Preoperative assessment of patients for vascular surgery

Effective preoperative evaluation of patients undergoing major vascular surgery presents a significant multidisciplinary challenge. A focussed preoperative evaluation targeted to organ systems can help mitigate the combined effects of inherently high-risk surgical procedures undertaken in an increasingly comorbid patient population. Careful history and examination supported by appropriate investigations and specialist input remains the cornerstone of this process, with risk increasingly quantified by dedicated scoring systems. In addition, the role and evidence base for objective assessment of functional capacity continues to build with cardiopulmonary exercise testing (CPET) now widely employed in vascular pre-assessment across the UK. When employed in a timely manner, complete preoperative assessment allows more informed decision-making surrounding surgery, frank discussion of risk with the patient and effective utilization of critical care resources if required.