Vascular Surgery

Abstract

This chapter discusses case studies of different persons requiring vascular surgery. Intravascular ultrasound interrogation is essential as it affects management and decision to stent. Differential diagnoses include an embolism secondary to cardiac arrhythmia; mural thrombosis; vegetations, cardiac tumours or proximal aneurysms; popliteal aneurysm thrombosis and arterial dissection. The chapter describes the natural history of asymptomatic carotid stenosis, and also describes the randomised controlled trial data that are available to assess treatment of asymptomatic carotid stenoses. It also discusses the risk factors for developing infrarenal abdominal aortic aneurysm. Patients with intermittent claudication have significantly increased risks of cardiovascular events. Controlling the cardiovascular risks is the main priority. Angioplasty and stenting should never be used in the non-decompressed venous bony thoracic outlet. Although angioplasty is safe after decompression, stenting even in this situation should be used with caution as it has been associated with worse outcomes.