Postgraduate Vascular Surgery: The Candidate's Guide To The Frcs (cambridge Medicine (paperback))

Postgraduate Vascular Surgery is your concise pocket guide to the FRCS and MRCS exams. Covering the full range of surgical interventions, including diagnosis, management, clinical investigation and treatment, all chapters have been written by specialists in their field. The chapters are structured with key bullet points for easy reference, as well as tables, figures and charts to aid understanding. Relevant references are included for further exploration of a particular topic. Tips and tricks on passing the exam are included. This book is aimed at candidates for the FRCS and intercollegiate MRCS exams, surgical trainees and those following a sub-speciality of vascular surgery. Tables, charts and photographs in each chapter cover conditions and causes for easier understanding Bullet points and key boxes at the end of chapters to aid quick revision All important topics covered concisely for quick pocket reference Cover......Page 1 Half-title......Page 3 Title......Page 5 Copyright......Page 6 Contents......Page 7 Contributors......Page 9 Preface......Page 11 Section 1 Final FRCS vascular clinicals......Page 13 How do PAs present?......Page 15 What are your indications for elective repair?......Page 16 The case......Page 17 What endovascular interventions can be helpful in managing large tumours?......Page 18 The case......Page 19 How do FAPs present?......Page 20 The case......Page 21 What are the complications of an AV fistula?......Page 22 What are the secondary causes of lymphoedema?......Page 23 What surgical procedures are performed to manage lymphoedema?......Page 24 How is neuropathy tested?......Page 25 What imaging aids the diagnosis of osteomyelitis?......Page 26 Which cranial nerves are at risk during carotid endarterectomy?......Page 27 When would you use a carotid shunt?......Page 28 How would you manage a postoperative cerebrovascular event (CVE) following recent carotid endarterectomy?......Page 29 How is the diagnosis made?......Page 30 How is Buerger’s disease managed?......Page 31 Venous malformations......Page 32 The basics......Page 33 What concerns would you have over performing superficial venous surgery in KTS?......Page 34 The basics......Page 35 What are the common configurations causing popliteal artery compression?......Page 36 What other rare vascular disorders can causes arterial claudication in the younger patient?......Page 37 The case......Page 38 The basics......Page 39 The case......Page 40 How do you manage venous ulcers?......Page 41 How is compression hosiery classified?......Page 42 What CT features of an AAA would you consider in assessing it for a conventional stent graft?......Page 43 The basics......Page 44 Early complications......Page 45 References......Page 46 Section 2 Final FRCS vascular topics......Page 47 The need for cardiovascular risk factor management in patients with peripheral arterial disease......Page 49 Why do we as vascular surgeons need to treat risk factors?......Page 50 Smoking......Page 51 Smoking: current recommendations......Page 52 Dyslipidemia......Page 53 Statins and inflammatory response......Page 55 Hypertension......Page 56 Antiplatelet therapy......Page 57 Diabetes: current recommendations......Page 58 Homocysteine......Page 59 References......Page 60 Aetiology......Page 61 Assessment of the acutely ischaemic limb......Page 62 Management......Page 63 Investigation......Page 64 Embolectomy......Page 65 Thrombolysis......Page 66 Palliative care......Page 67 Rhabdomyolysis......Page 68 References......Page 69 Epidemiology......Page 70 Examination......Page 71 Ankle brachial pressure index (ABPI) measurement......Page 72 Investigations......Page 73 Reducing cardiovascular risk......Page 75 Improving walking distance......Page 77 Surgical bypass......Page 78 Amputation......Page 79 Diabetic vascular disease......Page 80 Ischaemia......Page 81 Conclusion......Page 82 References......Page 83 Background......Page 84 Analgesia......Page 85 Thrombolysis......Page 86 Surgery versus thrombolysis......Page 87 Surgical bypass......Page 88 Femoro-popliteal bypass......Page 89 Angioplasty......Page 90 Arterial puncture site haemorrhage......Page 91 Contrast induced nephropathy (CIN)......Page 92 SFA stenting......Page 93 Stent grafts......Page 94 Graft/stent surveillance......Page 95 Evidence-based approach......Page 96 References......Page 97 Definition......Page 98 Aetiology......Page 99 Presentation......Page 100 Computerised tomography......Page 101 Treatment......Page 102 Open aneurysm repair......Page 103 Endovascular aneurysm repair (EVAR)......Page 104 Type I......Page 106 Follow up post EVAR......Page 107 Fenestrated and branched grafts......Page 108 Treatment of ruptured AAAs......Page 109 References......Page 110 Aetiology and pathophysiology......Page 111 Imaging and classification......Page 112 Preoperative assessment......Page 113 Type I, II, III and V thoracoabdominal aortic aneurysms......Page 114 Type IV thoracoabdominal and suprarenal aneurysms......Page 115 Reducing the overall risk......Page 116 Reducing the risk of paraplegia......Page 117 Reducing complications of blood loss and coagulopathy......Page 118 References......Page 119 Aetiology......Page 120 Presentation......Page 121 Diagnosis and classification......Page 122 Type A......Page 123 Type B – complicated......Page 124 References......Page 125 Pathophysiology......Page 127 Investigation......Page 128 When to repair......Page 129 Conduits......Page 130 Management of thromboembolism......Page 131 The endovascular era......Page 132 References......Page 133 Pathophysiology......Page 135 Investigation......Page 136 Outcome......Page 137 Treatment......Page 138 References......Page 140 Clinical features......Page 141 Pathology......Page 142 Clinical features......Page 143 Clinical features......Page 144 Clinical features......Page 145 Pathology......Page 146 Demographics......Page 147 Demographics......Page 148 Investigations......Page 149 Symptomatic carotid disease......Page 150 Asymptomatic carotid disease......Page 152 Performance of CEA......Page 154 Demographics......Page 155 Prognosis......Page 156 References......Page 157 Introduction......Page 158 Clinical presentation......Page 159 Roos test (Elevated Arm Stress Test, EAST)......Page 160 Investigations......Page 161 Arterial TOS......Page 162 References......Page 163 Introduction......Page 164 Botulinum toxin......Page 165 Local surgical treatments......Page 166 References......Page 167 Background......Page 168 Diagnosis......Page 169 Treatment......Page 170 Antegrade versus retrograde inflow reconstruction......Page 171 Autogenous versus prosthetic grafts......Page 172 Percutaneous transluminal angioplasty and stenting (PTA/stent)......Page 173 References......Page 175 Pathophysiology......Page 176 Anatomical factors......Page 177 Differential diagnosis......Page 178 Blood gases......Page 179 Surgical......Page 180 Prevention......Page 181 References......Page 182 General considerations......Page 184 Investigations [2]......Page 185 General principles of arterial repair......Page 186 Limb distal vessel injury......Page 187 Management......Page 188 Penetrating carotid injuries......Page 189 Blunt carotid artery injury in the neck......Page 190 Management of retroperitoneal haematomas......Page 191 Mesenteric vessel injuries [10]......Page 192 Specific injuries of open surgery......Page 193 References......Page 194 History of amputation......Page 195 Epidemiology of amputation......Page 196 Preoperative assessment......Page 197 Principles of amputation surgery......Page 200 Mid-foot amputation......Page 201 Through-knee amputation......Page 202 Late complications......Page 203 References......Page 205 Primary......Page 207 Pathophysiology......Page 208 Presentation......Page 209 Duplex ultrasonography......Page 210 Computed tomography......Page 211 Compression therapy......Page 212 Prevention of infection......Page 213 Debulking operations......Page 214 References......Page 215 Epidemiology......Page 216 Asymptomatic varicose veins......Page 217 Symptomatic varicose veins......Page 219 Duplex......Page 220 Contrast venography......Page 221 Compression stockings......Page 222 Catheter ablation......Page 223 Saphenofemoral junction ligation and great saphenous vein stripping......Page 224 Recurrent varicose veins......Page 225 Complications of treatment (Table 18.3)......Page 226 Aetiology......Page 227 Superficial venous surgery......Page 228 Management of leg ulcers......Page 229 References......Page 230 Pathophysiology......Page 232 Assessment of risks......Page 233 Diagnostic evaluation......Page 234 Information and assessment......Page 235 Unfractionated heparin......Page 236 Direct thrombin inhibitors......Page 238 Summary......Page 239 References......Page 240 Causative organisms......Page 241 Clinical presentation......Page 243 Magnetic resonance (MR) scanning......Page 244 In situ vein graft......Page 245 Infected aortic grafts......Page 246 Infected carotid patches......Page 248 Infected peripheral grafts......Page 249 Revascularisation......Page 250 Infected femoral pseudoaneurysms......Page 251 Mycotic aneurysms......Page 252 References......Page 253 Introduction......Page 254 Hamburg classification......Page 255 Extra-truncular congenital vascular malformations......Page 256 Investigation......Page 257 Indications for treatment......Page 259 Surgical treatment......Page 260 Endovascular therapy......Page 261 Ethanol......Page 262 Technique......Page 263 References......Page 264 Vasospasm (Raynaud’s phenomenon)......Page 266 Nomenclature used in vasospastic disorders......Page 267 Haemodynamic changes......Page 268 Clinical presentation......Page 269 Laboratory investigations......Page 270 Calcium channel blockers......Page 271 Peripheral vasodilators......Page 272 Diagnostic criteria......Page 273 Treatment......Page 274 Investigations......Page 275 Clinical presentation......Page 276 Clinical presentation......Page 277 Clinical presentation......Page 278 Investigations......Page 279 Clinical presentation......Page 280 Pseudoxanthoma elasticum......Page 281 References......Page 282 General preoperative assessment......Page 284 Risk assessment and scoring systems for surgery......Page 285 Diabetes......Page 287 Percutaneous coronary interventions (PCIs), coronary stents and cardiac surgery......Page 288 Clopidogrel......Page 289 Management of emergency or acute cases......Page 290 Definitions of organ failure......Page 291 Respiratory failure......Page 292 Cardiac failure......Page 294 Renal failure......Page 295 Established acute renal failure......Page 296 Nutrition......Page 297 Severe sepsis......Page 298 References......Page 299 Diagnosis of need for access placement......Page 300 Timing of access placement......Page 301 Types of vascular access......Page 302 Operative techniques......Page 303 Arteriovenous access grafts......Page 304 Early failure of grafts......Page 305 Surveillance of access......Page 306 Failing central venous catheter......Page 307 Conclusion......Page 308 References......Page 309 Introduction......Page 310 Special considerations......Page 311 Kidney transplantation......Page 312 Trauma......Page 313 Contraindications for kidney transplantation......Page 314 Allocation and ethics of organs for transplantation......Page 315 The donor operation......Page 319 Operative technique......Page 321 Veno-venous bypass......Page 0 Pancreas transplantation......Page 322 Late......Page 323 Late......Page 324 Graft rejection and immunosuppression......Page 325 Outcome......Page 326 Further reading......Page 328 Index......Page 329 "Postgraduate Vascular Surgery is your concise pocket guide to the FRCS and MRCS exams. Covering the full range of surgical interventions, including diagnosis, management, clinical investigation and treatment, all chapters have been written by specialists in their field. The chapters are structured with key bullet points for easy reference, as well as tables, figures and charts to aid understanding. Relevant references are included for further exploration of a particular topic. Tips and tricks on passing the exam are included. This book is aimed at candidates for the FRCS and intercollegiate MRCS exams, surgical trainees and those following a sub-speciality of vascular surgery"--Provided by publisher