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Central Lines: R IJ (kinks, thrombosis), L Subclavian (stenosis), Femoral (infxn) Purulent thrombophlebitis Tx: resect vein Claudication initial

Tx: exercise, smoking cessation, diet Ankle Brachial Index (ABI): Normal: 0.8 - 1 Claudication: 0.5 0.8 (decreases with exercise Pain at rest: < 0.4 Compartment syndrome: damage deep peroneal nerve cant dorsiflex foot Compartment syndrome: pres > 30, leave open 5-10 days, K, pain on passivemotion CEA Indications: >70% stenosis or >60% stenosis with sx Young person with Sx carotid stenosis: fibromuscular dysplasia (Tx: angioplasty) CEA 5-yr stroke rate: No sx: 11% 5% Sx: 26% 9% SAPPHIRE trial: coronary artery stents are not inferior to CEA in high risk patients CEA CN injury: vagus nerve hoarseness CEA post-op stroke Tx: thrombectomy Recurrent carotid stenosis: myointimal hyperplasia Internal carotid artery obstruction: retrograde flow to ophthalmic artery Symptomatic carotid stenosis and AAA: fix carotid first 5-yr AAA rupture risk: increased w/ HTN, COPD <5cm: 20% 5-7cm: 33% >7cm: 95% MCC AAA: atherosclerosis Infected aortic graft Tx: Axillo-BiFem bypass resect graft, ligate aorta Popliteal aneurysm: 50% bilateral, 33% have AAA, do bypass b/c risk of emboli Complication of popliteal aneurysm: thrombosis Splenic aneurysm: tx if >2cm, has sx, or is of childbearing age SMA thrombus: narrowing at takeoff SMA embolus: meniscus sign (Tx: embolectomy + necrotic bowel rxn + 2nd look) Effort thrombosis: upper extremity venous thrombosis (Tx: thrombolytics + heparin) MCC of acutely ischemic leg: proximal thigh ischemia due to external iliac Early sign of graft thrombosis: Doppler change (biphasicmonophasic) Baseball pitchers: subclavian vein thrombosis after hrowing (Tx: local t-PA, heparin) Angioplasty: best for common iliac Cold pulseless foot: cardiac embolism (Tx: embolectomy) Reperfusion free oxygen radicals: due to xanthine oxidase Reperfusion injuries: due to neutrophils AVM: sudden LOC, young people bleeds or old people aneurysms (Tx: resection) Mesenteric ischemia: do angiogram Constricted vessels from pressors (Tx:Papavarine or NGN injection) Thrombus (Tx: TPA) Embolus (Tx: embolectomy) Fibromuscular dysplasia: young woman with HTN (Tx: R renal artery angioplasty) Takayasu arteritis: young female - temporal arteritis of aorta/pulm artery (Tx: steroids) Glomus cell tumor: painful digit tumor composed of blood v + nerves (Tx: shell it out)