Medical and Technical Considerations in Vascular Surgery

Abstract

It is estimated that in the year 2020 more than a million non-cardiac, vascular surgery procedures will be performed annually in Europe. The same applies for the US. With this growing application of high-risk procedures, it is important to continuously strive for improved patient safety and surgical outcome. Regarding patient safety, it is key to recognize a change in patient populations and patient selections. Due to anesthetic and medical improvements as well as surgical innovation, the vascular surgery population is increasing in age, tends to have more co-morbidity and more often uses multiple prescription drugs. In other words, it is a fragile population, undergoing high-risk surgery. Cardiovascular adverse events are responsible for a major proportion of morbidity and mortality in patients undergoing vascular surgery, with an estimated incidence of more than 5% of ischemic complications, and up to 10% new-onset arrhythmias in major vascular surgery. In the first part of this thesis, certain patient safety issues, secondary prevention and future perspectives are discussed, regarding these cardiovascular complications.