Vascular Surgery elective (for the non-surgeon)

[UCA2390]

Hello! Starting a vascular surgery sub-i next week. I am going into EM. I am not a surgeon, I just didn't want to do the medicine sub-i and instead chose for 2 weeks vascular and 2 weeks trauma surgery.

Any advice on a resource for this elective? What should I focus my studying on? So far I know the aorta, and its main branches. Its a start, lol.

Thanks!

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[Hangry]

As much as I usually hate them, textbooks can be great for this. See if your school library website has a surgery textbook like Schwartz available online and just read the one chapter on vascular. Usually a great thousand foot view and basic primer of a surgical specialty without bogging you down too much.

 

[justin1390]

I am quite certain Pestana has a vascular surgery section, and I would most definitely go over that. In general, there are some basic things vascular surgeons are going to want you to know:

1. How to interpret dopplers (triphasic, biphasic, and monophasic correlated with severity of peripheral arterial disease
2. Carotid ultrasound velocity cutoffs for % stenosis (faster flow = more stenosis)
3. Treatment for claudication
4. Indication for dual anti-platelet therapy
5. Indications, procedural notes, complications, and anatomy of the follow procedures are a must: fistulas, popliteal, SFA, PFA, carotid endardectomy, acute ischemic limb, etc.
6. Consider a used copoy of Zollinger's Atlas of Surgery, you'll look like a star.
7. Know the anatomy of the veins and arteries (intima, adventia, etc)

Hope that helps a bit! I did a month of vascular surgery, so hopefully are on point, but every surgeon is quite different

 

[TypeADissection]

Gonna echo the well-written post above. Use the rotation to really hone your history and physical exam skills. Very few people get only one vascular surgery procedure in their lifetime. Get familiar with the doppler to obtain signals and calculate an ABI yourself at the bedside. Have someone teach you how to interpret ABIs/PVRs. Understand the pathogenesis of carotid artery disease or vertebrobasilar insufficiency. What it means to proceed with medical optimization. Knowing how heparin drips work and titrate. Acute limb ischemia classifications. All of these things will only help you one day to not just help the vascular surgeon but ultimately the patient when you're the ED attending and seeing this stuff. Cheers.