ABS Vascular Surgery key terms

A permanent focal enlargement of the abdominal aorta, usually infrarenal, defined as a diameter of 3.0 cm or more, or more than 1.5 times the expected normal diameter for that segment.

Complete or contained disruption of an aneurysm wall causing retroperitoneal or intraperitoneal hemorrhage, typically presenting with sudden severe back or abdominal pain, hypotension, and a pulsatile mass; mortality remains very high.

A focal dilation of the popliteal artery, most often bilateral and associated with a contralateral or aortic aneurysm; it threatens the limb through thrombosis, embolism, or rupture rather than bleeding.

Atherosclerotic narrowing or occlusion of the distal aorta and iliac arteries that may produce buttock and thigh claudication, erectile dysfunction, and absent femoral pulses when the occlusion is complete.

Narrowing of one or both renal arteries, usually from atherosclerosis at the ostium or from fibromuscular dysplasia more distally, which can cause hypertension, ischemic nephropathy, and sometimes flash pulmonary edema.

Insufficient splanchnic blood flow, typically from atherosclerotic stenosis of at least two of the three visceral arteries, producing postprandial abdominal pain, food fear, and weight loss.

Narrowing of the extracranial internal carotid artery, usually atherosclerotic, that reduces cerebral perfusion and serves as a source of emboli causing transient ischemic attack or stroke in the corresponding territory.

Transient monocular visual loss described as a curtain descending over one eye, caused by temporary retinal ischemia, classically from an embolus arising in the ipsilateral carotid artery.

Open surgical removal of atheromatous plaque from the carotid bifurcation through an arteriotomy, usually closed with a patch, performed under local or general anesthesia with or without shunting.

A rare complication after carotid revascularization marked by headache, seizures, confusion, and sometimes intracerebral hemorrhage, caused by loss of cerebral autoregulation and excessive blood flow to a chronically hypoperfused hemisphere.

Atherosclerotic narrowing of arteries supplying the limbs, most commonly the superficial femoral and popliteal, which may be asymptomatic or cause claudication, rest pain, or tissue loss.

Reproducible muscle discomfort in the leg, relieved by rest, that occurs at a predictable walking distance when arterial supply cannot meet the metabolic demand of exercising muscle.

Severe limb ischemia manifested by ischemic rest pain, nonhealing ulceration, or gangrene, with objectively reduced ankle pressure or toe pressure, carrying a high risk of amputation without revascularization.

Sudden arterial occlusion causing pain, pallor, pulselessness, poikilothermia, paresthesia, and paralysis; limb viability depends on the severity and duration, and emergent revascularization or amputation is required.

Impaired venous return from chronic valve failure or outflow obstruction, producing edema, skin hyperpigmentation, lipodermatosclerosis, and ulceration typically near the medial malleolus.

Formation of thrombus within a deep vein, usually of the lower limb, which can obstruct venous return and embolize to the pulmonary arteries; risk factors include immobility, surgery, cancer, and thrombophilia.

Accumulation of protein-rich interstitial fluid from impaired lymphatic drainage, causing nonpitting swelling, skin thickening, and a predisposition to cellulitis; it may be primary or follow surgery, radiation, or infection.

A percutaneously placed device in the inferior vena cava intended to trap thromboemboli from the legs when anticoagulation is contraindicated or has failed; it does not treat existing thrombus.

Findings that reliably indicate major arterial disruption, including pulsatile bleeding, expanding hematoma, absent distal pulses, bruit or thrill, and signs of limb ischemia; they generally prompt immediate exploration or imaging.

Elevated pressure within a closed fascial compartment that impairs capillary perfusion, causing pain out of proportion, tense swelling, and paresthesia; without urgent fasciotomy it progresses to muscle necrosis and nerve injury.

A contained rupture of an artery in which blood is held by surrounding tissue or adventitia rather than all three vessel wall layers; causes include catheterization, trauma, and infection, and it may thrombose, expand, or embolize.

A large-vessel granulomatous arteritis affecting the aorta and its main branches, usually in young women, causing stenosis, occlusion, or aneurysm, with diminished pulses and unequal blood pressures.

A granulomatous vasculitis of medium and large arteries, especially the temporal and ophthalmic branches, presenting in older adults with headache, jaw claudication, and risk of irreversible vision loss.

Combined B-mode imaging and Doppler velocity measurement used to assess vessel anatomy, plaque, stenosis severity, and flow direction; it is the first-line noninvasive test for carotid, venous, and graft evaluation.

The ratio of systolic pressure at the ankle to the higher brachial systolic pressure; values of 0.90 or below indicate peripheral arterial disease, while very high values suggest arterial calcification.

Contrast-enhanced computed tomography with thin-slice reconstruction that maps arterial anatomy, stenosis, aneurysm, and bleeding; it is fast and widely available but requires iodinated contrast and radiation.

Catheter-based injection of contrast with digital subtraction of background structures, providing the reference standard for arterial anatomy and allowing immediate endovascular treatment in the same setting.

A rise in serum creatinine occurring within days of intravascular iodinated contrast administration, reflecting acute tubular injury; risk is increased by pre-existing renal impairment, diabetes, dehydration, and contrast volume.

Placement of a stent-graft within the aorta through femoral access to exclude an aneurysm from the circulation; it has lower early morbidity than open repair but requires lifelong imaging surveillance.

Persistent blood flow into the aneurysm sac from a branch vessel such as a lumbar artery or the inferior mesenteric artery after endovascular repair; many resolve or are observed, but sac growth warrants intervention.

Closure of an arteriotomy with a vein or synthetic patch to widen the lumen and reduce restenosis after endarterectomy or embolectomy; it is standard after carotid endarterectomy in many practices.

An immune-mediated reaction to heparin in which antibodies activate platelets, causing thrombocytopenia and paradoxical thrombosis; heparin must be stopped and a non-heparin anticoagulant started.

A preoperative tool that estimates major cardiac complications after noncardiac surgery using six factors, including coronary disease, heart failure, cerebrovascular disease, diabetes, renal impairment, and high-risk surgery.

Local and systemic damage produced when blood flow returns to ischemic tissue, with oxygen free radicals, inflammatory activation, and capillary leak causing compartment swelling, rhabdomyolysis, acidosis, and arrhythmia.

Permanent discontinuation of tobacco use, the single most effective intervention to slow atherosclerotic progression, improve bypass graft patency, and reduce cardiovascular and aneurysm-related events.

Inhibition of HMG-CoA reductase to lower LDL cholesterol and stabilize plaque; high-intensity dosing reduces cardiovascular events and is recommended for nearly all patients with established arterial disease.

A structured, medically supervised walking program of repeated bouts to near-maximal claudication pain, which improves walking distance and quality of life in peripheral arterial disease and is first-line before intervention.

Graduated external pressure applied with bandages or stockings to counteract venous hypertension, heal venous ulcers, and control edema; correct pressure and adherence are essential, and arterial perfusion must be assessed first.

Transtibial amputation preserving the knee joint, typically with a posterior myocutaneous flap; it offers better prosthetic walking potential and lower energy cost than above-knee amputation when the limb is viable.