Atherosclerosis and Peripheral Vascular Disease

male > female, strongly associated with smoking and affects the leg more than the arm. Patients are usually over 50 yrs.
Sympt
* Intermittent claudicating. * Cold feet or legs.
* Peripheral cyanosis. * Late rest pain.

Signs
* Peripheral pulses. * leg ulcers, absenceof hair
* finally frank gangrene.

Investig
X-ray
® calcification of Arteries.
Doppler ultrasound.
Angiography for revascularisation.

ttt
Medication has a little role.
Balloon angioplasty for iliac or femoral stenosis.
Calcium channel blockers.
Amputation.

Management of P. Vas. Disease
G. measures
Indicat for revascular
· Stop smoking.
· Lose wt if obese.
· Stop vasoconstrictors.
· Control D.M & hypertension.
· Exercise (collateral).
· Avoid infection, trauma.
· Vasodill and anticoagulant are unhelpful.
· Acute ischaemia embolectomy
or amputation
· Chronic ischaemia with impaired skin and tissue viability.
· Disabling symptoms due to severe stenosis.

N.B.
Atherosclerosis is also presented with coronary heart disease and cerebrovascular disease.

Source: Internal Medicine Book of Dr.Osama Mahmoud (Ain Shams University)