Outpatient Coumadin Average INR goals?
2-3
Can you give patients Bactrim while taking Coumadin?
No, raises I&R
Why do we still use Coumadin?
It is cheap and completely reversible
Do you respecc the blood vessel?
Yes, put respecc on the vessel's name
What is the most common coronary artery?
Left anterior descending artery LAD. I dont remember what tf she said about it but I know its common for something.
Why are chest tubes placed?
Compression on lung, pneumothorax
Where is a chest tube placed?
5th intercostal space at the anterior or midaxillary line. Nipple line
Slide OVER the TOP of the rib!
Suction or water Seal
Why do you slide the chest tube over the top of the Rib?
Vasculature/Nerves are under the ribs
Cardio-pulmonary bypass
Cooling and high potassium based solution
Which 3 main Vessels do you harvest?
1. Internal Mammary Artery
2. Saphenous vein
3. Radial Artery
75y/o male presents to your office with amaurosis fugax in his right eye. He has been having TIAs over the last 3 months. His home medication include a simvastatin, plavix and metoprolol.
What tests do you want to consider?
Thats CAD
Carotid Duplex US check for stenosis
What is a carotid endarterectomy and what is the Risk?
Risk is CVA
What is aortic dissection?
Intimal tear with dissection of blood through media of the aortic wall
What is the tx for Type A aortic dissection?
Surgery
What is the Tx for Type B aortic dissection?
BP control!!!!
For surgery need higher than 120 BP
What is a complication from an Endovascular repair??
Endoleak
-persistent blood flow outside lumen of endoluminal graft but within aneurysm sac or adjacent segment being treated by device
What is the most common type of Endoleak?
Type 2
What is an Abnormal ABI, PAD?
<0.9 or
>1.40
What does vascular surgery do for PAD?
Angiogram and Intervention. Evaluate co-morbidities even in surg
Angioplasty or stent or bypass
PAD usual access for intervention?
Common femoral or brachial
Anastamosis
a connection made surgically between adjacent blood vessels, parts of the intestine, or other channels of the body, or the operation in which this is constructed.
Acute limb ischemia
TPA
Do you swab a wound if it doesn't look infected per Vascular lecture?
Nope