Vascular Medicine

Overall Rotation Goals and Objectives:

This rotation provides an introductory experience in vascular and endovascular medicine. The goals of the experience are for trainees to become familiar with consultation in vascular medicine, diagnostic vascular imaging procedures, and the variety of peripheral artery interventional procedures, including, but not limited to: noninvasive vascular study interpretation, diagnostic angiography, peripheral interventions including carotid, vertebral, mesenteric, renal, aortic, iliac, and lower extremity intravascular interventions, as well as venous interventions for DVY, PE and varicose vein ablation.

• Fellows will gain experience in the prevention, evaluation and management of both inpatients and outpatients with the following disorders: a) peripheral arterial disease, b) renal artery stenosis, c) mesenteric ischemia; d) extracranial cerebrovascular disease, e) aneurysmal disease, f) arterial dissection, g) arterial and venous thromboembolism.
• Noninvasive vascular tests such as a) segmental blood pressure measurements, arterial and venous duplex ultrasonography, and computed tomographic and magnetic resonance angiography, b) accuracy and limitations of diagnostic tests.
• Invasive procedures: a) radiation physics, safety, and radiographic imaging equipment, b) principles of image acquisition and display, c) advantages, disadvantages, and potential complications of iodinated and non-iodinated contrast agents, d) advantages, disadvantages, potential outcomes, and complications of interventional procedures, e) indications, alternatives, and contraindications for catheter-based interventions
• Fellows will gain introductory experience in the range of interventional vascular procedures.

Fellows will gain knowledge of the following content areas:

• vascular biology precepts that govern normal blood vessel function.
• pathologic mechanisms that lead to vascular disease, including the molecular and cellular processes that result in atherosclerosis and thrombosis.
• systemic manifestations of atherosclerosis and the risk factors that contribute to its development.
• guidelines established to modify risk factors.
• pathophysiology, clinical manifestations, natural history, evaluation, and management of peripheral arterial disease, renal artery stenosis, extracranial cerebrovascular disease, aortic and peripheral artery aneurysms, and other arterial diseases.
• pathophysiology, clinical manifestations, evaluation, and management of venous thromboembolism.
• prothrombotic disorders including inherited and acquired hypercoagulable states.
• pathophysiology, clinical manifestations, evaluation, and treatment of chronic venous insufficiency and lymphedema.
• preoperative evaluation and perioperative care of the vascular surgery patient.
• Non-invasive vascular tests including duplex ultrasonography of peripheral arteries and veins, carotid arteries, renal arteries, and physiologic tests of the peripheral circulation.
• magnetic resonance and computed tomographic angiography.