Vascular surgery

Author(s):  
Anil Agarwal ◽  
Neil Borley ◽  
Greg McLatchie

This chapter covers vascular operations. Treatments described for varicose veins are high tie and multiple avulsions, radio-frequency ablation, and foam sclerotherapy. Repair of elective and ruptured abdominal aortic aneurysm and endovascular repair are described. Operations like aortobifemoral bypass, femoral popliteal above- and below-knee bypass graft, and femoro-distal bypass are included. Urgent operations like femoral and brachial embolectomy, lower limb fasciotomy are also described. In addition, above- and below-knee amputations and vascular access are included.

Over the last three decades, vascular surgery has transformed into a new specialty incorporating endovascular therapies. The field of vascular and endovascular therapy covers an extensive range of conditions and disorders of the arteries and veins such as lower limb ischaemia, abdominal aortic aneurysm, carotid disease, and varicose veins. This chapter covers recent key clinical evidence associated with the above conditions.


2020 ◽  
Vol 64 ◽  
pp. 80-87 ◽  
Author(s):  
Alejandro Fierro ◽  
Gaspar Mestres ◽  
María Alejandra Díaz ◽  
Paolo Tripodi ◽  
Xavier Yugueros ◽  
...  

Vascular ◽  
2016 ◽  
Vol 24 (5) ◽  
pp. 449-453 ◽  
Author(s):  
Emily Munday ◽  
Stuart Walker

Objectives Centralisation of vascular surgery services has coincided with a move towards endovascular repair of ruptured abdominal aortic aneurysms with the goal to improve patient outcomes. The aim of this study was to assess the effect of rural presentation and transfer times on survival from ruptured abdominal aortic aneurysm. Design A retrospective review. Materials All patients presenting with ruptured abdominal aortic aneurysm to public hospitals in Tasmania between July 2006 and April 2013. Methods Demographic data, Glasgow aneurysm score, Hardman index, transfer times, operative technique and 30-day mortality were collected from medical records. Results Over the study period 127 patients presented to public hospitals in Tasmania with ruptured abdominal aortic aneurysm. A total of 27 presented to north west hospitals where no vascular surgery service is provided (NWRH), 23 to a northern hospital where an intermittent vascular surgery service is provided (LGH) and 77 to the state tertiary vascular surgery service (RHH). Of these, 4 (14.8%) died at NWRH, 6 (26.1%) died at LGH and 43 (55.8%) died at RHH without operation. Of the 35 patients transferred from NWRH and LGH to RHH, 5 died without operation. Median time from presentation to theatre at RHH if transferred from NWRH was 6.25 hours, from the LGH 4.75 hours, compared to 2.75 hours when presenting directly to RHH. Open repair was performed in 41 patients and endovascular repair in 23 patients. Overall 30-day mortality in those treated at RHH was 26.6% (39.0% for open repair, 4.3% for endovascular repair). Mortality for intended operative patients initially presenting to non-RHH hospitals was 33.3% vs. 32.3% for those initially presenting to RHH. p Value 0.93. Conclusion There was no clinical or statistical disadvantage to rural presentation and transfer for patients presenting with ruptured abdominal aortic aneurysm in Tasmania. Endovascular repair has a role despite long transfer times.


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