Acute Arterial Occlusion - Surgical Recall
Terms in this set (16)
What are the 6 Ps of acute arterial occlusion?
What is the classic timing of pain with acute arterial occlusion from an embolus?
--Pt can tell you exactly when it happened
What is the immediate preoperative management of acute arterial occlusion?
--Prevent any more clot from forming
--Define the anatomy
What are the sources of emboli?
75% = cardiac
25% = aorta
What is the most common cause of embolus from the heart?
What is the most common site of arterial occlusion by an embolus?
Common femoral artery
--SFA is most common site of atherosclerosis, not embolus
What other diagnostic studies are in order?
-Look for MI/a-fib?
-Look for clot/MI/valve vegetations?
--Look for MI/a-fib
--Look for clot/MI/valve vegetation
What is the treatment of acute arterial occlusion?
--Cutdown and Fogarty balloon
Treatment for acute arterial occlusion is cutdown and Fogarty balloon embolectomy. What is a Fogarty?
Fogarty balloon catheter
--Catheter with a balloon tip
--Can be inflated with saline when past embolus to pull embolus out
How many mm in diameter is a 12 French Fogarty catheter?
French/3 = size in mm
12French = 4mm
What must be looked for postoperatively after reperfusion of a limb
--Renal failure from myoglobinuria
What is compartment syndrome?
Following reperfusion of ischemic limb, there is edema of the muscle
--Causes increased pressure
--Increased pressure impedes capillary flow
--Further ischemia occurs
--Myonecrosis develops once pressure reaches 30mmHg
What are the signs/symptoms of compartment syndrome?
Pain = first sign
PULSES ARE PRESENT in most cases
--Systolic pressure is higher than 30mmHg
Can a pt have a pulse and compartment syndrome?
How is the diagnosis of compartment syndrome made?
Can measure the compartment pressure
What is the treatment of compartment syndrome?