Vascular surgery: an update

Caring for patients with vascular illnesses has become increasingly more complex and has changed dramatically over the past 10 years, with a widening array of diagnostic and treatment options. Carotid artery stenting has the potential to become a viable alternative to open surgery in high-risk patients with carotid artery disease (i.e., patients older than 80 years and those with previous neck surgery or irradiation, contralateral carotid artery occlusion, contralateral laryngeal nerve injury, or angina). However, the effectiveness of carotid artery stenting as a therapy is still being evaluated in randomized trials. Endovascular aortic aneurysm repair is an option for patients who desire or require a less invasive modality and who have suitable aortic anatomy. Surgical reconstruction remains the standard treatment for ischemic rest pain and tissue loss (critical limb ischemia). Balloon angioplasty and stenting are treatment options for peripheral vascular disease, although treatment is dependent on the arterial segment or segments involved.