2021 RCOA Anaesthetics Curriculum - Annex E - Stage 3 Special Interest Areas; Anaesthesia for Vascular Surgery
Below is a selection of CPD articles, key trials and editorials which have been mapped to the new Royal College Curriculum (2021). It is based on the key capabilities in stage 3 - special interest areas (Anaesthesia for Vascular Surgery).
This is not an exhaustive, or comprehensive list to cover these areas, but is designed to offer trainees and trainers some direction and guidance to their Vascular training time. It may also be beneficial to those revising for their final FRCA exams.
Suggestions for further material in this page would be most welcome (via Education and training sub-committee).
Key Capabilities A
Capable of providing advanced cardiovascular risk assessment relating to vascular surgery.
Suggested Reading:
ESC 2022 Guidelines on cardiovascular assessment and management of patients undergoing non-cardiac surgery
Canadian Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment and Management for Patients Who Undergo Noncardiac Surgery (onlinecjc.ca)
Preoperative Assessment and Optimisation for Adult Surgery | Centre for Perioperative Care (cpoc.org.uk)
Durrand J and Danjoux G. Preoperative assessment of patients for major vascular surgery. Anaesthesia & Intensive Care Medicine. Volume 20, Issue 5, May 2019, Pages 257-261.
Zarinsefat A and Henke P. Update in preoperative risk assessment in vascular surgery patients J Vasc Surg 2015;62:499-509.
Key Capabilities B
Manages the preoperative care of elective and emergency open AAA repair.
Suggested Reading:
Abdominal aortic aneurysm: diagnosis and management - NICE guideline NG156,2020.
Abdominal aortic aneurysm: diagnosis and management – Evidence review L: Anaesthesia and analgesia for people having surgical repair of an abdominal aortic aneurysm – NICE guideline NG156, 2020.
Perioperative care in open aortic vascular surgery: A consensus statement by the Enhanced Recovery After Surgery (ERAS) Society and Society for Vascular Surgery - Journal of Vascular Surgery (jvascsurg.org)
Howell SJ. Abdominal aortic aneurysm repair in the United Kingdom: an exemplar for the role of anaesthetists in perioperative medicine. British Journal of Anaesthesia, 119 (S1): 15–22, 2017.
Duncan, A. Anaesthesia for open abdominal aortic surgery. Anaesthesia and Intensive Care Medicine 23(4): 222-228, 2022
Management and Transfer of Patients with a Diagnosis of Ruptured Abdominal Aortic Aneurysm to a Specialist Vascular Centre – RCEM Best Practice Guideline, 2019.
Cheesman M. Anaesthesia for the ruptured aortic aneurysm. Vascular Anaesthesia 17(5): 243-248, 2016.
Key Capabilities C
Manages the preoperative care of complex endovascular repair of thoracic and aortic aneurysm.
Suggested Reading:
NEJM 2010 – Endovascular versus Open Repair of Abdominal Aortic Aneurysm (EVAR 1 Trial):
NEJM 2010 – Endovascular Repair of Aortic Aneurym in Patients Physically Ineligible for Open Repair (EVAR 2 Trial):
Lancet 2016 - Endovascular versus open repair of abdominal aortic aneurysm in 15-years’ follow-up of the UK endovascular aneurysm repair trial 1 (EVAR trial 1): a randomised controlled trial
Anaesthesia and Intensive Care Medicine 2019 – Anaesthesia for endovascular aneurysm repair
Society for Vascular Surgery clinical practice guidelines of thoracic endovascular aortic repair for descending thoracic aortic aneurysms 2020
BJA Ed 2022 – Anaesthesia for endovascular repair of ruptured abdominal aortic aneuryms
BJA 2016 – Spinal cord protection in aortic endovascular surgery
Key Capabilities D
Manages the perioperative care for patients requiring carotid endarterectomy under general and regional anaesthesia.
Suggested Reading:
European Society for Vascular Surgery (ESVS) 2023 Clinical Practice Guidelines on the Management of Atherosclerotic Carotid and Vertebral Artery Disease
CEA review BJA 2007
GALA trial summary Lancet 2008
RA or GA for CEA review 2012
Regional anaesthesia for carotid endarterectomy Review BJA 2015
NYSORA US guided cervical plexus block
Arterial pressure management and carotid endarterectomy Review BJA 2009
Anesthesia Management for Carotid Endarterectomy: Review Article EJCM 2019
Key Capabilities E
Provides perioperative care of patients requiring vascular access procedure for renal dialysis.
Suggested Reading:
Anaesthetic management for vascular access surgery BJA CPD 2017
RA for AVF BJA editorial 2021
Key Capabilities F
Appreciates the complexities in organising regional vascular services.
Suggested Reading:
Guidelines for the Provision of Anaesthesia Services for Vascular Procedures RCOA 2022
GIRFT VASCULAR SERVICES REPORT 2018
Provision of Services for People with Vascular Disease 2021
PAD QIF March 2019 v2.pdf (vascularsociety.org.uk)
Association between neuraxial anaesthesia or general anaesthesia for lower limb revascularisation surgery in adults and clinical outcomes: population based comparative effectiveness study | The BMJ
Editor's Choice - European Society for Vascular Surgery (ESVS) 2020 Clinical Practice Guidelines on the Management of Acute Limb Ischaemia
