Limb Threatening Ischemia

Limb Threatening Ischemia
Vic V. Vernenkar, D.O.
General & Vascular Surgery, St. Barnabas Hospital, Bronx, New York
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Chapter Description:
Introduction
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Introduction
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Classification of Ischemia
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Clinical Presentation
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Clinical Presentation
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Clinical Presentation
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Clinical Presentation
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Clinical Presentation
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Diagnostic Evaluation
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Noninvasive Vascular Testing
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Noninvasive Testing
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Arteriography
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Tibial Disease
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Superficial Femoral Disease
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Popliteal Aneurysm
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Hypercoagulable States
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Management
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Chronic Critical Ischemia
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Immediate Treatment
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Initial Diagnostic Tests
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Emergency Arteriogram
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Choice of Operation
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Embolectomy
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Choice of Intervention
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Wake Up, It's Over
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Brief Description
This is a a clinical presentation on limb threatening ischemia by Vic V. Vernenkar.
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Mar 04, 2010	801	VA:03:04:2878:2010
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														<td width="6%"><strong>7</strong></td>
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														<td width="6%"><strong>9</strong></td>
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														<td width="6%"><strong>10</strong></td>
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			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide11.JPG" id="image_11"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>11</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275671"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_12" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(12);">
			<span style="display:none;" id="span_12">|~|/files/powerpoints_images/node275647/Slide12.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide12.JPG" id="image_12"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>12</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275673"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_13" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(13);">
			<span style="display:none;" id="span_13">|~|/files/powerpoints_images/node275647/Slide13.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide13.JPG" id="image_13"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>13</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275675"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_14" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(14);">
			<span style="display:none;" id="span_14">|~|/files/powerpoints_images/node275647/Slide14.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide14.JPG" id="image_14"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>14</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275677"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_15" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(15);">
			<span style="display:none;" id="span_15">Clinical Presentation|~|/files/powerpoints_images/node275647/Slide15.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide15.JPG" id="image_15"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>15</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275679">Clinical Presentation</div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_16" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(16);">
			<span style="display:none;" id="span_16">Diagnostic Evaluation|~|/files/powerpoints_images/node275647/Slide16.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide16.JPG" id="image_16"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>16</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275681">Diagnostic Evaluation</div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_17" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(17);">
			<span style="display:none;" id="span_17">Noninvasive Vascular Testing|~|/files/powerpoints_images/node275647/Slide17.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide17.JPG" id="image_17"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>17</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275683">Noninvasive Vascular Testing</div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_18" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(18);">
			<span style="display:none;" id="span_18">Noninvasive Testing|~|/files/powerpoints_images/node275647/Slide18.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide18.JPG" id="image_18"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>18</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275685">Noninvasive Testing</div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_19" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(19);">
			<span style="display:none;" id="span_19">Arteriography|~|/files/powerpoints_images/node275647/Slide19.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide19.JPG" id="image_19"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>19</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275687">Arteriography</div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_20" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(20);">
			<span style="display:none;" id="span_20">|~|/files/powerpoints_images/node275647/Slide20.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide20.JPG" id="image_20"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>20</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275689"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_21" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(21);">
			<span style="display:none;" id="span_21">Tibial Disease|~|/files/powerpoints_images/node275647/Slide21.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide21.JPG" id="image_21"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>21</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275691">Tibial Disease</div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_22" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(22);">
			<span style="display:none;" id="span_22">Superficial Femoral Disease|~|/files/powerpoints_images/node275647/Slide22.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide22.JPG" id="image_22"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>22</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275693">Superficial Femoral Disease</div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_23" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(23);">
			<span style="display:none;" id="span_23">Popliteal Aneurysm|~|/files/powerpoints_images/node275647/Slide23.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide23.JPG" id="image_23"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>23</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275695">Popliteal Aneurysm</div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_24" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(24);">
			<span style="display:none;" id="span_24">Hypercoagulable States|~|/files/powerpoints_images/node275647/Slide24.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide24.JPG" id="image_24"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>24</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275697">Hypercoagulable States</div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_25" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(25);">
			<span style="display:none;" id="span_25">|~|/files/powerpoints_images/node275647/Slide25.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide25.JPG" id="image_25"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>25</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275699"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_26" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(26);">
			<span style="display:none;" id="span_26">Management|~|/files/powerpoints_images/node275647/Slide26.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide26.JPG" id="image_26"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>26</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275701">Management</div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_27" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(27);">
			<span style="display:none;" id="span_27">|~|/files/powerpoints_images/node275647/Slide27.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide27.JPG" id="image_27"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>27</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275703"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_28" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(28);">
			<span style="display:none;" id="span_28">Chronic Critical Ischemia|~|/files/powerpoints_images/node275647/Slide28.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide28.JPG" id="image_28"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>28</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275705">Chronic Critical Ischemia</div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_29" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(29);">
			<span style="display:none;" id="span_29">|~|/files/powerpoints_images/node275647/Slide29.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide29.JPG" id="image_29"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>29</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275707"></div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_30" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(30);">
			<span style="display:none;" id="span_30">Immediate Treatment |~|/files/powerpoints_images/node275647/Slide30.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide30.JPG" id="image_30"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>30</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275709">Immediate Treatment </div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_31" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(31);">
			<span style="display:none;" id="span_31">Initial Diagnostic Tests|~|/files/powerpoints_images/node275647/Slide31.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide31.JPG" id="image_31"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>31</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275711">Initial Diagnostic Tests</div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_32" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(32);">
			<span style="display:none;" id="span_32">Emergency Arteriogram|~|/files/powerpoints_images/node275647/Slide32.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide32.JPG" id="image_32"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>32</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275713">Emergency Arteriogram</div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_33" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(33);">
			<span style="display:none;" id="span_33">Choice of Operation|~|/files/powerpoints_images/node275647/Slide33.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide33.JPG" id="image_33"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>33</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275715">Choice of Operation</div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_34" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(34);">
			<span style="display:none;" id="span_34">Embolectomy |~|/files/powerpoints_images/node275647/Slide34.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide34.JPG" id="image_34"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>34</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275717">Embolectomy </div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_35" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(35);">
			<span style="display:none;" id="span_35">Choice of Intervention|~|/files/powerpoints_images/node275647/Slide35.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide35.JPG" id="image_35"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>35</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275719">Choice of Intervention</div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
<tr height="68px">
	<td align="center" valign="bottom" height="68px" colspan="2">
		<div id="div_36" style="height: 68px; width: 300px; padding-top: 6px; cursor:hand;" class="cont_ents" onclick="fill_imagedetails(36);">
			<span style="display:none;" id="span_36">Wake Up, It\'s Over|~|/files/powerpoints_images/node275647/Slide36.JPG|~|563|~|422|~|0</span>
			<table cellspacing="0" cellpadding="0" border="0" align="right" width="294px">
				<tbody>
					<tr height="62px">
						
						<td width="36%" class="image_tag" style="cursor:hand;">
							<div style="overflow:hidden;height:61px;width:105px">
								<img height="79" width="105" border="0" src="/files/powerpoints_images/node275647/Slide36.JPG" id="image_36"/>
							</div>
						</td>
						<td class="image_tag_desc" width="64%">
							<table cellspacing="0" cellpadding="0" border="0" align="center" width="99%" class="table172X62" >
								<tbody>
									<tr>
										<td valign="top">
											<table cellspacing="0" cellpadding="0" border="0" align="center" width="96%">
												<tbody>
													<tr>
														<td width="94%" align="left"><strong>Image</strong></td>
														<td width="6%"><strong>36</strong></td>
													</tr>
													<tr>
														<td height="42" valign="top" colspan="2" align="left" text-align="left"><div id="imagedesc_275721">Wake Up, It's Over</div></td>
													</tr>
												</tbody>
											</table>
										</td>
									</tr>
								</tbody>
							</table>
						</td>
					</tr>
				</tbody>
			</table>
		</div>
	</td>
</tr>
</tbody>
</table>
</div>
<div style="width:100%; text-align:center; display:none;">
	<span><img src="/files/images/remove.gif" alt="Delete marked images" onclick="javascript:delete_images(document.form);"/><a href="javascript:delete_images(document.form);">Delete marked images</a></span>
	<span style="float:none;"><img src="/files/images/add.gif" alt="Add new images" onclick="javascript:add_images();"/><a href="javascript:add_images();" >Add new images</a></span>
</div>
</td>
</tr>
</tbody>
</table>
</td>
</tr>
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<div style="display:none;" id="last_image_slno">36</div>
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