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Femoral Artery Occlusion

Presentation

The superficial femoral artery is commonly affected in patients presenting with intermittent claudication and critical limb ischemia. [angiologist.com]

We present the case of a patient with a history of aortobifemoral grafting who presented with left lower extremity ischemic rest pain. [ncbi.nlm.nih.gov]

Case presentation A 59-year-old Caucasian woman presented with rest pain, numbness and cramps in the operated limb after hip replacement. [jmedicalcasereports.biomedcentral.com]

Post-operative complications such as hematoma, cellulitus, and abscess present with fever, erythema, tenderness, and signs of sepsis. [vasculardiseasemanagement.com]

Entire Body System

  • Intermittent Claudication

    Intermittent claudication Other names Vascular claudication, claudicatio intermittens Specialty Cardiology, vascular surgery Intermittent claudication, also known as vascular claudication, is a symptom that describes muscle pain on mild exertion (ache [en.wikipedia.org]

    Abstract This study was undertaken to evaluate the effects of untreated superficial femoral artery occlusion in patients undergoing aortofemoral bypass for intermittent claudication. [ncbi.nlm.nih.gov]

  • Swelling

    At home—PTA of the femoral artery Once at home, check the insertion site for bleeding, unusual pain, swelling, and abnormal color or temperature change at or near the insertion site. A small bruise is normal. [hopkinsmedicine.org]

    Some possible complications may include, but are not limited to: Heart attack Irregular heartbeat (heart arrhythmia) Hemorrhage Wound infection Swelling on the leg (edema) Clot in leg (blood clots) Fluid in lungs (pulmonary edema) Nerve injury Blockage [stanfordhealthcare.org]

    Inflammation in superficial or surface veins, such as those used to insert IV lines in the arm or to draw blood, can produce pain, redness, swelling, warmth, and discomfort. [bigbangpokemon.com]

    Willard to recognize and report signs of wound infection (warmth, abnormal drainage, redness or swelling around the wound, or increased pain). [journals.lww.com]

    Iatrogenic arterial access complications such as pseudoaneurysm or AV fistula are usually symptomatic with pain, swelling, edema, tenderness, and ecchymosis. [vasculardiseasemanagement.com]

  • Pallor

    Cold sensitivity: > Symptoms include changes in skin color such as pallor (paleness), cyanosis (bluish discoloration), or rubor (dark red coloration), and the patient often experiences paresthesia and pain. [daviespublishing.com]

    Most patients initially present with pain, pallor, pulselessness, and poikilothermia. Pain is often localized and less severe when the limb is in the dependent position. [ncbi.nlm.nih.gov]

    […] equal to 0.9 is diagnostic for peripheral artery disease best initial test Making the diagnosis based on clinical presentation Differential Arterial aneurysm distinguishing factors normal ankle-brachial index aneurysm seen on imaging Embolism (pain, pallor [medbullets.com]

    […] atherosclerosis of the lower extremity arteries: cyanosis atrophic changes like loss of hair, shiny skin decreased temperature decreased pulse redness when limb is returned to a "dependent" position (part of Buerger's test) The six "P"s of ischemia Pain Pallor [en.wikipedia.org]

    Acute thrombo-embolism from the left ventricle or proximal aneurysms preferentially lodge at arterial bifurcation points and present with the clinical syndrome of acute limb ischemia; i.e., “pain, pallor, pulselessness, paresthesia, paralysis”. [vasculardiseasemanagement.com]

Gastrointestinal

  • Diarrhea

    Patient and physician labeling will describe the basis for concern and the incomplete information available.[5] Adverse effects[edit] Possible side effects of cilostazol use include headache (the most common), diarrhea, severe heat intolerance, abnormal [en.wikipedia.org]

    However, cilostazol is associated with a greater frequency of minor side effects, including headache and diarrhea, and is contraindicated in patients with congestive heart failure. 5 Several drugs with phosphodiesterase III inhibitor activity (such as [marmur.com]

  • Constipation

    Potential side effects: Verapamil: hypotension, bradycardia, constipation Diltiazem: hypotension, bradycardia, risk of heart block Nifedipine: hypotension Propranolol: asystole, asthma attacks Contraindications[edit] Organic nitrates should not be taken [en.wikipedia.org]

Eyes

  • Prolapse

    In the case presented, balloon angioplasty provided temporary relief likely because the local thrombogenic stimulus with anchor plug/ prolapsing collagen plug and associated dissection flap was still present intraluminally. [cureus.com]

    [Evidence level C, descriptive study] View/Print Table TABLE 1 Differential Diagnosis of Intermittent Claudication Nonvascular causes Arthritis of the hips Restless legs syndrome Peripheral neuropathies Spinal stenosis (pseudoclaudication) Prolapsed intervertebral [aafp.org]

Workup

"Pretreatment imaging workup for patients with intermittent claudication: a cost-effectiveness analysis". J Vasc Interv Radiol. 14 (1): 53–62. PMID 12525586. ^ a b Frans, FA; Bipat, S; Reekers, JA; Legemate, DA; Koelemay, MJ (January 2012). [en.wikipedia.org]

Non-invasive workup, including a duplex sonogram, demonstrated distal aortic stenosis involving the aortoiliac bifurcation. She underwent an abdominal aortogram with bilateral lower extremity arterial run-offs. [cureus.com]

Laboratory testing A laboratory workup is helpful only for identifying accompanying silent alterations in renal function and elevated lipid profiles. [emedicine.medscape.com]

Diagnostic workup Head CTs and/or MRIs were performed to confirm the diagnosis of posterior circulation infarction, and angiography was recommended to locate the occlusion, responsible arteries, collateral flow, and other vascular lesions that may affect [jbiomeds.com]

Treatment

Less morbidity and better cost-effectiveness are suggested to be achieved in the treatment of chronic lower limb ischaemia with endovascular treatment compared to surgical treatment. [ncbi.nlm.nih.gov]

For treatment of TASC A lesions, the choice of treatment is endovascular, whereas it is surgery for TASC D lesions. [intechopen.com]

Less morbidity and better cost-effectiveness are suggested to be achieved in treatment of chronic lower limb ischaemia with endovascular treatment comparing to surgical treatment. [clinicaltrials.gov]

Prognosis

Patients with AIL usually have a poorer prognosis than those with other LEAD. [escardio.org]

The purpose of this study was to evaluate the incidence, risk factors, treatment and prognosis of PAE in primary SFA PTA + stent. [journals.plos.org]

The Fogarty catheter revolutionized the prognosis of these patients. Now, ever-greater advances are made, and even less invasive treatments gain space. [intechopen.com]

Differentiating between the 2 concepts is important in order to establish the therapeutic indication and the prognosis in patients with PAD. [revespcardiol.org]

Expectations (prognosis) The prognosis depends on the underlying disease and the stage at which peripheral vascular disease is discovered. Removal of risk factors, such as smoking, should be done immediately. [rjmatthewsmd.com]

Etiology

[…] resulting from obstruction of the peripheral arteries Epidemiology demographics affects older patients male > female location most commonly affects the popliteal artery risk factors smoking hypertension hyperlipidemia family history renal disease diabetes Etiology [medbullets.com]

Posttraumatic occlusion was thought to be the etiology (Figures 1,2,3&4). [ispub.com]

Emergency cesarean delivery and maternal diabetes or very high BMI of infant are risk factors for arterial occlusion and iatrogenic vascular injuries must also be considered in the etiology [ 2 ]. [omicsonline.org]

The two principal etiologies of acute ischemia of the lower limbs are arterial embolism and in situ thrombosis of an atherosclerotic artery. [intechopen.com]

Acute arterial occlusion is associated with increased morbidity, significant disability, and emergent operation in high-risk patients. [1][2][3] Etiology The most common cause of acute limb ischemia is in situ thrombotic occlusion. [ncbi.nlm.nih.gov]

Epidemiology

"Epidemiology, classification, and modifiable risk factors of peripheral arterial disease". Vasc Health Risk Manag. 3 (2): 229–34. doi:10.2147/vhrm.2007.3.2.229. PMC 1994028. PMID 17580733. [en.wikipedia.org]

Introduction Clinical definition ischemia resulting from obstruction of the peripheral arteries Epidemiology demographics affects older patients male > female location most commonly affects the popliteal artery risk factors smoking hypertension hyperlipidemia [medbullets.com]

Finally, from an epidemiologic point of view, the association between the ABI and the presence of vascular disease in other territories is also very interesting. [revespcardiol.org]

E27 - E30 __________________________ Introduction and Epidemiology Isolated atherosclerotic involvement of the common femoral artery (CFA) and its bifurcation are rare and reports consisting large patient series are unavailable. [vasculardiseasemanagement.com]

Other causes include embolic occlusion from the left heart, aorta, and iliac vessel, as well as penetrating or blunt trauma. [4] Epidemiology Published studies regarding the true incidence of acute limb ischemia are lacking. [ncbi.nlm.nih.gov]

Pathophysiology

OBJECTIVE: Recently, we have shown that shear stress regulates the angiogenic potential of endothelial cells in vitro by an Angiopoietin-2 (Ang2)-dependent mechanism; however its pathophysiological significance in vivo was not clear. [ncbi.nlm.nih.gov]

Pathophysiology[edit] Normally endothelial cells release prostacyclin and nitric oxide (NO) which induce relaxation of the smooth muscle cells, and reduce aggregation of platelets. [en.wikipedia.org]

From the pathophysiologic point of view, ischemia of the lower limbs can be classified as functional or critical. [revespcardiol.org]

Pathophysiology Single or multiple arterial stenoses produce impaired hemodynamics at the tissue level in patients with PAOD. Arterial stenoses lead to alterations in the distal perfusion pressures available to affected muscle groups. [emedicine.medscape.com]

Prevention

This case describes a mechanism of femoral artery occlusion by a suture-mediated APCD and suggests a method of prevention and treatment. [ncbi.nlm.nih.gov]

It helps prevent wounds or foot ulcers from becoming infected and painful or resulting in gangrene. Good foot care also helps prevent amputation. [msdmanuals.com]

This can be used to divide medication usage into broad categories of primary and secondary prevention.[17] Primary prevention[edit] For the primary prevention of cardiovascular disease, the United States Preventive Services Task Force (USPSTF) 2016 guidelines [en.wikipedia.org]

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