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Tibioperoneal Occlusive Disease Cheat Sheet (DRAFT) by [deleted]

This is a draft cheat sheet. It is a work in progress and is not finished yet.


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
3. Gangrene

Diagnosis and Assessment

    Ambulation - walk up 1 flight of stairs
    NM disease, edema, infection
C. ARTERIAL PERFUSION - assess for multilevel disease
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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