Critical limb ischemia (CLI) is the end stage of peripheral artery disease that results from the continued thickening of an artery’s inner lining. In peripheral artery disease, plaque-buildups usually cause obstructions that narrow the artery, leading to a decrease in blood flow to the body’s extremities, specifically the hands, legs, and feet (Hyperarts, 2017). Consequently, CLI patients experience severe pain because of this reduction in circulation. In addition to rest-pain many patients face, CLI can also cause sores and ulcers in the skin of the area receiving less blood flow, increasing the pain CLI patients experience daily. Not only does CLI cause chronic excruciating pain, this condition puts patients at a higher risk for cardiovascular events. Patients must seek medical therapy to treat critical limb ischemia because the condition does not resolve itself over time and it requires endovascular or surgical intervention (Teraa, Conte, Moll, & Verhaar, 2016). The most common types of CLI treatments physicians recommend fall into the revascularization category, a group of treatments that improve blood flow by attempting to resolve or remove obstructions in the artery. Currently, the two most popular forms of revascularization are endovascular intervention and surgical intervention (Fu et al., 2015). …show more content…
This procedure is popular because it is less invasive and requires less recovery time than bypass surgery (Sharma, Farber, & Menard, n.d.). In angioplasty, a catheter guides a balloon and stent through the artery to the blockage. Once the stent is in place, the physician or surgeon expands the balloon, which causes the stent to expand and push against the walls of the artery, widening the blood vessel and increasing blood flow through the
Transcatheter aortic valve replacement or TAVR is the latest technology used principally for the treatment of aortic stenosis, a condition in which one of the major valves of the heart, the aortic valve, becomes tight and stiff, usually as a result of aging (3). Since many patients who need aortic valve replacement for aortic stenosis are too sick to undergo major valve replacement surgery, they are unable to get the treatment they need. With the transcatheter aortic valve, this issue is bypassed because this valve can be implanted in the heart by accessing the patient’s heart through an artery in the groin. The valve can be inserted through a wire that can be pushed to the heart, and the old valve is simply pushed to the side when the new valve is implanted. This technology has been in use in the US with Edwards’ Sapiens valve since 2011 and has saved the lives of many patients with aortic stenosis (4).
A Transient Ischemic Attack, generally referred to as a TIA, is a type of stroke that only last a few min...
The purpose for the stent was to hold the coronary artery open to allow the blood to flow more freely.
Endovascular stent graft repair is designed to help reinforce a weakened aorta. Endovascular surgery is performed inside the aorta using thin, long tubes called catheters to place a stent surrounded with a fabric liner. Endovascular stent grafting uses an endovascular stent graft to reinforce the wall of the aorta and to help keep the damaged area from rupturing and developing into a potentially serious health problem that can be fatal and cause massive internal bleeding.
The human body is an amazing machine, we have cells, tissues, organs and organ system that come together to create the human race. Each system plays a key role in our bodies mechanism. Without each systems our bodies would not function properly, but what happens when one of these system fails? The Cardiovascular system components are blood, blood vessels and the heart. The hearts function is to pump blood to all the major organs and tissues (Circulatory). It’s also important to be aware of the derivation that our bodies may encounter, for example a stroke. In this passage I discuss different types of strokes, what are the signs and symptoms and after care for this disorder of the cardiovascular system.
Coronary artery disease (CAD) is the most common type of multifactorial chronic heart disease. It is a consequence of plaque buildup in coronary arteries. The arterial blood vessels, which begin out smooth and elastic become narrow and rigid, curtailing blood flow resulting in deprived of oxygen and nutrients to the heart [1].
After a thorough examination, J.P. was diagnosed with a deep vein thrombosis (DVT). “DVT develops most often in the legs but can occur also in the upper arms…” (Ignatavicius & Workman, 2013). Due t...
The term, ischemia, denotes inadequate blood supply to tissues due to blockage of the arterial inflow, while, reperfusion injury is defined as the injury caused by the restitution of blood flow after an ischemic peroid, leading to death of cells that were only reversibly injured at the time of blood flow restitution. [63]. The final infarct size after an MI event is therefore the result of the ischemic and reperfusion damage. For this reason, the term that best describes this process of myocyte death in reperfused MI is myocardial ischemia/reperfusion (I/R) injury [64]. In the early hours post myocardial ischemia, injured cardiac cells can release several molecules, including adenosine, opioids, and bradykinin, which activate the G protein signaling pathways therefore promoting myocardial survival. While in the late phase, myocardial ischemia induces upregulation of growth factors and cytokines, including VEGF, ILGF and SDF-1, in the injured myocardium, hence promoting a cardio-protective state. The liver also participates in cardioprotection through the up regulation and release of secretory proteins, including FGF21 and TFF3, which also promote cardiomyocyte survival. [65]. Foundational studies performed about three decades ago with animal models demonstrated that an early reperfusion was able to limit infarct size [66]. Then fibrinolysis was indisputably associated with a decrease in mortality in patients with STEMI [67].A decade later; primary angioplasty was shown to be more superior than fibrinolysis [68]. Currently primary coronary angioplasty (PCI) has been established as the backbone treatment for STEMI patients. The period from the onset of symptoms of MI (representative of the time of coronary occlusion) and reperfusio...
Coronary artery bypass graft surgery is a procedure that can be life-saving for patients with heart disease, but it also carries risks after the procedure that can impact patient outcomes negatively. Because over 395,000 Americans have CABG surgery each year, and the risk-adjusted mortality rate for patients is 2%, according to Centers for Disease Control (CDC) statistics, health care professionals must find ways of reducing risks and complications to improve the outcomes for many patients (Ferguson, 2012). Heart disease is often comorbid with other conditions, like lung disease, peripheral arterial disease, hypertension, and diabetes, which can raise the risk of complications (Ferguson, 2012; Nejati-Namin, Ataie-Jafari, Amirkalali, Hosseini, Sheik Hathollahi, & Najafi, 2013). Complications that can arise following surgery include atrial fibrillation, prolonged inflammatory reactions, a build up of fluid near the heart, accelerated atherosclerosis, and nearby vein or artery blockage (Gokalp, Ilhan, Gurbuz, Cetin, Kocaman, Erdogan, & … Satiroglu, 2013; Ferguson, 2012; Scheiber-Camoretti, Mehrotra, Ling, Raman, Beshai, & Bowman, 2013; Sicaja, Starcevic, Sebetic, Raguz, & Vuksanovic, 2013). These complications can lead to increased lengths of stay, increased readmission rates, risk of further complications, failure of the bypass graft, cognitive dysfunction and memory loss, patient suffering, and even death (Ferguson, 2012; Gokalp et al., 2013; Sicaja et al., 2013). In turn, nurses, other care providers, and institutions may face negative consequences themselves, including a risk of lawsuits, increased employee workload, higher per-patient costs, reduced or withheld private insurance, Medicaid, and Medicare reimbursements, auditing...
Peripheral artery disease is usually caused by atherosclerosis, which is when fatty deposits accumulate in the arteries of, most likely, limbs. This does affect all arteries throughout the body, then in turn, slowing the blood flow. PAD may also be due to inflammation of the blood vessels, injury to the extremities, or even exposure to radiation. “Peripheral arterial disease (PAD) affects approximately 10% of the American population” (Gurbir Dhaliwal; Peripheral arterial disease: Epidemiology, natural history, diagnosis and treatment; 2007). If not taken care of, PAD may lead to critical limb ischemia, open sores on the feet or legs that become infected by gangrene. The gangrene is then removed surgically, but doctors might have to amputate the extremity all together. Another issue that arises with PAD if it is not under control is the risk of stroke or heart attack. These can cause death to part of the heart or brain, or even death itself. The population more at risk would be smokers, diabetics, people who are obese, those with hypertension or hyperlipidemia, over the age of 50, have a family history of PAD, or those with a high level of homocysteine. If someone does fall into a few of these categories a physician can do a few tests to check for PAD. The doctor will more than likely start off with a physical exam, blood test, and possibly an ultrasound. From there the physician may try an ankle-brachial index, or ABI, which compares the blood pressure of the feet to the blood pressure of the arm. “An American survey of 2174 patients older than 40 years of age used the ankle-brachial index (ABI) as a screening tool, and showed a PAD prevalence of 0.9% between the ages of 40 and 49 years, 2.5% between the ages of 50 and 59 years, ...
Because I provide the surgeon with medications, hemostatic agents and irrigation solutions it is crucial to know the proper usage of each, along with the side effects, patient's allergies, and contradictions of certain medications and their reactive
The World Health Organisation (2013) explains that an Ischaemic stroke occurs as a result of a blood vessel becoming blocked by a clot, reducing the supply of oxygen to the brain and, therefore, damaging tissue. The rationale for selecting Mary for this discussion is; the author wishes to expand her evidenced based knowledge of stroke since it is the principal cause of disability and the third leading cause of mortality within the Scottish population (Scottish Intercollegiate Guidelines Network (SIGN), 2008) and, therefore, a national priority. In response to this priority, the Scottish Government (2009) produced their ‘Better Heart Disease and Stroke Care Action Plan’. Additionally, they have introduced a HEAT target to ensure 90% of stroke patients get transferred to a specialised stroke unit on the day of admission to hospital (Scottish Government, 2012).
Yi-Wen, C., Ya-Wen, S., & Miin-Rong, H. (2013). A nursing experience of an amputated patient with peripheral arterial occlusive disease [Chinese]. Tzu Chi Nursing Journal, 12(1), 108-117.
I sat behind a large wall of glass, through which I studied the surgeons as they delicately inserted catheters into people’s wrists and examined X-rays. The nurses got so used to having me around that they didn’t mind taking a few moments out of their exhaustive schedules to show me how arteries work, the different types of blood clots, and ways for treating them. Mesmerized, I observed the surgeons cautiously pumped precisely measured fluid into the bodies of their patients, after which they inserted a small balloon at the site of clot blockage which helped compress and remove the built-up plaque. After the procedures ended, I couldn’t help barraging the surgeons with questions, and found their stories just as inspiring as their work. Not only did they give me great advice and hilarious anecdotes, but after listening to my own story and aspirations they each spurred me to pursue my dreams with greater
Etiology Myocardial infarction occurs when the coronary arteries are blocked by a blood clot. It is commonly known as a “heart attack”. The heart needs its own constant supply of oxygen and nutrients to work properly. Two coronary arteries deliver oxygenated blood to the heart, and if one of these two arteries fails or becomes blocked, then a portion of the heart will not acquire the necessary oxygen. This clot could be because of CAD (coronary artery disease), which happens when the inner walls of the coronary arteries thicken because of buildup of cholesterol, fatty deposits, calcium among other elements that are carried in the blood (Boston Scientific, 2009).