EPISODE 49: In today’s episode I visit with a Vascular Surgeon to address vascular complications during pregnancy. This episode is great if you're a patient who has had any vascular complication as well as if you are a physician preparing for your oral board exams!
Guest: Dr. Patrick Duffy

In this episode, we discuss:
• What a Vascular Surgeon Does — 2:07 — The "plumbers of the body": arterial and venous disease, blood clots, atherosclerosis, and trauma.
• Venous Thromboembolism (VTE) in Pregnancy — 4:24 — Why pregnant patients are at higher risk for clots, and the DVT-to-PE relationship.
• Deep Vein Thrombosis (DVT) — 4:51 — Symptoms, diagnosis via venous duplex ultrasound, anticoagulation management, and prevention (compression, mobility, hydration).
• May-Thurner Syndrome — 20:53 — Right iliac artery compressing the left iliac vein; unprovoked left-leg DVT; treated with angioplasty and stenting.
• Pulmonary Embolism (PE) — 24:33 — Symptoms, overlap with pregnancy, CT angiogram vs. VQ scan, anticoagulation, and thrombectomy for cor pulmonale.
• IVC Filters — 32:38 — What they are, placement (neck or groin), indications, temporary vs. permanent, and removal.
• Laparoscopic Surgery in Pregnancy — 42:46 — Trocar placement, insufflation pressures, Veress needle complications, and managing retroperitoneal hematomas.
• Liver Rupture & Portal Hypertension — 49:20 — Diagnosis, embolization treatment, and a fatal case discussion involving liver varicosities.
• Varicose Veins in Pregnancy — 55:53 — Deep vs. superficial venous systems, superficial thrombophlebitis, vulvar varicosities, and when a cesarean might be warranted.
• Splenic Artery Aneurysm — 1:02:39 — Incidental findings, third-trimester rupture risk, treatment thresholds, and family history.
• Osler-Weber-Rendu Syndrome — 1:05:41 — Hereditary hemorrhagic telangiectasia, pulmonary and cerebral AVMs, autosomal dominant inheritance.

Helpful links:
May Thurner Syndrome: https://my.clevelandclinic.org/health/diseases/17213-may-thurner-syndrome
Multiple AVMs during pregnancy: https://www.degruyterbrill.com/document/doi/10.1515/crpm-2014-0014/html?srsltid=AYCX9vLFUwZn2XOeuQZhx0y6Or5BtPNR8S2funjn5c60TIGl2dHdh_qS


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