1. Surgical aspects of peripheral vascular diseases
Dr . Al-zoubi NABIL
Associate Professor of Vascular & Endovascular surgery
Faculty of Medicine -
Jordan University of Science and Technology. .

2. Vascular Surgery ???
Arterial System.
Venous System.
Lymphatic system.

3. Arterial Diseases ???? Stenosis and Occlusion .
Dilatation and Aneurysms .
Injuries .

4. Arterial Diseases Lower limbs. Upper limbs. Thoracic Aorta.
Abdominal Aorta.
Visceral vessels.
Supra-Aortic Trunks and Extra-Crainial Vessels.

5. Arterial Diseases
Acute
Chronic
Acute on top of chronic .

8. Muscular Vs Elastic Arteries

9. Introduction and General Principals

10. Periphral Arterial Occlusive Disease
PAOD is a manifestation of systemic atherosclerosis that is defined by progressive stenosis or occlusion of the arteries ( Mainly ) of the lower extremities.

11. Risk Factors

12. Risk Factors.

13. Atherosclerotic Plaque

14. Atherosclerotic Plaque

15. Atherosclerotic Plaque

16. Atherosclerotic Plaque

18. Clinical presentation
The clinical presentation of PAOD includes a spectrum that spans :-
1- Individuals with no apparent lower extremity ischemic symptoms,
2- Those who experience IC (discomfort in the limb muscles with exertion),
3-Those with symptoms of severe limb ischemia (pain at rest, nonhealing wounds, or gangrene).

19. Intermittent Claudication (IC)
The word claudication is derived from the Latin word claudico meaning “to limp.”
Often described as pain, cramping, aching, numbness, fatigue, or weakness in the muscles of the leg, thigh, or buttocks that occurs during exercise and abates in a short time with rest.
IC is the most common symptomatic manifestation of peripheral arterial disease (PAD)
Affects 5% of the adult population above the age of 55 yr.

21. (IC) Pathophysiology
At rest, the stenosis may have minimal hemodynamic effect on limb blood pressure or blood flow.
During exercise, however, the hemodynamic effects of the stenosis may result in a pressure gradient, and attenuation of the increase in blood flow to the muscle group supplied by this vessel; the demands of exercise for an increase in blood flow cannot be met

23. Chronic Critical Limb Ischemia
Rest pain and/or tissue necrosis in the form of ischemic ulcers and gangrene.
Smaller in numbers than other groups with vascular disease.
Diagnostic efforts, hospitalization rates, treatment modalities, and general medical care are usually significantly more intensive than in patients with IC.

24. Chronic Critical Limb Ischemia

25. Chronic Critical Limb Ischemia

26. Chronic Critical Limb Ischemia

28. Management Conservative Treatment and medical Rx.
-Risk factors modification
-Anti-platlets
-Statins
-Cilostazol
Surgical Treatment .
Endovascular Treatment.
Amputation.

29. Endarterectomy

30. Endarterectomy

32. Bypass surgery - ABF

33. Angioplasty

34. Angioplasty with stenting

35. Stent

36. ROBOTIQUE ENDOVASCULAIRE

37. Amputation.

38. Aneurysms

39. Aneurysms

40. Aneurysms

41. Aneurysms

42. Dissection

43. Dissection

44. Dissection