Book contents
- Frontmatter
- Contents
- Preface
- Contributors
- 1 Preoperative management
- 2 Principles of anaesthesia
- 3 Postoperative management
- 4 Nutritional support
- 5 Surgical sepsis: prevention and therapy
- 6 Surgical techniques and technology
- 7 Trauma: general principles of management
- 8 Intensive care
- 9 Principles of cancer management
- 10 Ethics, legal aspects and assessment of effectiveness
- 11 Haemopoietic and lymphoreticular systems: anatomy, physiology and pathology
- 12 Upper gastrointestinal surgery
- 13 Lower gastrointestinal surgery
- 14 Hernia management
- 15 Vascular surgery
- 16 Endocrine surgery
- 17 The breast
- 18 Thoracic surgery
- 19 Genitourinary system
- 20 Head and neck
- 21 The central nervous system
- 22 Musculoskeletal system
- 23 Paediatric surgery
- Index
15 - Vascular surgery
Published online by Cambridge University Press: 15 December 2009
- Frontmatter
- Contents
- Preface
- Contributors
- 1 Preoperative management
- 2 Principles of anaesthesia
- 3 Postoperative management
- 4 Nutritional support
- 5 Surgical sepsis: prevention and therapy
- 6 Surgical techniques and technology
- 7 Trauma: general principles of management
- 8 Intensive care
- 9 Principles of cancer management
- 10 Ethics, legal aspects and assessment of effectiveness
- 11 Haemopoietic and lymphoreticular systems: anatomy, physiology and pathology
- 12 Upper gastrointestinal surgery
- 13 Lower gastrointestinal surgery
- 14 Hernia management
- 15 Vascular surgery
- 16 Endocrine surgery
- 17 The breast
- 18 Thoracic surgery
- 19 Genitourinary system
- 20 Head and neck
- 21 The central nervous system
- 22 Musculoskeletal system
- 23 Paediatric surgery
- Index
Summary
Vascular surgery is concerned with the investigation and treatment of arterial diseases affecting the aorta and its branches and the arteries in the limbs and the neck, but excluding the coronary arteries. It is also concerned with the management of diseases of the venous system.
DISORDERS OF THE ARTERIAL SYSTEM
Arterial surgery has evolved rapidly over the last 50 years with the development of bypass techniques, prosthetic materials, sutures, percutaneous procedures and imaging. The number of patients treated annually continues to increase in parallel with the increasing age of the population.
A comprehensive review of the basic sciences in relation to the specialty of vascular surgery is beyond the scope of this book; however, some significant features are covered below.
Anatomy
The heart pumps blood in to the aorta, a large diameter vessel. With repeated branching the total cross-sectional area of the vessels increases in size until that of the capillaries is approximately 1000 times that of the aorta.
Collateral circulation
The development of collateral circulation is an important concept in arterial disease. In acute ischaemia the rapidity of onset prevents adequate collateral development; however, with slowly progressive chronic ischaemia, the collateral development may be so extensive as to fully compensate for major arterial occlusions (Fig. 15.1).
- Type
- Chapter
- Information
- Fundamentals of Surgical Practice , pp. 286 - 303Publisher: Cambridge University PressPrint publication year: 2006