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Vascular surgery in the elderly 

Vascular surgery in the elderly
Chapter:
Vascular surgery in the elderly
Author(s):

Sameer Somanath

and Elke Kothmann

DOI:
10.1093/med/9780199604999.003.0019
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date: 20 August 2019

This chapter reviews current practice in the care of elderly vascular patients and reviews the scope and risks of such surgery. The preoperative assessment of coexisting medical diseases is discussed. This includes ischaemic heart disease, testing of functional reserve, and cardiopulmonary exercise testing (CPE). Medical optimization with drug therapy is then described. Specific procedures are reviewed in detail, including aortic aneurysms, the role of multidisciplinary teams, and perioperative care. Endovascular and elective open repair are described before a description of current care for ruptured aortic aneurysms. The indications for carotid endarterectomy including investigations, risk assessment, medical treatment, and perioperative anaesthetic care are presented. Finally, peripheral vascular disease and revascularization are reviewed with a discussion on the management of limb amputation and acute limb ischaemia.

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