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Stand the patient up. Ask the patient to walk or repeatedly stand on tiptoes, flexing and extending the ankle. If the superficial veins fill, it suggests deep venous obstruction. No longer recommended. 1 Interpreting vascular scars. g. for EVAR Abbreviations: EVAR, endovascular aneurysm repair; LSV, long saphenous vein Vascular and Endovascular Surgery at a Glance, First Edition. Morgan McMonagle and Matthew Stephenson. 38 © 2014 John Wiley & Sons, Ltd. Published 2014 by John Wiley & Sons, Ltd.
How well controlled? • Do they have a family history of specific conditions? • Heart disease? • Stroke? • Peripheral vascular disease? • Aneurysms (particularly men)? • Cardiovascular history • Cardiac/cerebral: • Do they get chest pain? • Do they get shortness of breath (SOB)? • Ever had an MI? • Ever had a coronary angiogram? • Ever had a coronary artery bypass graft (CABG)? • Under a cardiologist? • Ever had a stroke or transient ischaemic attack (TIA)? • Vascular • Ever been seen by a vascular surgeon?
46 © 2014 John Wiley & Sons, Ltd. Published 2014 by John Wiley & Sons, Ltd. com/vascular Lower limb assessment As a ‘rule of thumb’ the mean velocity is 100 cm/s (±30–50%) including the aorta (peak systolic velocity [PSV] 100–150 cm/s) with triphasic morphology. There is a gradual decrease in velocities on moving distally down the arterial tree (loss of energy and increasing number of branches). 0 (≥50% stenosis). Distal to a stenosis, there is loss of the reverse-flow component of the waveform with poststenotic turbulence (spectral broadening).