Vascular Surgery

Progressive weakening and dilatation of the abdominal aortic wall beyond 3cm, which enlarges silently under rising wall tension until it ruptures, a catastrophic emergency defined by pain, hypotension and a pulsatile mass.

Sudden occlusion of a previously patent limb artery by embolus or in-situ thrombosis, cutting off perfusion so abruptly that irreversible muscle and nerve damage begins within hours, a surgical emergency defined by the six Ps.

Atherosclerotic narrowing of the internal carotid artery that sheds platelet or cholesterol emboli into the cerebral circulation, causing transient or permanent ischaemic events whose timing after symptoms dictates how urgently the artery must be fixed.

Atherosclerotic narrowing of the lower-limb arteries that limits blood flow to exercising, then resting, muscle in a dose-dependent way, producing intermittent claudication and, once supply can no longer meet resting demand, critical limb ischaemia with rest pain, ulceration and gangrene.

Dilated, tortuous superficial veins caused by incompetent venous valves that let blood reflux downward and pool under gravity, raising venous pressure until the skin itself begins to fail.