Critical Limb Ischemi Acute Presentation Of Peripheral Arterial Disease

The blood vessel that Dr. Eltahawy was concerned about was thin and looked as though it would collapse in on itself. First, Dr. Eltahawy tried a balloon catheter. At the top of the catheter was a small balloon that could inflate to maintain a shape or structure of a blood vessel. However, because the blood vessel was so thin, the balloon catheter was not very effective. Instead, Dr. Eltahawy installed a stent. A stent is a wire mesh tube. It is placed in a blood vessel permanently to maintain the shape of the vessel and to allow for the free flow of blood. Throughout this entire independent study, I realize that shadowing in the medical field is less about learning about medicine and more about discovering about whether becoming a doctor is the right step. This independent study has been a step in the right

1). Chest X-ray was normal. Initial laboratory studies were remarkable for white blood cells count of 12.1K, a creatine kinase MB fraction of < 3 mm was associated with significant reductions in restenosis and the rate of target vessel revascularization19. In SES-SMART trial patients were randomly assigned to receive a Sirolimus-eluting or bare-metal stent in small coronary artery. Sirolimus stent was associated with significant reductions in the rates of angiographic restenosis (primary outcome), target lesion revascularization and MI at 8 months20. The composite clinical endpoint ( death, non-fatal MI, ischemia- driven target lesion revascularization, and cerebrovascular accidents) was significantly lower with the sirolimus-eluting stent21. In the TAXUS V trial, in the subset of patients with small coronary arteries, the paclitaxel stent was associated with significant reductions in angiographic restenosis and target lesion revascularization at nine months compared to bare metal stents22. Although DES improves target lesion revascularization rates compared to bare-metal stents in small vessels, the absolute rates are still higher in small vessels than large

After the obstruction was detected with the arteriogram, the patient underwent percutaneous catheter-directed thrombolytic therapy with alteplase in order to regain blood flow and nutrients to the right foot and lower leg. This choice of therapy is chosen with the goal to quickly dissolve the arterial obstruction (National Institute of Health, 2014b). Although the TPA in alteplase will not restore the damaged or

This tool is applied to the assigned CPG "Clinical guidelines for stroke management 2010" in relation to the management, diagnosis and treatment of stroke. Stroke occurs when there are blood clots

Intermittent claudication is a symptom of Peripheral Arterial Disease (PAD). PAD is the gradual narrowing or full or partial blockage of the arteries due to plague, which is also known as atherosclerosis. This blockage deprives the lower extremities form receiving adequate blood that contain oxygen and nutrients. Smoking, obesity, hyperlipidemia, hypertension, diabetes mellitus and familial preposition puts patient at a higher risk for PAD. The elderly are also at a higher risk for PAD due to their various illness. PAD can lead to strokes, chronic angina and myocardial infraction (MI). A nurse assessing a patient with PAD will notice bruit or aneurysm during assessment. This is the first stage of PAD which is also known as the asymptomatic

Peripheral Vascular: Patient denies any coldness, numbness or tingling, swelling of legs or arms, discoloration in hands or feet, varicose veins or complications, intermittent claudication, thrombophlebitis, or ulcers. She states that she crosses legs at the knees occasionally when long term sitting, and she does not wear support hose in these circumstances.

The color, sensation, movement and pedal pulses of the operated leg should be assessed regularly to observe for any circulatory or neurological impairment. Pain assessments should be noted at regular intervals, since patients who have their pain well controlled following surgery are able to mobilize more quickly and easily, which helps reduce the risk of post-operative complications such as deep vein thrombosis, pulmonary embolism and respiratory infection. Prolonged and inadequate post-operative pain may result in higher mortality and morbidity rates, increased length of hospital stay and greater healthcare expenses (Eid and Bucknall 2008).

Vascular closure devices following cardiac catherization through the femoral artery have been gaining significant traction since its use in the mid-1990s. Compared to the previous gold standard of manual compression, VCDs allow for shortened time to ambulation, decreased duration of hospitalization post procedure, and increased patient comfort. The devices have also shown safeness comparable to manual compression. Despite the many advantages and variety of devices available, there are still complications to take into account. More common issues include device failure, bleeding, and hematoma. Less common but more serious complications include infection, ischemia, limb loss, and death.

During this procedure the Doctor/ Surgeon will numb the arm or groin and embed a(n) catheter into your artery. Then the catheter is threaded through the arterial system until it reaches the coronary (heart) artery. The catheter will be visible on an x-ray screen for the doctor or surgeon can see internally. The Doctor will then thread a very thin wire to the catheter across the blockage (cartilage). Right above this wire, a catheter with an expandable balloon is passed to the blockage. Once the balloon is inflated it will push the plaque to the side to open the artery and allow blood to flow through.In more than most, patients will receive a Stent (which is a collapsed wire mesh tube), this procedure is similar to angioplasty except a stent is permanent and angioplasty is temporarily. This stent is mounted on a special balloon, and is moved over the wire to the blocked area. When the balloon is inflated it opens and locks the stent in the artery, keeping it open. Lastly the balloon and catheter are taken out, and the artery will remain open and your heart will receive the blood it

d. No. The article ‘Unanswered Questions:…’ states that both the time course and magnitude for the increased risk of stent thrombosis are still not particularly clarified. Also, patients with coronary lesions and complex health conditions

The patient major symptom of chest pain, accompanied by SOB and diaphoresis prompted him to seek help in the emergency room (ER). He had this similar symptoms that eased up with rest for the past six months. However, in the past four days the symptoms became severe and unbearable. The patient returns to the hospital for follow up visit regarding the stent placement and review of risk factors associated with angina. The patient is still apprehensive of experiencing another episode of angina.

[7] However, diabetes still remains a major risk factor for restenosis after both bare-metal stents and DESs. [10] Diabetes mellitus is regarded as a proinflammatory and prothrombotic condition, and patients with diabetes mellitus are more frequently resistant to aspirin and clopidogrel than those without diabetes mellitus. [2] The minimum necessary duration of DAPT may be longer in diabetic than in nondiabetic patients. [2] Among diabetic patients, target vessel failure occurred more frequently with 6-month DAPT than with 12-month DAPT. [2] Prolonged DAPT for >6 months might be needed to prevent late stent thrombosis because of delayed vascular healing and inflammatory reaction after implantation of drug-eluting stents.

1. Angioplasty: Kereiakes and Wetherill write that “angioplasty is a procedure in which a heart doctor inserts a balloon catheter over a thin wire across an artery. The balloon is inflated and compresses the plaque to clear the arteries of any blockage.”(p. 106-107).

The stent will be placed where it can be expanded to hold the artery open. Some stents are designed to simply keep the artery held open. Other stents used are drug-eluting stents. These stents are coated with pharmacologic agents that work to prevent restenosis of the artery.

appear similar to conventional stents.”8 Middleton, Teefey and Darcy8 note that the use of PFTE endografts will likely become standard as their performance outweighs the early stent materials used. Color Doppler as well as pulsed Doppler should be used to interrogate the stent and supporting vessels. Velocity measurements are taken using angle correct and spectral waveforms are recorded. Careful examination of the liver vasculature is imperative to verify proper stent function. Specifically, thrombosis or occlusion can be assessed with color and Doppler ultrasound. Velocity parameters may vary from patient to patient and also will change from immediate post procedure velocities to those obtained during long term follow up. Universal Doppler