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السورية الخاصةالجامعةالبشري الطب كلية

الجـراحـة قسمقبطان عاصم الدكــتـور

MD – FRCSwww.surgi-guide.com

3rd lecture

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Medical support in chronic arterial iscaemia

Medical treatment for associated disease such as diabetes , hyperlipidemia.

Beta blockers may exacerbate claudication .Anti platelet agent , aspirin , clopidogrel as

an alternative .Vasodilators are unlikely to be beneficial.

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Collateral vessels develop 6 months after an occlusive episode .

Intermittent claudication considered relative indication for interventional or conventional treatment .

Rest pain considered an absolute indication for interventional or conventional treatment .

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Stenos left renal arterya. before dilatation , b. after balloon dilatation

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Stent deployment

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Arterial stent

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Operation for arterial stenosis or occlusionSite of diseaseAortoiliac

occlusion .Aorto femoral

occluaion.Superfacial femoral

artery occlusion .Popleteal occlusion .

Posterior tebial artery occlusion .

Type of operationAortoiliac bypass .Aortofemoral bypass

.Femoropopleteal

bypass.

Femorodistal popleteal bypass.

Femorodistal bypass .

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Types of bypass grafts

Autogenous saphenous vein ( as reversed conduit or in situ after valve disruption ).

Dacron graft .PTFE ( polytetrafluroethylene ) graft .PTFE ( rings supported ) .Human umbilical vein treated graft .

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