Arterial occlusion and its treatment....

Arterial occlusion and its treatment

1. DISEASES OF ARTERIES

2. IVD- A/F- Smoking High amounts of fats and cholesterol in the blood, High blood pressure, High amounts of sugar in the blood due to insulin resistance or diabetes. Coronary Heart Disease (CHD ) / Coronary Artery Disease- It is where atherosclosis affects the coronary arteries in the heart. If the flow of oxygen-rich blood to your heart muscle is reduced or blocked, angina or a heart attack may occur. It may feel like pressure or squeezing in your chest. The pain also may occur in your shoulders, arms, neck, jaw, or back. Angina pain may even feel like indigestion. A heart attack occurs if the flow of oxygen-rich blood to a section of heart muscle suddenly becomes blocked . If blood flow isn’t restored quickly, the section of heart muscle begins to die. Without quick treatment, a heart attack can lead to serious problems and even death.

3. Carotid artery disease occurs if plaque builds up in the arteries on each side of the neck (the carotid arteries). These arteries supply oxygen-rich blood to your brain. If blood flow to brain is reduced or blocked, even for a few minutes, the lack of oxygen may cause damage, or even death of brain cells. If brain cells die or are damaged because of a stroke, symptoms occur in the parts of the body that these brain cells control. Examples of stroke symptoms include sudden weakness; paralysis or numbness of the face, arms, legs causing inability to move.

4. Peripheral Arterial Disease- It is a disease in which plaque builds up in the arteries that carry blood to head, organs, and limbs. PAD usually affects the arteries in the legs, but it also can affect the arteries that carry blood from heart to arms, kidneys, and stomach. Blocked blood flow to legs can cause pain and numbness. It also can raise risk of getting an infection in the affected limbs. If severe enough, blocked blood flow can cause gangrene (tissue death). If the plaque builds up around the arteries that carry blood to the kidneys, it can impair kidney function.

5. Acute arterial occlusion is synonymous with acute limb ischemia and is considered a vascular emergency. Definition - sudden loss of limb perfusion for up to two weeks after the initiating event. Acute arterial occlusion can occur in any peripheral artery of the upper and lower extremities. Acute occlusion can lead to a limb or life-threatening ischemia. Diagnostic measures, treatment, and management depend on the affected artery and the patient's medical history. Acute arterial occlusion is time-sensitive if left untreated, can quickly progress to infarction and loss of limb and life . Acute arterial occlusion is associated with increased morbidity, significant disability, and emergent operation in high-risk patients

6. most typical area of arterial occlusion- distal superficial femoral artery .   C/F - pain in the involved muscle group which aggravates on exertion. This phenomenon is also termed intermittent claudication when a patient feels pain in the involved limb on walking. The 5 P's of acute arterial occlusion are  pain, pallor, pulseless, paresthesia and paralysis .

7. The most common cause of acute limb ischemia is in situ thrombotic occlusion . It is more common in the lower extremities, and the initiating event is a preexisting history of peripheral artery disease. Thrombotic occlusions can occur in any upper and lower extremities segment but most commonly affects the superficial femoral artery . Other causes- embolic occlusion from the left heart, aorta, and iliac vessels, penetrating or blunt trauma.

8. D/D- Arterial embolus Acute arterial thrombosis Chronic venous insufficiency Degenerative disk disease Osteoarthritis Spinal stenosis Thromboangiitis obliterans

9. Complications- Necrosis and gangrene Bleeding Stroke Myocardial infarction Death

10. Auxillary Management- Discontinue smoking Control hypertension Manage diabetes Maintain a healthy weight Remain compliant with medications

11. Vascular Surgery- Stage I : Non-threatened extremity; elective revascularization may or may not be necessary. Stage II : Threatened extremity; immediate revascularization is indicated to prevent tissue loss. Stage III : Ischemia has progressed to infarction, and salvage of the extremity is not possible