Preoperative assessment of vascular patients

Vascular surgical patients have a high incidence of morbidity and mortality following surgery. Preoperative assessment allows the anaesthetist to judge the risk of anaesthesia and surgery, to identify any medical factors that can be improved and to plan perioperative care. The risks and benefits should be fully discussed with the patient. Many proven risk factors can be readily identified by history and examination and simple tests. Only rarely will more invasive testing be indicated. Risk assessment, stratification and perioperative optimization are discussed. Specific conditions that occur frequently and their implications for the vascular anaesthetist are also described.