Peripheral Artery DiseasePeripheral Artery Disease

Natalie Bermudez, RN, BSN, MSNatalie Bermudez, RN, BSN, MSClinical Educator for Cardiac TelemetryClinical Educator for Cardiac Telemetry

Peripheral Artery DiseasePeripheral Artery Disease

“Hardening of arteries” - atherosclerosis

Caused by plaque accumulation on arterial walls – thrombus formation - stenosis

Peripheral Artery DiseasePeripheral Artery Disease

Occludes blood flow in peripheral arteries – arms and legs

Peripheral Artery DiseasePeripheral Artery Disease

Causes acute or chronic ischemia

May cause an embolus

Peripheral Artery DiseasePeripheral Artery Disease

ETIOLOGY:

SmokingDiabetes Mellitus

DyslipidemiaHypertension

Peripheral Artery DiseasePeripheral Artery Disease

Increased Risk:Increased Risk:50 years old

MaleAfrican American

ObesePersonal history of vascular

disease, MI, or stroke

Peripheral Artery DiseasePeripheral Artery Disease

Fontaine Stages:Fontaine Stages:I: mild pain on walking

("claudication") II: severe pain on walking relatively

shorter distances (intermittent claudication)

III: pain while resting IV: loss of sensation to the lower

part of the extremity V: tissue loss (gangrene)

Peripheral Artery DiseasePeripheral Artery Disease

Tissue Necrosis

a.k.a. Gangrene

Peripheral Artery DiseasePeripheral Artery DiseaseOther Signs & Symptoms:Other Signs & Symptoms:

Discoloration to affected extremity

Peripheral Artery DiseasePeripheral Artery DiseaseDiagnostic Diagnostic EvaluationEvaluation::

Arterial-Brachial Index (ABI)

Peripheral Artery DiseasePeripheral Artery DiseaseDiagnostic Evaluation:Diagnostic Evaluation:

Doppler ultrasoundMulti-slice CT scan

Peripheral Artery DiseasePeripheral Artery Disease

Treatment:Treatment:Smoking cessationRegular exerciseAngioplasty/PTCABypass graftingSympathectomyDigit/Limb Amputation

Peripheral Artery DiseasePeripheral Artery Disease

Medication Regimen:Medication Regimen:AspirinPlavix (clopidogrel)Statins

Peripheral Artery DiseasePeripheral Artery Disease

Prognosis for patients with PAD is Prognosis for patients with PAD is very poorvery poor

Occasionally thrombolysis Occasionally thrombolysis treatment is successfultreatment is successful