Preoperative evaluation and perioperative management of patients undergoing major vascular surgery

Figure 1.. Preoperative evaluation prior to major vascular surgery. ECG, electrocardiogram; MACE, major adverse cardiac events; METs, metabolic equivalents; TTE, transthoracic echocardiogram.

Figure 2.. ACC/AHA guidelines on exercise stress testing for myocardial ischemia and functional capacity, coronary revascularization, and antiplatelet recommendations prior to noncardiac surgery. First column is class of recommendation. Second column is level of evidence. ‘A’ is data derived from multiple randomized clinical trials or meta-analyses of these trials; ‘B’ is data derived from one or more randomized trials or meta-analyses of these trials; ‘C’ is data derived from non-randomized trials. Reprinted with permission from ref. 19. ©American Heart Association, Inc.

Figure 3.. Algorithm to guide stress testing modality prior to major vascular surgery. *Dobutamine-based nuclear pharmacologic stress testing may be a reliable substitute if reactive airway disease with ongoing wheezing or poorly controlled seizure disorder. CT, computed tomography; SBP, systolic blood pressure.