1. الجامعة السورية الخاصة كلية الطب البشري قسم الجـراحـة الدكــتـور عاصم قبطان MD – FRCS www.surgi-guide.com 3 rd lecture 1M.A.Kubtan

2. Medical support in chronic arterial iscaemia Medical treatment for associated disease such as diabetes, hyperlipidemia. Beta blockers may exacerbate claudication. Anti platelet agent, aspirin, clopidogrel as an alternative. Vasodilators are unlikely to be beneficial. M.A.Kubtan2

3. 3 Collateral vessels develop 6 months after an occlusive episode. Intermittent claudication considered relative indication for interventional or conventional treatment. Rest pain considered an absolute indication for interventional or conventional treatment.

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6. Stenos left renal artery a. before dilatation, b. after balloon dilatation M.A.Kubtan6

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11. Stent deployment M.A.Kubtan11

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14. Operation for arterial stenosis or occlusion Site of disease Aortoiliac occlusion. Aorto femoral occluaion. Superfacial femoral artery occlusion. Popleteal occlusion. Posterior tebial artery occlusion. Type of operation Aortoiliac bypass. Aortofemoral bypass. Femoropopleteal bypass. Femorodistal popleteal bypass. Femorodistal bypass. M.A.Kubtan14

15. Types of bypass grafts Autogenous saphenous vein ( as reversed conduit or in situ after valve disruption ). Dacron graft. PTFE ( polytetrafluroethylene ) graft. PTFE ( rings supported ). Human umbilical vein treated graft. M.A.Kubtan15

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