• Sara E Neves.
• Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA. Electronic address: saraeneves@gmail.com.
• Anesthesiol Clin. 2016 Dec 1; 34 (4): 775-795.

AbstractPatients with vascular disease and cardiac dysfunction present particular challenges to the anesthesiologist. They are hemodynamically brittle, at high risk of morbidity and mortality during surgery, and often carry additional comorbidities that increase their complexity and risk. Those with peripheral vascular disease should be assumed to have coronary artery disease and tend to have other systemic vascular problems. Poor cardiac function further worsens perfusion in an already compromised peripheral vascular system. Care of these patients requires judicious monitoring, an anesthetic that optimizes hemodynamic function, and avoidance of particularly likely complications such as perioperative myocardial ischemia, stroke, and bleeding.Copyright © 2016 Elsevier Inc. All rights reserved.

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