Vascular Surgery

Peripheral artery disease (PAD) assessment begins with the ankle-brachial index (ABI), a simple, non-invasive test with >95% specificity for PAD diagnosis at a threshold of ≤0.90. The ABI also predicts cardiovascular morbidity and mortality independent of traditional risk factors, with values <0.70 associated with a 2-3 fold increased mortality risk.

Abdominal aortic aneurysm (AAA) rupture risk is determined by maximum diameter, with the UK Small Aneurysm Trial and ADAM trial demonstrating that elective repair at 5.5 cm threshold balances operative risk against rupture risk (annual rupture risk ~1% at 5.0 cm, ~10% at 5.5 cm, and ~20% at 6.0 cm). The Glasgow Aneurysm Score provides a more individualized rupture risk estimate incorporating patient age, comorbidities, and aneurysm morphology.

Venous disease classification uses the CEAP (Clinical, Etiology, Anatomy, Pathophysiology) system for chronic venous insufficiency, the VCSS (Venous Clinical Severity Score) for treatment response monitoring, and the Villalta scale for post-thrombotic syndrome diagnosis. These tools guide compression therapy, endovenous ablation, and venous stenting decisions.