amputation 13, 25, 39-43, 47 above knee 42
age 39
below-knee 41 complications 43 contraindications 40 Gritti-Stokes 41 incidence 39 indications 39,40 level 41,42
mortality and morbidity 42 myoplastic 42
rate and vascular unit competence 26 rehabilitation 43 technique 40-2 through knee 41 toe-foot 41 transmetatarsal 41 anaemia, in peripheral
vascular disease 14 aneurysms 49-54
complications of surgery 53 contraindications of surgery diagnosis of leaking 51 52 diagnosic problems 49, 50 dissecting aortic 54 increasing incidence 49 leaking, mortality 50 pathology 50 resuscitation 51, 52 rupture 50
size and danger 51 surgery of leaking 52 types 49
X-ray 50
angina, intestinal 60 angina pectoris
in peripheral vascular disease in dissecting aortic aneurysms-13 angiography 54
intestinal ischaemia 60, 61 interpretation 15
technqiues 15
in dissecting aneurysms 54 angioplasty, patch 16 anti-inflammatory drugs in
thrombophlebitis 84 anticoagulant therapy see also
heparin, warfarin arterial occlusion 36, 91 complications 98 contraindications 97, 98 deep vein thrombosis 96,98 pulmonary embolism 100 aortic regurgitation 54
aortic surgery complication 61 aortofemoral bifurcation grafts aortography 15 21
aortoiliac reconstruction 20, 21 complications and morbidity
21
endarterectomy procedure 20 extraperitoneal approach 21 mortality 21
sexual function after 57 arterial anatomy, lower limb 12 arterial insufficiency, features of
lower limb 11 arterial occlusive disease 11-17
see also ischaemic limb acute 11
chronic 11 examinations 12 investigations 14 presentation 11 risk factors 13 surgery 16 treatment 15, 16
arteriogram see angiography arteriopathy 51
artery dilatation 29-31 arthropathy, Charcot's 71 atheroma
development of risk factors auscultation 13
in peripheral vascular disease in cervical rib 66 12
axillo femoral grafts 27
bladder dysfunction in lumbar canal stenosis 76 blood pressure index (ankle/-
brachial systolic pressure) 15
British Diabetic Association, foot care 70
Buerger's disease
acute, hospitalization 47 aortography 46
dead tissue 47 description 45 smoking 46, 47 sympathectomy 47 ulcer 45
cauda equina syndrome back injury 75 decompression and
management 76 features 75
cervical rib, digital artery embolism 66
cigarette smoking
and peripheral vascular disease 13
and critical ischaemia 26 and vascular reconstruction
results 13
and Buerger's disease 45 claudication, intermittent 11
medical management 13 surgical management 19 venous 104
Cockett's operation 82 cold agglutinins and Raynaud's
phenomenon 67 cold, effects on skin 64 compression sclerotherapy 82
bandaging 89
blow-out identification 88 check-ups 90
compression technique 89 contraindications 88 deep vein thrombosis, complicating 91 endosclerosis 87
history 87
injection technique 89 intra-arterial injection
effects 91
procedure for 'spiders' 81 ulcers 111
computerised tomography in aneurysms 51, 54 in lumbar canal stenosis 76 coronary artery by-pass grafting critical ischaemia in limb 25 13 cryoglobulinaemia and
Raynaud's phenomenon 67
deep vein thrombosis anticoagulants 95
diagnosis and ultrasound 96 heparin 94,96
hospital admission 97 pneumatic leg compression 95 prevention 94-6
recurrent 98. 99 surgical risks 95, 96 ulcers 108
warfarin 97
dermatomyositis and Raynaud's phenomenon 66 dextran
arterial occlusion 36 deep vein thrombosis 95 diabetes mellitus
complications and feet 69 neuropathy 70
prevention of complications diabetic foot 70 69-73
arterial changes 69 assessment 72 neuropathy 71
poor healing and pathogens septic 70 70
ulcers 71 diet 14
digital artery thrombosis 66 dissecting aortic aneurysm 54 Dopple ultrasound 14
anklelbrachial pressure index ankle pressures 15 15, 25 deep vein thrombosis 96, 99 saphenous vein 84
technique in arterial assessment 14 technique in venous
assessment 104 drugs, vasoactive and lower limb
ischaemia 15, 16 eczema, venous 110
elastic stockings 81,85,90,105, 110,112
elevation and exercise test for claudication 12 embolectomy, arterial
delayed 36 technique 37
embolectomy, pulmonary 100 embolism, arterial
aetiology 33
clinical presentation 35 diagnosis 35
management 36 saddle 34 silent 35
time factor in management 36 uncommon causes 34 embolism, pulmonary 99
endocarditis, and arterial embolism 34 exercise in management of
claudication 14 extra-anatomic grafts 27 femoral artery 12 femoro-femoral grafts 27 femoro-popliteal reconstruction
complications 23 endarterectomy 21 mortality 23 patency rate 22
saphenous vein by pass 22 synthetic grafts 22
fibrinogen (1251) uptake test 94, 99
Fogarty's balloon catheter 37 foot see diabetic
care 70 gangrene 26
diabetic 69 dry 72 features 40
management of diabetic 72
"pre-senile" 45 wet 35. 39, 72 grafts, arterial 16, 17
venous 105 heparin
in acute arterial occlusion 36 deep vein thrombosis
prevention 94 deep vein thrombosis management 96 in pulmonary embolism 100 hyperhidrosis, in Buerger's
disease 46 hyperlipidaemia 14 hypertension
cerebrovascular accident 13 venous 110
iliac artery 12 iliac stenosis 31
iliofemoral venous thrombosis venous obstruction 98 104 impotence
assessment 56
incidence, post-operative 57
prevention and surgical treatment 57 steal phenomenon 56 vasculogenic 56
intermittent claudication 11, 46 benign course 13
coronary artery disease 13 disability assessment 19 exercise 14
pain relief 15, 16
surgical treatment 19-23 see also aortoiliac, femoro- popliteal
venous 104 intestinal ischaemia
acute, causes and surgery 61 chronic and surgery 60 intestinal tract
angina 60
infarction fatality 60 pathology, arterial 59 vascular anatomy 59 vascular surgery 59-61 ischaemia, tissue damage rate ischaemia 34
acute 33 arteriogram 26
critically ischaemic limb 25 Doppler pressures 25 embolism 33
features 25 management 27 rest pain 26 sympathectomy 27 thrombosis 33
vascular reconstruction 27 limb salvage 25, 27
lipids, in peripheral vascular disease 14
lower limb see also diabetic foot blood supply 12
calf muscle pump 78 examination 12 exercise test 12 venus anatomy 77
lumbar canal stenosis 75, see also cauda equina syndrome
mesenteric artery steal syndrome 61
mesenteric vein occlusion 60 mini injections, for varicose
veins 81
myocardial infarction, surgery risk 13
naftidofuryl 15, 27
neuroma, post amputation 43 neuropathy and diabetic control
71
oral contraceptives and
compression sclero- therapy 88
pain
causes in lower limb 11 emboli 35
pleuritic 99 rest 26, 39, 40
percutaneous transluminal angioplasty 29-31 advantages 30
and atheroma 30 complication rate 30 controversy 29 indications 31 procedure 29 vessels dilated 30 phantom limb 43 platelets
in <:leep vein thrombosis 93 anti platelet drugs 15 polyarteritis nodosa and
Raynaud's phenomenon polymyositis and Raynaud's 66
phenomenon 66 polytetrafluoroethlyene (PTFE)
grafts 17 popliteal artery 12
polycythaemia, in peripheral vascular disease 14 post-thrombotic syndrome
103-5 features 103 ulcers 108
venous outflow obstruction venous reconstruction 104 105 prostaglandins 15
prostheses, amputation 43 protamine sulphate 98
pulmonary embolism
arterial gas measurements 99 chest x-ray 100
clinical symptoms 99 diagnosis 99
management 100
pulmonary embolectomy 100 recurrent 100
thrombolysis 100 pulses, examination of 12 pyoderma gangrenosum 71
Raynaud's disease diagnostic criteria 65 treatment 68
Raynaud's phenomenon 65-8 assessment and diagnosis 67 associated conditions 65 blood disorders 67 cold injury 67 eRST syndrome 65 treatment 67 vibration injury 67 Raynaud's syndrome
cold effects 64
description, Raynaud 63 clinical features 64 restless leg syndrome 84
rheumatoid arthritis and
Raynaud's phenomenon 66
salvage, limb 25
sapheno-poplitealligation 83 saphenous vein
grafts 22
long and short 77
normal and varicose filling stripping 82 80
valves 77
sclerotherapy see compression sclerotherapy
Seldinger technique of aortography 15 serum phosphate in acute
intestinal ischaemia 61 sexual function 55-7 see also
impotence
ejaculation mechanism 56 and impotence 56
spinal reflexes 55
Sjorgen's syndrome and
Raynaud's phenomenon skin 66
blood vessel function 63 graft and ulcers 112 oxygen requirements 64 smoking 13,26
amputation 13 Buerger's disease 45
sodium tetradecyl sulphate intra-arterial effects 91 irritant 90
sclerosant 81, 89 spinal stenosis 75 streptokinase 37, 98, 100
ileofemoral venous thrombosis suloctidil 15 98
superficial thrombophlebitis 83 sympathectomy
dorsal in Raynaud's 68 lumbar in ischaemia 27 in Buerger's disease 47
phenol 27
systemic lupus erythematosis and Raynaud's phenomenon 66 systemic sclerosis and Raynaud's
phenomenon 65 temperature regulation 64 thromboangiitis obliterans;
Buerger's disease 45
thromboembolism 93 thromboendarterectomy 16 thrombolytic therapy
in arterial embolism 37 in ileofemoral venous
thrombosis 98
in pulmonary embolism 100 thrombophlebitis, superficial
and varicose veins, treatment 83 and Buerger's disease 46 90 thrombosis
arterial,
aetiology and history 33 clinical presentation 35 management 37
thrombolytic therapy 37 venous,
pathogenesis 93 prevention 94 clinical features 96 management 96 Trendelenburg's operation
for varicose veins 82 for pulmonary embolus 100 ulcers
aetiology 107,108,111 Buerger's disease 46
deep vein abnormalities 108 eczema and dermatitis 110 excision and grafting 112 features 108
historical 107 hypertension 110 investigations 109 local treatment 111 management 110 neuropathic 71 outpatient care 111 overtreatment 109 patient history 109 pressure 26 recurrence 112 surgery 112 varicose 70,107 venous 107 ultrasound
in diagnosis of aneurysms 51 umbilical vein grafts 17, 22 vein grafts 17, 22, 105 valve grafts 105 varicose veins see also
compression sclero- therapy
anatomy 77
avulsion and excision 82 bleeding 80
body image 79 causes 79
clinical features 79 elastic stockings 81 examination 80 mini injections 81 post operative care 83 primary 78
recurrent, causes and treatment 83 secondary 78
surgical procedures 82 thrombophlebitis 83
valve incompetence sites 80 vascular reconstruction
critical ischaemia 27 survival time 27 valve grafts 105 venous by-pass 105 vasoactive drugs 15 vasodilators 15 vein by-pass 105
vena caval umbrellas 101 venography 96
techniques 105 venous claudication 104 venous outflow obstruction
investigations 104 management 105
venous reconstructive surgery venous thromboembolism see 105
also deep vein thombosis
blood structure and flow 93 clot propagation 93
ileo femoral 98
post operative mobilization predisposing factors 93 93 vibration injury and Raynaud's
phenomenon 67 vitamin Kl 98
warfarin therapy 97
