Health

What are the major pathways of collateral circulation to supply the lower extremities in a patient with known aortic occlusion? A simple way to help remember the collateral supply is to divide it into anterior, middle, and posterior pathways. • Anterior pathway: Subclavian artery through the internal mammary artery to the superior epigastric artery, to the …

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How are groin pseudoaneurysms treated? Pseudoaneurysms resulting from femoral artery puncture can be managed in several ways, based on the patient’s clinical status and the anatomy of the lesion. The first step is to recognize that the complication has occurred. A postprocedure groin check may reveal a pulsatile mass or ecchymosis. The patient may complain …

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What is an ACT measurement? ACT stands for activated clotting time . It is a clotting test that may be performed in the interventional suite and is commonly used to monitor the effect of heparin. A small sample of whole blood is placed in the testing machine, and a result is available in less than 5 minutes. …

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What is Leriche syndrome? Leriche syndrome is a set of symptoms and signs due to chronic lower extremity ischemia resulting from aortoiliac obstruction. It is characterized by intermittent buttock claudication, absent femoral pulses, and sexual impotence.

Pulse Volume Recording Examination is a noninvasive method to evaluate arteries of the lower extremity. PVR stands for pulse volume recording. A brachial pressure and arterial waveform are obtained as reference standards. The process is repeated at different stations, including the high thigh, low thigh, calf, ankle, and foot. The segmental pressures and waveforms are analyzed …

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Contraindications to thrombolysis • Absolute contraindications include active internal bleeding, known intracranial pathology, stroke within the past 6 months, craniotomy in the past 2 months, irreversible limb ischemia, and infected bypass graft. • Relative contraindications include uncontrollable hypertension, history of gastrointestinal bleeding, bacterial endocarditis, diabetic retinopathy, coagulopathy, pregnancy, recent major surgery, recent major trauma, and recent cardiopulmonary …

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How is a thrombolysis procedure performed? A thorough history and physical examination of the patient are performed. Particular attention should be given to any prior surgeries described in the history. Understanding the patient’s vascular anatomy is of paramount importance for planning access and intervention. Prior arteriograms, if available, should be reviewed. These may also help …

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