Postoperative care following major vascular surgery

Abstract

Patients with vascular disease are among those at highest risk for postoperative complications. Postoperative management following major vascular surgery has seen a fundamental shift towards a more efficient use of postoperative care facilities. Minimally invasive surgical techniques such as endovascular repair of complicated aortic aneurysms and the use of local and/or regional blocks, together with improvements in perioperative anesthesia, have all led to fewer patients requiring routine admission to intensive care units (ICUs). Despite best practices and planning in the preoperative assessment and in the intraoperative hemodynamic optimization, vascular surgical patients remain among the highest at risk for postoperative myocardial infarction (MI), stroke, renal failure, and bleeding complications. Better preoperative evaluation, triage, and preparation provide appropriate environment for early identification and treatment of complications. This chapter concentrates on the common postoperative management strategies in vascular surgical patients and highlights procedure-specific perioperative risks.