Vascular surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Vascular surgery is a subspecialty of general surgery in which diseases of the vascular system, or arteries and veins, are managed, largely via surgical intervention, and was originally founded by Dr. Clyde Otis Hagood Jr. The vascular surgeon is trained in the diagnosis and management of diseases affecting all parts of the vascular system except that of the heart and brain. Cardiothoracic surgeons manage surgical disease of the heart and its vessels. Neurosurgeons manage surgical disease of the vessels in the brain (eg intracranial aneurysms).

Breadth of discipline

Arterial diseases ( especially in Diabetics )
- Aneurysms
- Ischemia
  - Limb ischemia
    - Acute limb ischemia
      - Thrombectomies
      - Embolectomies
      - Anti-coagulation and Thrombolysis
    - Chronic limb ischemia
      - see intermittent claudication and peripheral artery occlusive disease
      - Diabetic foot ulcers
  - Mesenteric ischemia
  - Renal ischemia
- Extracranial cerebrovascular disease
  - Carotid Endarterectomy and other carotid surgery
  - Surgery of the vertebral system
Venous disease
Lymphatic disease
- Lymphoedema

Vascular Medicine
- Medical disorders with a significant vascular components, for example:
  - Raynaud's syndrome
  - Scleroderma

Training

Previously considered a field within general surgery, it is now considered a specialty in its own right. As a result, training has been, or is being re-structured from previously having to complete full general surgery training followed by a period of further vascular surgery training, to being trained in vascular surgery alone from start to finish.

Programs of training are slightly different depending on the region of the world one is in.

Country	Standards body	Professional representation	Minimum Length of training (post intern)
Australia and New Zealand	Royal Australasian College of Surgeons	Australian & New Zealand Society of Vascular Surgery (ANZSVS)	6 years
United Kingdom	Royal College of Surgeons of England, Royal College of Surgeons of Edinburgh	Vascular Society of Great Britain and Ireland	8 years
USA	Accreditation Council for Graduate Medical Education (ACGME), American Board of Surgery	American College of Surgeons Multiple vascular societies	8 years

Surgical Procedures

By no means exhaustive, but below are a number of common procedures and indications for vascular surgeons.

Indication/disease	Procedure
Abdominal Aortic Aneurysm	Open AAA repair Endoluminal AAA repair (EVAR)
Carotid stenosis	Carotid endarterectomy Carotid stenting
Varicose veins	Vein stripping Sclerotherapy and Foam sclerotherapy Laser ablation Ambulatory phlebectomy
Peripheral arterial occlusive disease	Angioplasty with/out Stenting Bypass surgery
Acute limb ischaemia	Balloon embolectomy Thrombectomy Bypass surgery
Aortic dissection	Open repair Thoracic stent graft