Vascular surgery

Question 1

Define critical ischaemia

Answer 1

rest pain which requires opiates for >2 weeks and tissue loss assc. with ABPI <0.5

Question 2

Critical ischaemia triad

Answer 2

1. Ischaemic rest pain
2. Arterial insufficiency ulcers
3. Gangrene

Question 3

Why does rest pain occur?

Answer 3

Metabolic demands of LL not met.
Worse at night and disturbs sleep as…

At night- warmth from covers increase metabolic demand, reduced CO and vasodilation, koss of gravity effect on pedal BP

Relieved by swinging legs to hang out of bed or placing feet onto a cold floor

Question 4

Complications of critical limb

Answer 4

More sensitive to trauma. Wounds take a long time to heal and ulcers form.

Infection more likely to occur and can lead to gangrene- rapid spread wors ein diabetes