Vascular Surgery Oral Board Practice Cases by Domain: Arterial, Venous, Access, Trauma, Imaging, and Rescue

Symptomatic stenosis

A patient has a recent nondisabling hemispheric event and severe ipsilateral disease. Define timing, imaging, medical therapy, CEA versus stenting strategy, and perioperative neurologic risk.

High-risk anatomy

A prior neck operation, radiation, high lesion, or restenosis changes exposure. Defend TCAR, transfemoral stenting, redo CEA, or medical therapy and state embolic protection.

Postoperative deficit

A new deficit occurs after CEA or stenting. Give the immediate blood-pressure, imaging, re-exploration, thrombectomy, and intracranial evaluation sequence.

Neck hematoma

The patient develops airway compromise after CEA. Prioritize airway and decompression, then address bleeding source and antithrombotic therapy.

Intact AAA

Choose surveillance, EVAR, or open repair based on size, symptoms, anatomy, physiology, life expectancy, access, and long-term surveillance burden.

Ruptured AAA

Resuscitate, decide whether imaging is safe, choose EVAR or open control, discuss occlusion balloon, access, abdominal compartment syndrome, and ICU care.

Type B dissection

Separate uncomplicated disease from rupture, malperfusion, refractory pain, expansion, or other complicated features and describe medical versus endovascular treatment.

Blunt thoracic injury

Integrate injury grade, associated trauma, timing, blood-pressure control, TEVAR anatomy, left-subclavian strategy, and spinal-cord risk.

Endoleak or graft infection

Classify the failure, define urgency, explain imaging, reintervention, explant or reconstruction, and surveillance.

Acute mesenteric ischemia

Differentiate embolic, thrombotic, dissection-related, and nonocclusive disease; resuscitate, revascularize, assess bowel, and plan second look.

Chronic mesenteric ischemia

Confirm symptoms and anatomy, select target vessels, choose open or endovascular therapy, and discuss nutrition and surveillance.

Renal artery disease

Distinguish incidental stenosis from selected indications for intervention and integrate medical therapy, renal function, and anatomy.

Visceral aneurysm

Use location, size, pregnancy potential, symptoms, rupture risk, and branch anatomy to choose surveillance, embolization, stent graft, or open repair.

Claudication

Start with risk reduction and exercise, define when revascularization is justified, and compare endovascular and open durability.

CLTI

Stage limb threat and anatomy, control infection, plan revascularization, choose conduit and target, integrate wound care, and define functional goals.

Acute limb ischemia

Classify viability, heparinize when appropriate, choose imaging and revascularization, and anticipate fasciotomy and reperfusion injury.

Popliteal aneurysm

Address asymptomatic thresholds, acute thrombosis, runoff, thrombolysis, bypass, endovascular options, and contralateral screening.

Failed bypass or stent

Identify inflow, conduit or device, target and outflow failure; choose thrombectomy, revision, lysis, new bypass, endovascular treatment, or amputation.

Iliofemoral DVT

Choose anticoagulation alone versus selected intervention, address bleeding risk, post-thrombotic syndrome, compression, and follow-up.

Phlegmasia

Resuscitate, anticoagulate, assess limb threat, and explain urgent thrombectomy or thrombolysis plus compartment monitoring.

Iliocaval obstruction

Interpret imaging, define chronicity and symptoms, plan recanalization and stenting, manage inflow, and state antithrombotic follow-up.

Venous ulcer

Integrate arterial assessment, compression, superficial and deep venous disease, wound care, intervention, and recurrence prevention.

Lymphedema

Confirm diagnosis, exclude venous and systemic causes, use conservative care, and define selected procedural or referral pathways.

New access

Use the patient’s life plan, vessel mapping, comorbidity, prior access, catheter status, inflow, and outflow to choose fistula, graft, or another strategy.

Nonmaturation

Identify inflow, anastomotic, conduit, outflow, and central venous causes and choose revision or endovascular treatment.

Steal

Assess severity, inflow and access flow, rule out other ischemia, and choose banding, DRIL, RUDI, proximalization, revision, or ligation.

Bleeding or infection

Control hemorrhage, protect life, define infected material and sepsis, and plan salvage, excision, revision, or new access.

Extremity injury

Use hard and soft signs, associated fracture, shunt, sequence with orthopedics, repair or ligation, venous injury, and fasciotomy.

Junctional hemorrhage

Obtain proximal control, use temporary measures, choose open or endovascular repair, and plan massive transfusion and damage control.

Iatrogenic injury

Manage wire perforation, access rupture, embolization, dissection, pseudoaneurysm, or arteriovenous fistula with immediate control and definitive repair.

Delayed presentation

Recognize pseudoaneurysm, AV fistula, thrombosis, infection, or embolization and select imaging and treatment.

Duplex interpretation

Read velocities, waveforms, ratios, flow direction, graft findings, access maturation, and limitations; state the management consequence.

Access planning

Choose percutaneous, open femoral, iliac, brachial, axillary, carotid, or alternative access based on sheath, calcification, diameter, prior repair, and bailout.

Risk reduction

Prescribe antiplatelet or anticoagulant therapy, statin, blood-pressure and diabetes management, smoking cessation, exercise, and foot care for the specific disease.

Surveillance

Select modality, interval, expected findings, and threshold for reintervention after open, endovascular, venous, or dialysis-access treatment.