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Division of Vascular Surgery
Performance Objectives
Postgraduate Year Four/Five

Review and be proficient in all the previous objectives.  In addition:

1.         Obtain vascular control of diseased or traumatically occluded blood vessels using:

            a.         Vascular clamps
            b.         Vessel loop/Rummel tourniquet
            c.         Balloon occlusion
            d.         Digital compression

 2.        Participate in thromboendarterectomy and thrombectomy / thromboembolectomy.

 3.        Demonstrate appropriate vascular suture techniques.

 4.        Evaluate and manage sympathectomy procedures.

 5.        Demonstrate the appropriate incisions and exposure of:

            a.         Abdominal aorta and its major branches
            b.         Portal venous system
            c.         Peripheral arterial system
            d.         Carotid arterial system
            e.         Arteriovenous fistula

 6.        Obtain vascular control of major vessels

            a.         Aorta
            b.         Vena cava

7.         Participate in endarterectomy and bypass grafting.

8.         Demonstrate ability to manage graft and suture materials.

9.         Perform selected operative procedures or selected parts of the following operative procedures under supervision:

            a.         Aortic aneurysm repair
            b.         Carotid endarterectomy
            c.         Aorto-iliac occlusive disease
            d.         Femoral popliteal occlusive disease
            e.         Correction of portal hypertension
            f.          Peripheral vascular trauma

10.       Discuss and demonstrate the role of adjunctive measures in operative procedures including angioscopy, thrombolytic therapy, and video-assisted procedures.

11.       Select and use proper advanced techniques in managing patients with a variety of vascular disorders such as:

            a.         Ruptured aortic aneurysm
            b.         Central vascular trauma
            c.         Suprarenal aortic aneurysm
            d.         Renovascular hypertension
            e.         Femoral tibial bypasses

12.       Perform alternative methods of bypass grafting such as:

            a.         Extra-anatomic bypass, principles and techniques
            b.         Indirect revascularization
            c.         In situ  techniques
            d.         Sequential and composite techniques

13.       Manage prosthetic graft infections to include:

            a.         Diagnosis
            b.         Selection of alternate routes for revascularization
            c.         Selection of appropriate graft materials
            d.         Timing of interventions

14.       Manage complications of common major vascular procedures such as:

            a.         Carotid endarterectomy
            b.         Aortic reconstruction
            c.         Lower extremity vascular reconstruction

Duties and Responsibilities

 1.      Oversee evaluation and daily management of all vascular patients.

 2.      Participate in major vascular reconstructions as primary surgeon or assistant.

 3.      Communicate directly with attending regarding patient findings and care plans.

 4.      Insure appropriate informed consent is obtained and communicate with patient families as appropriate.

 5.      Communicate with nursing service representatives regarding daily management and discharge planning.

 6.      Coordinate availability of ICU/ACU beds with assistance of PG2.

 7.      Provide daily instruction on patient care and evaluation to medical students.

 8.      Attend conferences as listed above.

 9.      Participate in call schedule as assigned.

10.     Accomplish operative reports as primary surgeon within 24 hours.

11.     Assign other administrative tasks to more junior residents as appropriate.