ABS Vascular Surgery study guide
ABS Vascular Surgery · Work through your exam, one topic at a time.
ABS vascular surgery certification is a voluntary board credential from the American Board of Surgery for surgeons who have completed an approved vascular surgery training pathway and want to demonstrate specialty knowledge beyond state licensure. Vascular surgery is defined by the ABS as the diagnosis and comprehensive, longitudinal management of arterial, venous, and lymphatic disorders, excluding intracranial and coronary arteries. The ABS Vascular Surgery study guide has 10 sections and about 3,000 words.
01Aneurysmal Disease of the Aorta and Peripheral Arteries
An arterial aneurysm is a focal, permanent dilation exceeding 3.0 cm in the aorta or 50% of expected normal diameter elsewhere. Most abdominal aortic aneurysms (AAAs) are infrarenal and degenerative, driven by medial proteolysis.
332 words, about 2 min02Arterial Occlusive Disease of the Aorta and Its Branches
Leriche syndrome - buttock and thigh claudication, absent femoral pulses, erectile dysfunction - indicates infrarenal aortic occlusion. TASC II grades aortoiliac and femoropopliteal lesions from A (focal, endovascular-friendly) to D (diffuse, surgical); favorable iliac lesions are stented with good patency, while extensive disease is best treated with aortobifemoral bypass.
315 words, about 2 min03Cerebrovascular and Neurovascular Disease of the Neck
NASCET compares the narrowest residual lumen with the normal distal internal carotid artery; ECST uses an estimated normal bulb, so an ECST 80% is roughly a NASCET 70%. Quote the method used by the trial you are citing.
308 words, about 2 min04Peripheral Arterial Occlusive Disease of the Upper and Lower Extremities
An ankle-brachial index of 0.90 or less is abnormal; 0.91–1.0 is borderline and warrants exercise testing. Claudication corresponds to Rutherford 1–3 or Fontaine II.
296 words, about 1 min05Venous and Lymphatic Disorders
Use the Wells score to guide testing: low or intermediate probability with a negative D-dimer excludes DVT (age-adjust the threshold above age 50). Duplex shows loss of compressibility, absent phasicity, and failure to augment.
304 words, about 2 min06Vascular Trauma and Inflammatory/Vasculitic Disease
Hard signs - pulsatile bleeding, expanding hematoma, absent distal pulse, thrill or bruit, or ischemia with neurologic deficit - mandate immediate exploration or on-table angiography. Soft signs warrant an ankle-brachial index: above 0.9 with no soft signs permits observation, while 0.9 or less or any abnormal finding calls for CT angiography.
287 words, about 1 min07Noninvasive Vascular Laboratory Testing and Diagnostic Imaging
Measure the ABI with the patient supine after ten minutes of rest, using a cuff about 20% wider than the limb, and record the higher of the dorsalis pedis and posterior tibial pressures. Values of 0.90 or less are abnormal, 0.91–1.0 borderline, and above 1.3 suggest medial calcinosis from diabetes or renal failure; in those patients use toe pressures (normal toe-brachial index above 0.7; toe pressure under 30 mmHg predicts poor healing) or transcutaneous oximetry.
309 words, about 2 min08Open and Endovascular Operative Techniques and Complications
Obtain proximal and distal control before opening the vessel. Choose conduit deliberately: autologous vein is preferred below the knee and across joints, while prosthetic is acceptable for aortic and above-knee reconstruction, often with a vein patch or cuff to improve compliance at the anastomosis.
284 words, about 1 min09Critical Care and Perioperative Management of the Vascular Patient
Cardiac events are the leading cause of perioperative death in vascular surgery. Use the revised cardiac risk index and functional capacity to decide who needs stress testing; do not delay urgent limb salvage for testing in an asymptomatic patient.
281 words, about 1 min10Medical Management, Risk Factor Modification, Wound Care, and Amputation
Smoking cessation is the single most powerful intervention - combine counseling with varenicline, which outperforms nicotine replacement. Prescribe high-intensity statin for every patient with peripheral arterial disease or aneurysm, targeting LDL below 70 mg/dL (below 55 in very high risk), adding ezetimibe or a PCSK9 inhibitor if needed.
284 words, about 1 min