Vascular Medicine

A

• Acrocyanosis & Achenbach Syndrome — Recognition & Management

  Primary acrocyanosis is benign distal cyanosis; Achenbach syndrome causes sudden painful finger bruising. Rule out serious mimics (Raynaud, emboli, vasculitis) and reassure.
• Acute Limb Ischemia - Recognition and Initial Anticoagulation

  Recognize the six Ps, start systemic anticoagulation promptly, classify severity, and obtain urgent vascular consultation for revascularization.
• Anticoagulation Reversal - Warfarin and DOAC Major Bleeding

  Identify the agent and timing, control bleeding source, reverse anticoagulation with targeted antidotes or prothrombin complex concentrate, and restart thoughtfully after hemostasis.
• Antithrombotic Therapy in PAD — Single vs Dual Pathway

  Choose antithrombotic therapy by PAD phenotype and bleeding risk: single antiplatelet for most; consider dual pathway inhibition (rivaroxaban 2.5 mg BID + aspirin) in symptomatic PAD and post‑revascularization.

B

• Buerger Disease (TAO) — Diagnosis & Smoking Cessation

  Thromboangiitis obliterans (Buerger disease) is a non‑atherosclerotic, segmental vasculitis in young tobacco users causing distal ischemia. Absolute tobacco cessation is the only disease‑modifying therapy.

C

• Cholesterol Embolization Syndrome — Diagnosis & Management

  Look for livedo reticularis/blue toe, eosinophilia, AKI after vascular procedures. Management is supportive: stop anticoagulation if suspected procedure‑related plaque disruption, control BP, statins, and renal support.

D

• Deep Vein Thrombosis - Outpatient Anticoagulation Selection

  Stable patients without high risk features can start outpatient anticoagulation; choose a direct oral anticoagulant for most and consider low molecular weight heparin in active cancer or pregnancy.
• Deep Vein Thrombosis - Probability and Ultrasound Diagnosis

  Use pretest probability and D dimer to guide imaging; compression ultrasound is first line and repeat imaging is needed in selected high risk patients with negative initial study.
• Deep Vein Thrombosis — Evaluation & Treatment

  Use Wells score and D-dimer to guide ultrasound; treat proximal DVT with anticoagulation; consider serial imaging for isolated distal DVT; choose DOACs for most, LMWH for cancer and pregnancy.

E

• Extended VTE Therapy — Who Needs It & How

  After initial 3–6 months, extend anticoagulation in unprovoked VTE or persistent risk factors if bleeding risk is acceptable; use reduced‑dose DOACs for long‑term prevention.

H

• Heparin Induced Thrombocytopenia - 4T Score and Management

  Suspect HIT with a platelet fall and new thrombosis after heparin exposure; stop all heparin, start a non heparin anticoagulant, and confirm with immunoassay and functional testing.

I

• IVC Filters — Indications, Retrieval & Complications

  Reserve IVC filters for acute VTE with absolute contraindication to anticoagulation or recurrent VTE despite adequate anticoagulation. Plan retrieval early to reduce complications.

L

• Lipodermatosclerosis — Recognition & Care

  Inflammatory panniculitis from chronic venous insufficiency. Treat with compression, ambulation, weight management, and address reflux; topical steroids for acute phase; pentoxifylline as adjunct.
• Lymphedema vs Venous Edema — Differentiation & Care

  Differentiate lymphedema (non‑pitting, Stemmer sign) from venous edema (pitting, worse at day’s end). Treatments differ: CDT for lymphedema vs compression/elevation for venous disease.

P

• Peripheral Artery Disease - Medical Therapy and Supervised Exercise

  All patients need antiplatelet therapy, high intensity statin, smoking cessation, blood pressure and diabetes control, and supervised exercise therapy; consider cilostazol when no heart failure.
• Post‑Thrombotic Syndrome — Prevention & Management

  Chronic symptoms after DVT (pain, swelling, heaviness, ulcers). Prevent with appropriate anticoagulation and early mobilization; manage with compression, exercise, and ulcer care.
• Pulmonary Embolism - Risk Stratification and Disposition

  Use validated tools with clinical judgment to identify low risk patients for outpatient care and high risk features for admission and escalation.
• Pulmonary Embolism - Submassive Thrombolysis Decision

  In normotensive PE with right ventricular strain and elevated biomarkers, prioritize anticoagulation and monitoring; consider thrombolysis or catheter based therapy when clinical deterioration or very high risk features are present.

S

• Superficial Vein Thrombosis - Treatment and Risk Stratification

  Treat symptomatic or extensive superficial vein thrombosis with anticoagulation in high risk patterns and use supportive measures for limited disease.

U

• Upper Extremity DVT - Catheter Associated Management

  Treat symptomatic or catheter related upper extremity DVT with anticoagulation; remove the catheter only when no longer needed or nonfunctional and continue therapy for at least three months.

V

• VTE in Pregnancy — Diagnosis & Treatment

  Use compression US for DVT; V/Q or CTPA for suspected PE with pregnancy‑adapted protocols. Treat with LMWH throughout pregnancy and 6 weeks postpartum; avoid warfarin and most DOACs.