PVD -PERIPHERAL VASCULAR DISEASE


This was a 55-year-old gentleman , a known case of  T2DM , Systemic Hypertension, Coronary arterial heart disease with history of C.A.B.G. 5 years ago. He also had a congenital disease of hip joints and used to walk with a slight limp. He was getting pain in  both thigh regions , more on the right side , over the past 6 months. His pain increased on walking . He consulted his orthopaedic surgeon , who told him that after appropriate investigations he might need surgical correction for his long-standing hip disease. Of late his pain was increasing even with mild exertion and was extending to the legs also. As I had known him for a long time he came to me for a second opinion . I felt his symptoms were due to a vascular insufficiency and advised him a doppler study of the lower limb arteries.

The following pictures were obtained .

Rt common femoral artery showed monophasic flow

Rt common femoral artery showed monophasic flow

 

PVD_2

 

PVD_3

Rt Common Femoral artery showed  nearly 70 % obstruction.

PVD_4

 

 

RT SUPERFICIAL FEMORAL ARTERY SHOWS MONOPHASIC FLOW

RT SUPERFICIAL FEMORAL ARTERY SHOWS MONOPHASIC FLOW

PVD_6

 

PVD_7

 

PVD_8

 

 

 

 

LEFT SUPERFICIAL FEMORAL ARTERY SHOWS MONOPHASIC FLOW

LEFT SUPERFICIAL FEMORAL ARTERY SHOWS MONOPHASIC FLOW

 

 

LEFT POPILITEAL ARTERY SHOWS MONOPHASIC FLOW

LEFT POPILITEAL ARTERY SHOWS MONOPHASIC FLOW

 

RIGHT POSTERIOR TIBIAL ARTERY SHOWS MONOPHASIC FLOW

RIGHT POSTERIOR TIBIAL ARTERY SHOWS MONOPHASIC FLOW          

 

LEFT POSTERIOR TIBIAL ARTERY SHOWS MONOPHASIC FLOW

LEFT POSTERIOR TIBIAL ARTERY SHOWS MONOPHASIC FLOW

BOTH DORSALIS PEDIS ARTERIES SHOW LOSS  OF ARTERIAL TONE AND MONOPHASIC FLOW.

PVD_16

 

 

BOTH COMMON ILIAC ARTERIES AND EXTERNAL ILIAC ARTERIES SHOWED TRIPHASIC FLOW.

EXTENSIVE ATHEROSCLEROTIC OBSTRUCTIVE DISEASE OF THE LOWER LIMB ARTERIES WAS SEEN WITH THE CHANGES IN THE RIGHT COMMON FEMORAL ARTERY BEING MORE THAN THE LEFT CFA.

A vascular surgeon’s consultation was sought . Subsequently PTA ( percutaneous transluminal angioplasty ) with stent was done at the common femoral level and superficial femoral level on both sides. The patient is doing well subsequently.

reference :

Ultrasonography in Vascular Diagnosis: A Therapy-Oriented Textbook and Atlas (Google eBook). Front Cover. B. Herwig, Wilhelm Schäberle. Springer,

www.­worldwidewounds.­com/­2000/­sept/­Michael-­Lunt/­Doppler-­Imaging.­html

 

 

12 thoughts on “PVD -PERIPHERAL VASCULAR DISEASE

    • I agree that doctors should take a overview and look beyond their speciality;
      I always remember what Prof CUV ( the neurologist ) used to say in our classes in Stanley – always remember a single two eyed tiger is more likely than two one eyed tigers walking side by side . PVD is always more likely in I somebody with proven CAHD

      Like

  1. I would like to know if the patient was diabetic
    and if he was a smoker.
    A very good case study.
    Thank you.
    Sincerely,
    Henry Pereira RDMS,RVT

    Like

  2. Your advice saved the patient’s life. I like your images,they are quite illustrative with good content. I am currently pursuing a course in vascular technology and this has contributed a lot to my learning. Thanks for this contribution.

    Like

  3. Dear Kriznan, nice case well oriented the diagnostics and the treatment through the use of stems as well with patient with a several arterial problem, but i suggest to do prevention with the patients in order to reduce the cost of interventional cases. I recommended you tried the ESAOE ultrasound System which offer a nice tools called “QIMT and QAS” prevention suite, the first one you can measure the intima media in microns using Radio frequency technics associated with ultrasound beam with a high precision and the second one Quality Arterial Stiffness, to check it with a very accurately precision the stiffness of the arterial body, excellent tools which help to the prevention suite of the arterial deseases…try it.

    Like

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