|Title||Endo Vascular Aortic Repair Assessment and Surveillance|
By the end of this module, the Clinical Scientist in HSST will be able to apply their knowledge, skills and experience in the clinical setting to undertake endo vascular aortic aneurysm repair assessment and surveillance for suspected endoleak and other graft related complications. They will also be able to recognise, deliver, report and interpret the appropriate physiological test/s to address the findings from initial clinical assessment. They will apply their detailed knowledge of management options available to the supervising clinician based on the investigative findings whilst critically evaluating their own response to both normal and complex situations using the professional attributes and insights required of a Consultant Clinical Vascular Scientist.
Knowledge and understanding
By the end of this module, the Clinical Scientist in HSST will be able to analyse, synthesise, evaluate and critically apply their expert knowledge to the assessment of a range of patients, including those with complex problems, urgent or critical conditions with respect to Abdominal Aortic Aneursym (AAA) repairs and Endo Vascular Aortic Repair (EVAR) assessment including:
- types of EVAR stent grafts used to treat AAA and the rational for using specific devices including fenestrated and hybrid devices.
- the range, variety and consequences of pathology including:
- endoleaks and endoleak types.
- stent misplacement and migration.
- graft stenosis.
- graft kinking and limb retraction.
- graft occlusion or limb occlusion.
- thrombus formation.
- sac expansion.
- contrast agents for the detection of endoleak.
- normal and pathophysiological haemodynamics.
- presenting signs and symptoms and identify possible alternative diagnoses.
- range of medical, interventional and surgical management options.
- diagnostic techniques used by clinical vascular scientists to assess the range of grafts.
- the appropriate technique for each patient.
- complementary use of angiography, CT and MRA in the diagnosis and management.
- recognition of the clinical sequelae of the diagnosis.the relevance of sac expansion or retraction
- recognition of how diagnosis affects the management pathway.
Technical and clinical skills
By the end of this module, the Clinical Scientist in HSST will be able to demonstrate a critical understanding of current research and its application to the performance and mastery of technical skills including:
- AAA and EVAR duplex and spectral Doppler measurement for the detection of endoleak and other graft related complications.
- optimisation of ultrasound controls to enable detection of both high and low velocity flow.
- recognition of sources of artifact and errors in measurements and taking appropriate action.
By the end of this module, the Clinical Scientist in HSST will be expected to critically reflect and apply in practice, with respect to EVAR assessment in a range of patients, clinical and communication skills to advise and communicate effectively with patients, relevant clinicians and other healthcare professionals and will:
- take a clinical history and perform clinical assessment of patient.
- choose and provide expert opinion on the most appropriate technique/test for the clinical presentation including opinion regarding the need for contrast studies.
- perform the ultrasound imaging or physiological measurement diagnostic.
- analyse and interpret physiological images and measurements to determine the presence of endoleak and graft related complications.
- formulate and organise data (clinical history, clinical assessment, scientific results) to accurately report cases and emphasise the key findings and diagnoses.
- compare all data to justify and validate the conclusion.
- communicate with the multi-disciplinary team and participate in multi- disciplinary teams.
- reflect on the challenges of applying research to practice in relation to these areas of practice and suggest improvements, building on a critique of available evidence.
Attitudes and behaviours
By the end of this module, the Clinical Scientist in HSST will be expected to evaluate their own response to both normal and complex situations demonstrating the professional attributes and insights required of a Consultant Clinical Scientist working within the limits of professional competence referring as appropriate to senior staff and will:
- communicate appropriately with the patient and place the patient at the centre of care.
- prioritise the safety of the patient.
- consistently work to high standards of clinical practice applying knowledge and evidence, making decisions and evaluating the impact of those decisions.
- monitor, evaluate and maintain clinical practice standards.
- share data on clinical practice standards with service users and managers to encourage dialogue and debate.
- recognise the importance of the multi-disciplinary clinical team and will take responsibility for ensuring appropriate and effective decision making processes are in place.
- support and contribute to the development of multidisciplinary clinical team working and work with the team to determine scientific service priorities.
- balance data confidentiality, security and protection, and the sharing of data with relevant stakeholders, including patients, to ensure high-quality patient- centred care.
- be committed to and support continuous improvement of vascular services, with particular reference to auditing practice, evidence based practice, innovation, new and improved technologies.