- Dx: Patients present with incidental finding, pulsatile mass, leak, infection, or ischemia.
- CT scan is best to determine size and anatomy of aneurysm.
- Ultrasound can follow.
Carotid Artery Disease
- Dx: Patients present asymptomatic, with TIA's, or with stroke.
- Ultrasound is first line stud
| Normal|| ICA PSV < 125|| ICA EDV < 40|
| 50-70%|| ICA PSV 125-230|| ICA EDV 40-100|
| >70%|| ICA PSV > 230|| ICA EDV > 100|
- CTA can be used to better determine location of stenosis
- Tx: Management is based on symptoms and stenosis
- Carotid endarterectomy
- Carotid stent for lesion higher than C2, reoperative neck, prior radiation, high medical risk.
Peripheral Vascular Disease
- Popliteal exposure above knee:
- Medial thigh incision.
- Sartorious muscle is retracted posteriorly.
- Adductor magnus m. is retracted anteriorly.
- Enter popliteal fossa.
- Popliteal exposure below the knee:
- Medial lower leg incision 1cm below the medial border of the tibia.
- Gastrocnemius is retracted posteriorly.
- Enter the popliteal fossa.
- Toe pressure > 30mmHg is associated with good healing
- TBI < 0.64 is abnormal, indicateding arterial disease