61 Arterial disorders

AMPUTATION General Amputation should be considered when part of a limb is dead, deadly or a dead ...

ANEURYSM General Dilatations of localised segments of the arterial system are called aneurysms ...

ARTERIAL STENOSIS AND OCCLUSION Cause and effect Peripheral arterial stenosis or occlusion is pre...

ARTERIOVENOUS FISTULA Communication between an artery and a vein may be either a congenital malfo...

ARTERITIS AND VASOSPASTIC CONDITIONS Thromboangiitis obliterans (Buerger’s disease) This is chara...

Abdominal aortic aneurysm Abdominal aortic aneurysm is by far the most common type of large-vesse...

Acrocyanosis Acrocyanosis may be confused with Raynaud’s disease but it is painless and not episo...

Acute limb ischaemia ALI is an emergency that requires rapid, accurate clinical assessment and em...

Acute mesenteric ischaemia Acute mesenteric occlusion may be either thrombotic (follow - ing athe...

Clinical features The majority of arterial aneurysms are asymptomatic at the time of identificat...

Cystic myxomatous degeneration This is typified by an accumulation of clear jelly (like a synovia...

Distal and transmetatarsal amputation In patients with small-vessel disease, typically caused by ...

Embolic occlusion An embolus is an object that has become lodged in a vessel and causes obstructi...

FURTHER READING Bhattacharya V , Stansby G (eds). Postgraduate vascular surgery: a candidate’s gu...

Features of chronic arterial stenosis or occlusion in the leg Intermittent claudication Intermitt...

Femoral aneurysm True aneurysm of the femoral artery is uncommon. Complications occur in less th...

GANGRENE Gangrene refers to the death of macroscopic portions of tissue, which turns black beca...

Iliac aneurysm This usually occurs in conjunction with aortic aneurysm and only rarely on its own...

CH A P TER INTRODUCTION Arterial disorders represent the most common cause of morbidity and early...

Investigation of arterial occlusive disease Most patients with symptomatic lower limb ischaemia p...

Learning objectives To understand: The nature and associated features of occlusive peripheral • a...

Major amputation Choice of operation The major choice is between an above- and below-knee operati...

Management of arterial stenosis or occlusion General Only one-quarter of patients presenting wit...

Miscellaneous Other types of gangrene commonly encountered include bedsores and frostbite. Bedso...

Operations for arterial stenosis or occlusion Site of disease and type of operation Surgical oper...

Other forms of arteritis Arteritis occurs in association with many connective tissue disorders, e...

Other forms of embolism Infective emboli of bacteria or an infected clot may cause mycotic aneur...

PERIPHERAL ANEURYSM Popliteal aneurysm Popliteal artery aneurysm accounts for 70% of all periphe...

Raynaud’s disease This idiopathic condition usually occurs in young women and a ff ects the hands ...

Raynaud’s syndrome Raynaud’s syndrome is the peripheral arterial manifestation of a collagen dis...

Separation of gangrene A zone of demarcation between the truly viable and the dead or dying tiss...

Specific varieties of gangrene Diabetic gangrene Diabetic gangrene is usually caused by a combinat...

Sympathectomy Endoscopic transthoracic sympathectomy is now reserved as a minimally invasive trea...

Treatment of gangrene How much of a limb or digit can be salvaged depends on the blood supply pr...

disease The principles of arterial surgery outlined above can be applied at other arterial sites...