Overlap of Atherosclerotic Disease

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Overlap of Atherosclerotic Disease
CerebrovascularDisease
CoronaryDisease
Peripheral Arterial Disease
Patients with one manifestation often have
coexistent disease in other vascular beds
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The 3 Steps of Platelet Aggregation
Adhesion
Aggregation
von Willebrand Factor/GPlb bind
Platelets
Fibrinogen
Collagen GPla/lla bind
Lipid core
Activated GPllb/llla
Platelet
Activation
Thrombin
ADP
5 HT
TXA2
Adaptec from Schafer. Am J Med 1996101199-209.
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Atherosclerotic Plaque

Unstable
Stable
Lumen
Endothelium
Thrombus
Platelets
Lipid Rich Core
ThickFibrous Cap
ThinFibrous Cap
Falk E et al. Circulation. 199592657-671.
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Pressures Needed To Calculate The Ankle-Brachial
Index (ABI)
Right Arm Pressure
Left Arm Pressure
ABI Interpretation
Above 0.90 Normal 0.71-0.90 Mild
Obstruction 0.41-0.70 Moderate
Obstruction 0.00-0.40 Severe Obstruction
Pressure
Pressure
PT
PT
DP
DP
ABI Ankle pressure/Brachial pressure