
|
Definition
| pain, pallor, pulselessness, paresthesias, paralysis |
|
|
Term
| treatment of thromboembolic disaese |
|
Definition
| anticoagulation with IV heparin, immediate operation for occlusive emobli to the extremities, thrombotic occlusion requires an arteriogram, compartment syndrome may require fasciotomy |
|
|
Term
| ischemic muscle pain resulting from inadequate oxygenation during exercise |
|
Definition
| intermittent claudication |
|
|
Term
| what is a sign of more advanced critical ischemia? |
|
Definition
| pain at rest = increased risk for tissue infection or gangrene |
|
|
Term
| how do you dx chronic occlusive disease of the lower extremities |
|
Definition
| segmental doppler pressure ABI determinations, angiography, MRA and duplex ultrasonography for delineation of central vs peripheral vascular |
|
|
Term
| how do you dx chronic occlusive disease of the lower extremities |
|
Definition
| segmental doppler pressure ABI determinations, angiography, MRA and duplex ultrasonography for delineation of central vs peripheral vascular |
|
|
Term
| surgery indications with chronic occlusive disease |
|
Definition
| disabling claudication or limb-threatening ischemia |
|
|
Term
| injury caused by deceleration |
|
Definition
| deformation of the arterial wall |
|
|
Term
| injury caused by arteriovenous fistula |
|
Definition
| traumatic communication between an injured artery and vein |
|
|
Term
| injury cased by penetrating trauma |
|
Definition
| varying degrees of laceration |
|
|
Term
| injury caused by blunt trauma |
|
Definition
| disruption of the arterial wall |
|
|
Term
|
Definition
| alternative to open repair in the hemodynamically stable patient with a nonbleeding traumatic arterial lesion |
|
|
Term
| risk factors for primary venous insufficiency (varicose veins) |
|
Definition
| >50yo, heredity, gravitational hydrostatic force |
|
|
Term
| how do you dx primary venous insufficiency |
|
Definition
| handheld doppler instrument supplemented by duplex evaluation |
|
|
Term
| indications for treatment of primary venous insufficiency |
|
Definition
| pain, fatigability, heaviness, recurrent superficial thrombophlebitis, external bleeding, appearance |
|
|
Term
| non-operative management of primary venous insufficiency |
|
Definition
| external compression using elastic hose (daytime hours), lower extremity elevation twice a day |
|
|
Term
| surgical open for primary venous insufficiency |
|
Definition
| sclerotherapy - dilute injection of sclerosant directly into the vessel or ambulatory phlebectomy |
|
|
Term
| treatment for severe chronic venous insufficiency |
|
Definition
| surgery = subfascial endoscopic perforator vein surgery, perforating vein division using laparoscopic instrumentation, direct venous reconstruction |
|
|
Term
|
Definition
venous stasis
endothelial injury
hypercoagulable state |
|
|
Term
|
Definition
+ Homan's
pitting edema
pain
blanching |
|
|
Term
| most accurate method to assess for a DVT |
|
Definition
|
|
Term
| most used method to assess for a DVT |
|
Definition
|
|
Term
|
Definition
| full anticoagulation for a minimum of 3 months, thrombolysis, or surgical venous thrombectomy |
|
|
Term
|
Definition
| thoracic outlet syndrome, occult malignancy, secondary to indwelling central venous catheter or pacemaker |
|
|
Term
|
Definition
| anticoagulation therapy, greenfield filter or vena caval filter placement, consider option of retrievable IVC filter |
|
|
Term
|
Definition
| for frequent access to the vascular system: avoid multiple need punctures, acute and chronic renal failure, regular administration of meds, administration of blood/blood products |
|
|
Term
| subtaneously placed prosthetic materal necessary in pts with poor peripheral veins |
|
Definition
|
|
Term
| complications of prosthetic grafts |
|
Definition
| hemorrhage, thrombosis, occlusion, infection |
|
|
Term
| what is required after central venous catheter placement? |
|
Definition
|
|
Term
| compliations of a central venous catheter |
|
Definition
| pneumothorax, hemothorax, arterial injury, bleeding, nerve injury, thrombosis, infections |
|
|
Term
| complications of AV fistulas |
|
Definition
| failure to mature (enlarge to a usuable diameter), aneurysms and thrombosis |
|
|
Term
| only absolute indication for peritoneal dialysis |
|
Definition
| inability to undergo hemodialysis (poor vascular access, unstable CV system, bleeding diatheses) |
|
|
Term
| contraindications for peritoneal dialysis |
|
Definition
| obliteration of the peritoneal space from previous surgery, inadequate peritoneal clearance, and lack of diaphragmatic integrity |
|
|
