Vascular Surgery

An abdominal aortic aneurysm (AAA) is a focal abdominal-aortic dilatation that is often silent until it becomes symptomatic or ruptures; management is determined by symptoms, diameter, growth, anatomy, operative risk and patient preference.

Sudden arterial occlusion cuts limb perfusion faster than collaterals can compensate, so nerve and then muscle fail within hours and the limb is lost unless flow is restored.

Atherosclerotic carotid stenosis can embolise to the retina or ipsilateral cerebral circulation; recent carotid-territory TIA or non-disabling stroke makes the lesion time-critical, with urgent imaging, best medical treatment and selected carotid endarterectomy.

Peripheral arterial disease (PAD) is a manifestation of systemic atherosclerosis in which lower-limb arterial flow cannot meet demand, causing intermittent claudication or, when tissue perfusion is inadequate at rest, chronic limb-threatening ischaemia.

Varicose veins are superficial veins made tortuous by venous reflux; symptoms, skin change, ulceration, bleeding or thrombosis determine referral, with duplex-guided intervention preferred over routine compression hosiery when treatment is suitable.