This is a draft cheat sheet. It is a work in progress and is not finished yet.
General
Greater than 60% associated with diabetes mellitus and renal insufficiency |
Clinical Presentation
Claudication: exertional
cramping pain due to
ischemia of muscle bed |
Critical Limb Ischemia:
insufficient blood flow
to meet metabolic demand |
Iliac vessels Thigh |
1. Rest pain |
Femoral Calf |
2. Ulceration |
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3. Gangrene |
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Diagnosis and Assessment
A. FUNCTIONAL STATUS
Ambulation - walk up 1 flight of stairs
B. LIMB FACTORS
NM disease, edema, infection
C. ARTERIAL PERFUSION - assess for multilevel disease
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Pulse exam: femoral (R/O suprainguinal inflow disease), popliteal (R/O flow-limiting prox stenosis), PT/DP not commonly palpable
Physiologic testing* - confirm dx of PAD, localize level of obstructive lesions and assess adequacy of tissue perfusion and wound healing potential |
Physiologic Testing
Doppler exam
Triphasic - normal transduction of systolic and diastolic pulse
Biphasic - mild/moderate disease
Pressure indices
Ankle-Brachial Index (ABI)
>1.3-1.5 medial calcification resistant to compression
>1.0 Normal
>0.9-1.0 Asymptomatic or minimal disease
0.5-0.9 Claudication
<0.5* Ischemic rest pain/CLI (~ ankle pressure <50)
*ABI >0.5 = single level, <0.5 multilevel disease |
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