Please enable JavaScript.
Coggle requires JavaScript to display documents.
Peripheral Vascular Disease: Arterial and Venous Insufficiency - Coggle…
Peripheral Vascular Disease: Arterial and Venous Insufficiency
Causes
Arterial
Results from atherosclerosis that occurs in the arteries of the lower extremities (inadequate blood flow)
Atherosclerosis is caused by the gradual thickening of the lining of the arteries from plaques forming, narrowing the vessel
Stiffening and narrowing of the arteries decreased blood supply to affect tissues
Characterized as inflow or outflow- tissue damage occurs below arterial obstruction
Venous
Interference with adequate return of blood flow from the extremities, resulting in blood stasis
Occurs due to incompetent valves in the veins of the lower extremities, causing pooling of blood and dilation of veins
Veins are unable to carry fluid and wastes from the lower extremities, resulting in swelling, venous stasis ulcers, and cellulitis
Causes by prolonged venous HTN that results in valve damage, causing backup of blood, edema, and damage to the tissue
Manifestations
Arterial
Numbness in feet when in bed
Decreased capillary refill of toes (>3secs.)
Burning, cramping, pain in legs during exercise
Loss of hair on lower calf, ankle, foot
Decreased or nonpalpable pulses
Dry, scaly, mottled skin
Thick toenails
Cold and cyanotic extremity
Decreased redness of extremity
Muscle atrophy
Ulcers and possible gangrene of toes
Venous
Limb pain of aching and feeling of fullness or heaviness in legs after standing
Stasis dermatitis- brown discoloration along the ankles, extending up the calf
Edema
Stasis ulcers, typically around the ankles
Necrosis, skin atrophy
Brown pigmentation of skin
Collaborative Treatment
Arterial
Provide warm environment for extremities
Smoking cessation
Exercise
Avoid stress and caffine
Elevate legs
Surgery
Venous
Elevate legs
Elevate legs above the heart when in bed
Wear TEDs
Avoid crossing legs
Wound care and dietician to facilitate healing process
Labs/Diagnostics
Arterial
Exercise tolerance testing (stress test)
Plethysmography
Arteriography
Segmental systolic blood pressure measurements
Magnetic resonance angiography
Ankle-brachial index
Doppler-derived maximal systolic acceleration
Venous
Vascular ultrasound
X-rays
Risk Factors
Arterial
Diabetes
Cigarette smoking
Hyperlipidemia
Obesity
HTN
Sedentary lifestyle
Older than 65
Elevated C-reactive protein
Females
Hyperhomocysteinemia
Familial predisposition
Venous
Sitting or standing in one position for long periods of time
Obesity
Pregnancy
Thrombophlebitis
Cigarette smoking
Older than 50
Complications
Arterial
Graft occlusion after surgery
Wound or graft infection
Compartment syndrome
Venous
Venous ulcers
Stasis dermatitis