a peripheral vascular disease

×

m is a recurring inflammation and thrombosis (clotting) of small and
medium arteries and veins of the hands and feet.
m also known as ›
›
›

m Úhis disease was first reported by Leo Buerger in 1908, who
described a disease in which the characteristic pathologic findings
² acute inflammation and thrombosis (clotting) of arteries and
veins ² affected the hands and feet.
m Believed to be an autoimmune vasculitis that result s in occlusion of
distal vessels.
O

O
en between 20 and 35 years
of age

Heavy smoking or chewing of

tobacco is a causative or an
aggravating factor


 
 
m ain- it is the most outstanding symptom- due to intermittent
claudication.
m Rest pain with persistent ischemia of 1 or more digits - due to
occlusion of decreases blood flow.
m aresthesia ± due to diminished nerve sensation.
m Finger¶s and toes turn pale when exposed to cold(Raynaud¶s
phenomenon) ± due to decreased blood flow as affected by cold
temperature.
m Absent or weak tibial pulse
m Cyanosis - ( cyanosis bluish discoloration of the skin and mucous
membrane due to lack of oxygen in the blood) a later
manifestation.
m Ulcerations and gangrene ± if there is prolonged insufficient blood
supply
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× 
m Ãegmental limb blood pressure
m Duplex Ultrasonography
ay indicate presence of distal extremity ischemia (indicated by
claudication, pain at rest, ischemic ulcers or gangrene)
m Contrast Angiography
ay indicate a proximal source of emboli. It is the most conclusive
diagnostic procedure for peripheral vascular diseases.
m ay be accompanied by Atherosclerosis of the large vessels
m atient¶s ability to walk is severely limited
m Higher risk for non-healing wounds because of impaired
circulation
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ain Objectives are:
Úo improve circulation to extremeties
revent progression of the disease
rotect the extremeties from trauma and infection

m Ãmoking cessation
has shown to slow the progression of the disease and decrease the
severity of amputation in most patients, but does not halt the
progression.
m Regional sympathetic block/Ganglionectomy
produces vasodilation and increases blood flow

Ganglion ± Is a biological tissue mass, most commonly a

mass of nerve cell bodies
m ºascular surgery
can sometimes be helpful in treating limbs with poor perfusion
secondary to this disease. Use of vascular growth factor and stem
cell injections have been showing promise in clinical studies.
m Amputation
Occasional below knee is necessary
Indications:
Gangrene especially if there is moist, severe rest pain or severe
sepsis
m Ãtreptokinase
Has been proposed as adjuvant therapy in some cases
a protein secreted by several species of streptococci can
bind and activate human plasminogen. Ã is used as an
effective and inexpensive clot-dissolving medication in some
cases.
O    
m Assess pain ± monitor if it is being tolerated or needs medication to
relieve pain.
m Obtain blood pressure ± serves as a baseline data for peripheral
pulse
m Assess signs of ulcer formation
Assess for signs of gangrene
m Quit smoking ± to prevent further occlusion of the blood vessels
m Foot care ± to decrease the occurrence of infection and gangrene.
m rotect from trauma to avoid source of infection
m Enough rest
m Increase fluid intake
m Ãocks or stocking must always clean
m Ãlight massage of the food with moisturizer
m Avoid circular or rolled stocking