Carotid stenosis

Disease class: Carotid artery diseases

Carotid artery diseases

Disease class: Cerebrovascular disorders

Types

• Carotid artery injuries
• Carotid artery thrombosis
• Carotid-Cavernous sinus fistula
• Carotid stenosis
• Moyamoya disease

Varicocele

Disease class: Vascular diseases

Signs

• Testicular lumps

Venous insufficiency

Disease class: Vascular diseases

Signs

• Varicose veins

 

CHA2DS2-VASc

Also known as

• CHADS-VASc

Calculates stroke risk for patients with atrial fibrillation, possibly better than the CHADS₂ Score.

CHA2DS2-VASc Score	Stroke Risk %	95% CI
0	0	-
1	1.3	-
2	2.2	-
3	3.2	-
4	4.0	-
5	6.7	-
6	9.8	-
7	9.6	-
8	12.5	-
9	15.2	-

C 
 Congestive heart failure (or Left ventricular systolic dysfunction)
1 H
 Hypertension: blood pressure consistently above 140/90 mmHg (or treated hypertension on medication)
1 A₂
 Age ≥75 years
2 D
 Diabetes Mellitus
1 S₂
 Prior Stroke or TIA or thromboembolism
2 V
 Vascular disease (e.g. peripheral artery disease, myocardial infarction, aortic plaque)
1 A
 Age 65–74 years
1 Sc
 Sex category (i.e. female sex)
1

Transient Ischaemic Attack

Disease class: Brain ischaemia

Also known as

• TIA
• Mini-stroke
• Warning-stroke

 

See also

• Stroke

[Vascular surgery] Introduction

Vascular surgeons specialise in diseases of the vascular system, including the lymphatic system. 

 

Procedures

 

Vascular diseases

 

Diseases

• Abdominal aortic aneurysm: Can rupture and cause massive internal haemorrhage.
• Carotid artery disease: Can lead to strokes. 
• Peripheral vascular disease
• Arterial ulceration
• Venous ulceration
• Uncontrolled bleeding
• Foreign bodies in the vasculature : This problem is usually iatrogenic.
• These include catheter fragments, guidelines, IVC filters, stents, sheath fragments, and other medical devices. 
• Thromboangiitis obliterans

Varicose veins

Disease class: Vascular diseases

Causes

• Venous insufficiency

Renal artery obstruction

Disease class: Kidney diseases

Fibromuscular dysplasia

Disease class: Arterial occlusive diseases

Chylous ascites

Disease class: Peritoneal diseases

Coagulation

Coagulation is a function of the blood and blood vessels.

 

Function

• When there is damage to vascular endothelium, the body must rapidly support the vulnerable structure and promote wound healing. Coagulation is initiated at sites of damage, to form a solid 'clot' which prevents leakage of blood.
• The viscosity of the blood is modified by coagulation (clotting) and anti-coagulation (clot-breaking) processes. These opposing processes occur continously, and the balance is adjusted at any point of abnormality in the vasculature. This is an example of dynamic equilibrium. 
• With too much anti-coagulation, the body haemorrhages (bleeds) too easily.
• With too much coagulation, the vessels of the body become obstructed. This leads to ischaemia and tissue necrosis.

Components

There are three primary components of the coagulation system:

1. Coagulation cascade (protein factors)
2. Platelets
3. Vascular endothelium

Pathophysiology

• Blood coagulation disorders
• blood coagulation disorders, Inherited 
• Blood platelet disorders 
• Coagulation protein disorders 
• Haemostatic disorders 
• Haemorrhagic disorders

Phlebitis

Disease class: Peripheral vascular diseases

Disease class: Vasculitis

Subtypes

• Thrombophlebitis

Phlebitis refers to inflammation of a vein.

Peripheral arterial disease

Disease class: Peripheral vascular diseases

This is the narrowing of the blood vessels in the peripheries, usually the legs.
This is usually mediated by the process of atherosclerosis. 
Blood flow is restricted, causing pain in the affected area.
The symptoms usually worsen gradually and irreversibly, over a long time period.

Risk factors

• Chronic tobacco smoke exposure 
• Hyperlipidaemia
• Diabetes mellitus
• Advanced age 

 

Symptoms

• Intermittent claudication
• Muscle weakness 
• Muscle wasting
• Numbness
• Hair loss in the affected site
• Erectile dysfunction
• Arterial ulceration

 

Complications

• Critical limb ischaemia
• Digital amputation
• Limb amputation

 

Management  

• Promote smoking cessation
• Statin therapy 

• Angioplasty
• Percutaneous transluminal angioplasty (PTA)
• Stenting
• Endarterectomy
• Atherectomy 
• Vascular bypass
• Femoral popliteral bypass surgery

Mesenteric vascular occlusion

Disease class: Peritoneal diseases

QRISK

Current version: QRISK3

Estimates the 10-year cardiovascular risk of an individual.

 

Prognosis

A QRISK over 10 indicates a 10% risk of CVD event over the next ten years. This indicates that primary prevention with lipid lowering therapy (such as statins) should be considered.

 

See also

• Framingham Risk Score

Framingham Risk Score

Estimates the 10-year cardiovascular risk of an individual.

 

See also

• QRISK

Embolism and Thrombosis

Disease class: Vascular diseases 

Types

• Embolism
• Thromboembolism
• Thrombosis

Polycystic kidney diseases

Disease class: Cystic kidney diseases

Types 

• polycystic kidney, Autosomal dominant
• polycystic kidney, Autosomal recessive

Associated with 

Brain haemorrhage

Dissecting aneurysm

Disease class: Aneurysm

Types

• carotid artery, Internal, Dissection
• Loeys-Dietz syndrome
• Vertebral artery dissection