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Equipment to perform one-lung ventilation should be available when thoracoscopic or thoraco-abdominal procedures are performed.

The impact of perioperative hypothermia may be more pronounced in vascular patients – equipment should be available to monitor and maintain normothermia.^27,28

Equipment should be immediately available for rapid blood gas analysis, near patient tests of coagulation, e.g. thromboelastograph and activated clotting time, and the measurement of haemoglobin and blood glucose.^29,30

All relevant staff should be appropriately trained in the use of the above equipment.

Vascular theatres should be of adequate size to facilitate the use of this equipment safely, with additional storage capacity.

Facilities to provide postoperative level 1 and 2 care should be available 24/7.

In centres performing arterial surgery, adequate level 2 and 3 critical care facilities should be available onsite to facilitate both routine and emergency workloads. This should include the ability to provide renal replacement therapy.²

Where anaesthesia is provided for endovascular procedures the anaesthetic facilities and equipment should be equivalent to those of a modern operating theatre environment. This includes post-anaesthesia recovery facilities with adequate levels of trained recovery room staff.³¹

Endovascular procedures involve significant potential exposure of the patient and staff to ionising radiation. Recommendations for facilities and training outlined in chapter 7 should be followed.^32, 33 Suitable lead aprons and lead barriers, and eyewear and dose meters should be available for the anaesthetic team in such an environment.

Risk stratification based on clinical history may help guide management.³⁶ However, determination of a patient’s functional capacity may be difficult if exercise tolerance is limited by peripheral vascular insufficiency, respiratory or other disease.^10,35 Clinical guidelines should be developed for further investigation, referral, optimisation, and management according to local facilities and expertise.³⁷