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Radiology
Peripheral Arterial Disease
Built from Fundamentals of Diagnostic Radiology
What’s inside
12 sections · 95 slides
Definition and Risk Factors
Atherosclerosis beyond the heart, and what drives it
- What peripheral arterial disease is
- Risk factors for PAD
- Risk factor details and outcomes
Pathogenesis
Plaque forms by the response-to-injury sequence
- Atherosclerosis: the response-to-injury sequence
- Where plaque forms
Clinical Presentation
Claudication, rest pain, and the pulse exam
- Claudication and its level
- Rest pain and other clues
- Conditions that mimic PAD
- Pulse examination
- Doppler signals and other exam signs
Imaging Workup
Doppler ultrasound, ABI/PVR, CTA, MRA, and DSA
- Imaging options for PAD
- Vascular Doppler ultrasound
- Doppler ultrasound: strengths and limits
- Vascular Doppler ultrasound in Buerger disease
- Ankle–brachial index: how it is calculated
- ABI limitations and the toe–brachial index
- Ankle–brachial index values in PAD
- ABI and pulse volume recordings in claudication
- CT angiography technique
- CT angiography: strengths and limits
- Normal CTA runoff anatomy
- MR angiography technique and role
- MR angiography: strengths and limits
- MRA of superficial femoral artery occlusion
- Digital subtraction angiography
- DSA advantages and CO2 angiography
- DSA disadvantages
- Angioplasty and stenting of the iliac artery
- Carbon dioxide angiography in renal dysfunction
- Angioplasty and stenting of the superficial femoral artery
Classification and Decision Making
Staging severity from claudication to critical limb ischemia
- The PAD severity spectrum
- Critical limb ischemia
- Rutherford classification of PAD
- TASC-II lesion classification
- TASC-II classification of arterial lesions
Interventions
Medical therapy, angioplasty, and stents
- Risk modification and medical therapy
- 80%
- When revascularization is needed
- Percutaneous transluminal angioplasty
- Restenosis after angioplasty
- Drug-eluting balloons
- Vascular stents
- Stent limitations
Acute Limb Ischemia
The threatened limb is an emergency
- Acute limb ischemia overview
- Two causes of acute occlusion
- Embolic versus thrombotic causes
- Imaging acute limb ischemia
- Treating acute limb ischemia
- Outcomes and reperfusion injury
- Thrombectomy for acute limb ischemia
Vasospasm
Raynaud phenomenon, ergotism, and spasm after intervention
- Raynaud phenomenon
- Secondary Raynaud and treatment
- Raynaud phenomenon on angiography
- Ergotism
- Ergotism and post-intervention spasm
Other Vascular Disorders
Cystic adventitial disease, Mönckeberg sclerosis, Buerger disease
- Cystic adventitial disease
- Cystic adventitial disease: mechanism and care
- Mönckeberg medial sclerosis
- Buerger disease
- Buerger disease: findings and treatment
- Buerger disease on angiography
Impingement Syndromes
Thoracic outlet, popliteal entrapment, May–Thurner
- Thoracic outlet syndrome
- The three types of TOS
- Venous and arterial TOS
- Diagnosing and treating TOS
- Venous thoracic outlet syndrome
- Popliteal entrapment syndrome
- May–Thurner syndrome
- May–Thurner: imaging and treatment
Vessel Wall Disorders
Inherited and acquired arterial wall disease
- Marfan syndrome
- Vascular Ehlers–Danlos syndrome
- External iliac artery dissection in Ehlers–Danlos syndrome
- Loeys–Dietz syndrome
- Fibromuscular dysplasia
- Fibromuscular dysplasia “string of pearls”
- Peripheral arterial aneurysms
- Managing peripheral aneurysms
- Persistent sciatic artery
- Exercise-related endofibrosis
- Persistent sciatic artery
- Common iliac artery aneurysm
- Popliteal artery aneurysm
AVF and Pseudoaneurysm
Traumatic artery-to-vein connections and false aneurysms
- Arteriovenous fistula and pseudoaneurysm
- Imaging and treating AVF and pseudoaneurysm
- Traumatic arteriovenous fistula
- Key takeaways
- Suggested readings
- Suggested readings
- Suggested readings
- Suggested readings
- Suggested readings
- Suggested readings
- Suggested readings
- Suggested readings
- Brant and Helms' Fundamentals of Diagnostic Radiology