30 - Concepts of Care for Patients with Vascular Conditions

acute arterial occlusion

the sudden blockage of an artery, typically in the lower extremity, in the patient with chronic peripheral arterial disease

aneurysm

a permanent localized dilation of an artery that enlarges the artery to at least two times its normal diameter

ankle-brachial index (ABI)

the measurement of arterial insufficiency based on the ratio of ankle systolic pressure to brachial systolic pressure

arterial revascularization

a surgical procedure most commonly used to increase arterial blood flow in the affected limb of a patient with peripheral arterial disease

arterial ulcer

a painful ulcer caused by diminished blood flow through an artery that develop on the toes (often the great toe), between the toes, or on the upper aspect of the foot

arteriosclerosis

a thickening or hardening of the arterial wall, often associated with aging

arteriotomy

a surgical opening into an artery

atherectomy

an invasive nonsurgical technique in which a high-speed, rotating metal burr uses fine abrasive bits to debulk the inside of an artery while minimizing damage to the vessel

atherosclerosis

a type of arteriosclerosis that involves the formation of plaque within the arterial wall

autogenous

describes belonging to the person

collateral circulation

the circulation that provides blood to an area with altered tissue perfusion through smaller vessels that develop and compensate for the occluded vessels

deep vein thrombosis (DVT)

a blood clot that forms in one or more of the deep veins in the body, usually the legs

embolus

a blood clot or other object (e.g., air bubble, fatty deposit) that is carried in the bloodstream and lodges in another area

endovascular stent graft

the repair of an abdominal aortic aneurysm using a stent made of flexible material

heparin-induced thrombocytopenia (HIT)

a potentially devastating immune-mediated adverse drug reaction caused by the emergence of antibodies that activate platelets in the presence of heparin

hyperlipidemia

an elevation of serum lipid levels in the blood

hypertensive crisis

a severe elevation in blood pressure (greater than 180/120), which can cause damage to organs such as the kidneys or heart

inferior vena cava filtration

a type of vascular filter inserted by a surgeon percutaneously into the inferior vena cava

inflow disease

an obstruction in the distal end of the aorta and the common, internal, and external iliac arteries that result in pain or discomfort in the lower back, buttocks, or thighs

intermittent claudication

a characteristic leg pain experienced by patients with chronic peripheral arterial disease

orthostatic hypotension

a decrease in blood pressure (20 mm Hg systolic and/or 10 mm Hg diastolic) that occurs when the patient changes position from lying or sitting to standing

outflow disease

an obstruction in the femoral, popliteal, and tibial arteries and below the superficial femoral artery (SFA) that cause burning or cramping in the calves, ankles, feet, and toes

peripheral vascular disease (PVD)

a disorder that changes the natural flow of blood through the arteries and veins of the peripheral circulation, causing decreased perfusion to body tissues

phlebitis

an inflammation of a vein, which can predispose patients to thrombosis

primary hypertension

the most common type of hypertension; not caused by an existing health problem

rubor

a dusky red discoloration of the skin

secondary hypertension

an elevated blood pressure that is related to a specific disease (e.g., kidney disease) or medication

stasis dermatitis

a change in skin pigmentation along the ankles that may extend up to the calf

stasis ulcer

an ulcer formed as a result of edema or minor injury to the limb that typically occurs over the malleolus

telangiectasias

a vascular lesion with a red center and radiating branches

thrombectomy

a surgical procedure used to remove deep thrombosis, or blood clots that have formed in the deep veins

thrombophlebitis

a thrombus that is associated with inflammation

thrombus

a blood clot believed to result from an endothelial injury, venous stasis, or hypercoagulability

varicose veins

distended, protruding veins that appear darkened and tortuous

venous insufficiency

an alteration of venous efficiency by thrombosis or defective valves caused by prolonged venous hypertension, which stretches the veins and damages the valves, resulting in further venous hypertension, edema, and eventually venous stasis ulcers, swelling, and cellulitis

venous thromboembolism (VTE)

a term that refers to both deep vein thrombosis and pulmonary embolism

Virchow triad

the three factors that contribute to thrombosis: stasis of blood flow, endothelial injury, and hypercoagulability