‏1,634.00 ₪

Atlas of Vascular Surgery and Endovascular Therapy: Anatomy and Technique

‏1,634.00 ₪
ISBN13
9780323566940
מהדורה
2nd Edition
זמן אספקה
21 ימי עסקים
עמודים / Pages
891
תאריך יציאה לאור
22 בנוב׳ 2024
**Selected for 2025 Doody’s Core Titles® with "Essential Purchase" designation in Vascular Surgery**

Using a highly visual, step-by-step approachAtlas of Vascular Surgery and Endovascular Therapy: Anatomy and Technique, Second Edition, is an easy-access, comprehensive guide to the surgical treatment of diseases and disorders most often encountered by vascular surgeons. Editor Elliot L. Chaikof, MD, PhD, leads a team of academic and clinical leaders in the field who provide expert coverage of more than 100 common and complex procedures, including surgical and endovascular techniques. This full-color, single-volume reference provides a convenient review of key procedures with an emphasis on anatomy and imaging studies as they apply to each technique, enabling surgeons to prevent and plan for complications and secure the best outcomes for their patients.
Key features
  • Covers the full range of diseases and disorders most important to vascular surgeons using a step-by-step procedural approach accompanied by relevant imaging studies
  • Uses a consistent and logical chapter structure throughout, covering Historical Background, Indications, Preoperative Preparation, Pitfalls & Danger Points, Operative Strategy, Operative Technique, Postoperative Care, Postoperative Complications, and References
  • Includes new chapters on Transcarotid Artery Revascularization with Dynamic Flow Reversal (TCAR), Surgical Treatment of Subclavian-Axillary Vein Thrombosis, Reconstruction of the Portal Vein and Hepatic Artery, Endovascular Therapy for Superior Vena Cava Syndrome, Approach to Patients Presenting for Hemodialysis Access, and more
  • Contains more than 1,000 full-color illustrations, including procedural photos and beautifully illustrated drawings that highlight the relevant anatomy and techniques in specific treatments
  • Features numerous video clips of key intraoperative moments, which are particularly beneficial for real-time review of endovascular interventions
  • An eBook version is included with purchase. The eBook allows you to access all of the text, figures and references, with the ability to search, customize your content, make notes and highlights, and have content read aloud. Additional digital ancillary content may publish up to 6 weeks following the publication date
מידע נוסף
מהדורה 2nd Edition
עמודים / Pages 891
תאריך יציאה לאור 22 בנוב׳ 2024
תוכן עניינים

Title of Book

Instructions for online access

Cover image

Title page

Table of Contents

SECTION EDITORS

Copyright

Dedication

Preface

Preface 1st Edition

Preface 2nd Edition

Acknowledgment

Contributors

Section I. Surgical and Endovascular Techniques

  1. General Principles of Vascular Surgery

Preoperative Preparation

Presentation and Natural History of Vascular Disease

Diagnosis

Planning a Treatment Strategy

Preoperative Assessment

Preparation of the Operating Room and Interventional Suite

Equipment and Personnel

Positioning and Preparation of the Patient

Surgical Exposure and Choice of Incision

Basic Principles of Vascular Surgery

Instruments

Fixed Retractor Systems

Exposure and Control of Blood Vessels

Basics of Electrosurgical Instruments

Methods of Arteriotomy

Techniques of Anastomosis

Beveled End-to-Side Anastomosis

Nonbeveled End-to-Side Anastomosis

End-to-End Anastomosis

Small Vessel End-to-End Anastomosis

Acknowledgments

  1. General Principles of Sedation, Angiography, and Intravascular Ultrasound

Historical Background

Sedation, Analgesia, and Anesthesia

Fluoroscopic Principles

Image Acquisition

Contrast Injection Techniques

Radiation Exposure and Safety

Modification of Image Acquisition Technique

Reduce Radiation Scatter and Exposure

Additional Measures

Principles of Ultrasound-Guided Arterial Puncture

Angiographic Contrast Media

Special Consideration: Patients with Renal Dysfunction

Renal Protection

Reduce Contrast Volume

Avoidance of Iodinated Contrast

Special Consideration: Patients with Contrast Media Reactions

Treatment for Contrast Media Reactions

CO2 Angiography

Intravascular Ultrasound

Optical Coherence Tomography

  1. General Principles of Endovascular Therapy: Access Site Management

Historical Background

Indications

General Considerations for Access

Access Site

Coagulation

Laboratory Testing

Patient Positioning

Anesthesia

Ultrasound Guidance

Strategies for Commonly Accessed Vessels

Common Femoral Artery

Brachial Artery

Axillary Artery

Radial Artery

Pedal Access

Popliteal Artery

Arterial Bypass Grafts

Internal Jugular Vein

Common Femoral Vein

Brachial and Basilic Veins

Popliteal and Posterior Tibial Veins

Strategies for the Difficult Groin

Obesity

Scarred Groin

Calcification

Pulselessness

Compression and Closure Devices

Manual Compression Technique

Blood Pressure

Anticoagulation

Activity Restrictions

External Compression Devices

Arterial Closure Devices

Acknowledgments

Postoperative Complications

  1. General Principles of Endovascular Therapy: Guidewire and Catheter Manipulation

Historical Background

Guidewire Selection

Guidewire Handling

Catheter Selection

Sheath Selection

Catheter Handling

Crossing a Stenosis

Retrograde Access

Avoiding and Managing a Subintimal Guidewire

Crossing an Occlusion

  1. General Principles of Endovascular Therapy: Angioplasty, Stenting, Recanalization, and Embolization

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Endovascular Strategy

Endovascular Technique

Anesthesia

Balloon Angioplasty

Modified Balloons

Drug-Coated Balloons

Stents and Stent Grafts

Recanalization

Atherectomy

Recanalization for Acute Thrombosis

Distal Embolic Protection

Therapeutic Embolization

Acknowledgments

Postoperative Care

Postoperative Complications

Section II. Surgical and Endovascular Treatment of Extracranial Cerebrovascular Disease

  1. Carotid Endarterectomy

Historical Background

Indications

Contraindications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Avoiding Intraoperative Stroke

Avoiding Cranial Nerve Injuries

Operative Technique

Choice of Anesthesia

Incision and Position

Mobilization of the Sternocleidomastoid Muscle

Mobilization of the Jugular Vein and Division of the Common Facial Vein

Exposure of the Common Carotid Artery

Isolation of the External Carotid Artery

Isolation of the Internal Carotid Artery

Exposure of the Distal Internal Carotid Artery

Arteriotomy and Shunt Placement

Endarterectomy

Patch Angioplasty

Closure

Postoperative Care

Postoperative Complications

  1. Eversion Endarterectomy and Special Problems in Carotid Surgery

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Operative Technique

Exposure of the Carotid Artery

Endarterectomy of the Internal Carotid Artery

Endarterectomy of the Common Carotid Artery

Anastomosis of the Internal to the Common Carotid Artery

Shunting During Eversion Carotid Endarterectomy

Postoperative Care

Postoperative Complications

Recurrent Stenosis

Infection

Special Problems in Carotid Surgery

Kinks and Coils in the Internal Carotid Artery

Fibromuscular Dysplasia

Redo Carotid Surgery

Recurrent Carotid Stenosis

Carotid Patch Aneurysm

Infected Carotid Patch

Extracranial Aneurysms of the Carotid Artery

Pitfalls and Danger Points

Operative Technique

SURGICAL Reconstruction

Endovascular Repair

Acknowledgments

  1. Carotid Angioplasty and Stenting

Historical Background

Indications

Preoperative Care

Pitfalls and Danger Points

Endovascular Strategy

Favorable and Unfavorable Aortic Arch Anatomy

Kinks and Coils of the Carotid Artery

Occluded External Carotid Artery

High-Risk Lesions

Severe Stenosis or String Sign

Tandem Lesions in the Common Carotid Artery

Fibromuscular Dysplasia

Redo Carotid Angioplasty

Endovascular Technique

Sheaths

Guide Wires

Catheters

Embolic Protection Device

Stents

Arterial Access

Catheterization of the Common Carotid Artery

Angiography of the Aortic Arch, Carotid, and Cerebral Circulation

Sheath Placement for Planned Intervention

Crossing a Lesion and Cerebral Protection

Angioplasty

STENT PLACEMENT

Completion Studies

Management of Arterial Spasm, Embolization, and Acute Occlusion

Neuro-Rescue

Acknowledgments

Postoperative Care

Postoperative Complications

  1. Transcarotid Artery Revascularization With Dynamic Flow Reversal (TCAR)

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Endovascular Strategy

Common carotid artery anatomy

Tortuous carotid artery

Occluded External Carotid Artery

High-risk carotid lesion

String sign

Stent selection

Endovascular Technique

Exposure of Common Carotid Artery

Venous Access

Arterial Access and Sheath Placement

Initiation of Dynamic Flow Reversal

Balloon Angioplasty

Stenting

Completion Studies

Poststent Balloon Angioplasty

Management of Arterial Spasm, Embolization, and Acute Occlusion

Cessation of Flow Reversal and Sheath Removal

Intolerance to Flow Reversal

Postoperative Care

Postoperative Complications

  1. Carotid Body Tumor

Historical Background

Preoperative Preparation

History and Physical Examination

Genetic and Functional Testing

Preoperative Imaging

Pitfalls and Danger Points

Operative Strategy

Classification and Surgical Anatomy of Carotid Body Tumors

Avoiding Cranial Nerve Injury

Bilateral Tumors

Avoiding Intraoperative Stroke

Minimizing Blood Loss and Preoperative Embolization

Operative Technique

Anesthetic Considerations

Patient Positioning

Incision

Exposure of The Carotid Bifurcation

Resection of The Shamblin Type I Carotid Body Tumor

Resection of The Shamblin Type II/III Carotid Body Tumor

Acknowledgments

Postoperative Care

Postoperative Complications

  1. Surgical Treatment of the Vertebral Artery

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Surgical Anatomy of The Vertebral Artery

Operative Technique

Exposure and Transposition of The Vertebral Artery Into The Common Carotid Artery

Exposure of The V2 Segment of The Vertebral Artery

V3 Exposure and Distal Vertebral Artery Reconstruction

Postoperative Care

Postoperative Complications

Section III. Surgical and Endovascular Treatment of Aortic Arch Vessel Disease

  1. Direct Surgical Repair of Aortic Arch Vessels

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Surgical Anatomy of The Aortic Arch and Branch Vessels

Avoiding Injury to Anatomic Structures

Avoiding Intraoperative Stroke

Assessment of A Suitable Clamp Site in The Aortic Arch

Median Sternotomy Versus Ministernotomy

Redo-Median Sternotomy

Special Considerations for Patients with Vasculitis

Operative Technique

Incision

Exposure of The Aortic Arch

Dissection of The Arch Vessels

Ascending Aorta-Innominate Artery Bypass

Ascending Aorta-Bilateral Carotid Artery Bypass

Closure

Acknowledgments

Postoperative Care

Postoperative Complications

  1. Extra-anatomic Repair of Aortic Arch Vessels

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Surgical Anatomy of the Common Carotid and Subclavian Arteries

Operative Technique for a Carotid-Subclavian Artery Transposition

Operative Technique for a Carotid-Subclavian Artery Bypass

Operative Technique for a Carotid-Carotid Artery Bypass

Postoperative Care

Postoperative Complications

  1. Endovascular Treatment of Aortic Arch Vessels

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Endovascular Strategy

Angiographic Anatomy of the Arch Vessels and Common Collateral Pathways

Unfavorable Anatomic Features for Interventions on the Innominate Artery

Unfavorable Anatomic Features for Interventions on the Common Carotid Artery

Unfavorable Anatomic Features for Interventions on the Subclavian Artery

Considerations in the Presence of Left Internal Mammary Artery Coronary Artery Bypass Graft

Selection of Antegrade or Retrograde Access for Treatment of the Innominate or Common Carotid Artery

Selection of Antegrade or Retrograde Access for Treatment of the Subclavian Artery

Role of Predilatation

Selection of a Stent

Multiple Arch Vessel Lesions

Use of a Cerebral Protection Device

Protection of the Vertebral Artery

Endovascular Technique

Access: Antegrade and Retrograde Approaches

Sheaths

Guide Wires

Catheters

Stents

Angiography of the Aortic Arch and Branch Vessels

Techniques for Selective Catheterization

Innominate Artery Angioplasty and Stenting

Common Carotid Artery Angioplasty and Stenting

Vertebral Artery Angioplasty and Stenting

Subclavian and Axillary Artery Angioplasty and Stenting

Endovascular Treatment of a Kommerell Diverticulum

Acknowledgments

Postoperative Care

Postoperative Complications

  1. Surgical Treatment of the Subclavian and Axillary Artery

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Surgical Anatomy of the Subclavian and Axillary Artery

Anatomic Considerations in Cases of the Aberrant Right Subclavian Artery

Avoiding Injuries to the Thoracic Duct

Avoiding Injuries to the Brachial Plexus

Avoiding Injuries to the Vertebral Artery

Avoiding Injuries Behind the Clavicle

Selection of a Conduit

Operative Technique

Repair of a Subclavian Artery Aneurysm: Subclavian-Axillary Bypass

Position and Incision

Exposure of the Supraclavicular Subclavian Artery

Exposure of the Axillary Artery

Subclavian-Axillary Artery Bypass

Carotid-Brachial Artery Bypass

Closure

Repair of an Aberrant Right Subclavian Artery

Position and Incision

Exposure of the Aberrant Subclavian Artery

Exposure of the Retroesophageal Subclavian Artery

Division and Ligation of the Retroesophageal Subclavian Artery

Subclavian Artery to Carotid Artery Transposition

Closure

Repair of a Kommerell Diverticulum

Position and Incision

Thoracic Exposure for Proximal Control of a Kommerell Diverticulum

Distal Exposure for Control of a Kommerell Diverticulum

Aortic Repair

Closure

Postoperative Care

Subclavian Artery Repair

Kommerell Diverticulum Repair

Postoperative Complications

Section IV. Surgical and Endovascular Treatment of Upper Extremity Vascular Disease

  1. Supraclavicular Approach for Surgical Treatment of Thoracic Outlet Syndrome

Historical Background

Preoperative Preparation

Principal Symptoms

Symptom Characteristics

Clinical History

Physical Examination

Provocative Maneuvers

Pitfalls and Danger Points

Operative Strategy

Surgical Anatomy of the Thoracic Outlet

Avoiding Inadequate Decompression and Recurrence

Avoiding Nerve Injury

Avoiding Vascular and Lymphatic Injury

Operative Technique

Position and Incision

Exposure

Scalenectomy

First Rib Resection

Brachial Plexus Neurolysis

Pectoralis Minor Tenotomy

Management of Associated Subclavian Artery Aneurysm

Management of Associated Subclavian Vein Stenosis or Occlusion

Closure

Acknowledgments

Postoperative Care

Postoperative Complications

  1. Surgical Treatment of Arterial Thoracic Outlet Syndrome

Historical Background

Indications

History and Physical Examination

Imaging

Preoperative Preparation

Pitfalls and Danger Points

Operative and Endovascular Strategy

Anatomy of the Thoracic Outlet

Surgical Instrumentation for Transaxillary First Rib Resection

Surgical Instrumentation for Supraclavicular First Rib Resection

Reconstruction of the Subclavian Artery

Operative Technique

Incision

Arterial Reconstruction

Exposure

Thoracic Outlet Decompression

Arterial Reconstruction

Closure

Postoperative Care

THORACIC OUTLET SYNDROME PROTOCOL

Physical therapy and exercise

Anticoagulation

Postoperative surveillance

Postoperative Complications

  1. Transaxillary First Rib Resection

Historical Background

Indications

Preoperative Preparation

Neurogenic Thoracic Outlet Syndrome

Venous Thoracic Outlet Syndrome

Arterial Thoracic Outlet Syndrome

Pitfalls and Danger Points

Operative Strategy

Surgical Anatomy of the Thoracic Outlet

Avoiding Injury to the Brachial Plexus

Operative Technique

Incision

Operative Exposure

Exposure of the Anatomic Triangle of the Thoracic Outlet

Exposure of the Inferior Border of the First Rib

Exposure of the Superior Border of the First Rib

Rib Resection

Closure

Acknowledgments

Postoperative Care

Postoperative Complications

  1. Endovascular Therapy for Subclavian-Axillary Vein Thrombosis

Historical Background

Indications

Preoperative Preparation

Diagnosis

Preoperative EVALUATION

Timing of Endovascular Intervention

Pitfalls and Danger Points

Endovascular Strategy

Angiographic Anatomy and VENOUS Collaterals

Timing of Intervention

Endovascular Technique

THE DECISION TO TREAT

Access

Sheaths

Guidewires

Catheters

Sheath Placement

Diagnostic Venography

Thrombolysis

Catheter-Directed Thrombolysis

Pharmacomechanical Thrombolysis

Aspiration Mechanical Thrombectomy

Angioplasty and Stenting

Completion Studies

Postoperative Care

Postoperative Complications

  1. Surgical Treatment of Subclavian-Axillary Vein Thrombosis

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Surgical Anatomy

Surgical Approach to First Rib Resection

Operative Technique

Patient Positioning

Special Instruments

Supraclavicular Incision

Infraclavicular Incision

Pectoralis Minor Tenotomy

Venous Reconstruction

Endovenectomy With Patch Angioplasty

Interposition Graft Placement

Jugular Vein Transposition

Arteriovenous Fistula

Wound Closure

Sternal Split

Claviculectomy

Postoperative Care

Postoperative Complications

Section V. Surgical and Endovascular Treatment of the Thoracic Aorta

  1. Direct Surgical Repair of Aneurysms of the Thoracic and Thoracoabdominal Aorta

Historical Background

Indications

Classification of Descending Thoracic and Thoracoabdominal Aortic Aneurysms

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Avoiding Spinal Cord Ischemia

Avoiding Visceral Ischemia

Avoiding Coagulopathy

Avoiding Embolization

Avoiding Diaphragmatic Paralysis

Avoiding Vagus Nerve Injury

Avoiding Esophageal Injury

Operative Technique: General Considerations

Patient Positioning

Incision

Retroperitoneal or Transperitoneal Thoracoabdominal Exposure

Distal Aortic Perfusion

Selection of A Site for Aortic Clamping

Use of Balloon Catheters for Intercostal Artery Control

Intercostal Artery Reattachment

Chronic Aortic Dissection

Prior Thoracic Endograft

Pain Control

Repair of a Descending Thoracic Aortic Aneurysm

Repair of an Extent I Thoracoabdominal Aortic Aneurysm

Repair of an Extent II Thoracoabdominal Aortic Aneurysm

Repair of an Extent III and V Thoracoabdominal Aortic Aneurysm

Repair of an Extent IV Thoracoabdominal Aortic Aneurysm

Postoperative Care

Postoperative Complications

  1. Endovascular Treatment of the Aortic Arch

Historical Background

Indications

Preoperative Preparation

Endovascular Strategy

Imaging

Proximal seal zone

Arch anatomy

Access

Intraoperative imaging

Endovascular Technique

Endovascular Repair of the Aortic Arch

Intraoperative Preparation

Sheaths

Guidewires

Catheters

Snare

Balloons

Stents

Embolic Coils and Plugs

Aortic Arch Devices

CUSTOM ASCENDING ARCH BRANCH

Gore Tag Thoracic Branch Endoprosthesis

Valiant Mona LSA Stent Graft System

Nexus Endospan Aortic Arch Endovascular Graft

Terumo Aortic Relaybranch Thoracic Stent Graft System

Fenestrated Aortic Arch Endografting

Chimney and Snorkel Techniques and in Situ Laser Fenestration

Hybrid Approaches for Aortic Arch Repair

Postoperative Care

Postoperative Complications

  1. Endovascular Treatment of a Thoracic Aortic Aneurysm

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Endovascular Strategy

Avoiding Access Vessel Complications

Device Selection

Intraoperative Imaging

Device Deployment

Avoiding Spinal Cord Ischemia

Avoiding Stroke

Avoiding Acute Kidney Injury

Avoidance of Arm Ischemia and Vertebrobasilar Insufficiency

Avoidance of Foregut Ischemia

Avoidance of Inaccurate Proximal Endograft Deployment

Avoiding Type I Endoleak

Avoiding Type II Endoleak

Avoiding Type III Endoleak

Endovascular Technique for Repair of a Descending Thoracic Aortic Aneurysm

Patient Preparation

Sheath

Guidewires

Catheters

Vascular Access

Endograft Deployment

DEPLOYMENT OF A GORE CONFORMABLE THORACIC ENDOPROSTHESIS (cTAG)

Deployment of a Zenith Alpha Endograft

Deployment of a Valiant CAPTIVIA Endograft

Deployment of a RELAYPRO Vascular Endograft

Postoperative Care

Postoperative Complications

  1. Endovascular Treatment of Aortic Dissection

Historical Background

Classification of Aortic Dissection

Indications

Complicated

High-Risk Features

Uncomplicated

Preoperative Preparation

Endovascular Strategy

Access

Thoracic Endovascular Aortic Repair

Intraoperative Imaging

Endovascular Technique

Tevar for Aortic Dissection

Hybrid Procedures for Aortic Dissection

Total Aortic Arch Debranching (Zone 0 Coverage)

Carotid-Carotid and Carotid-Subclavian Bypass (Zone 1 Coverage)

Aortic Fenestration

Postoperative Care

Postoperative Complications

  1. Endovascular Treatment of Traumatic Thoracic Aortic Disruption

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Endovascular Strategy

Sizing of an Endovascular Graft

Extent of Repair

Endovascular Technique

Access

Anticoagulation

Sheath

Guidewires

Catheters

Endograft

Imaging and localization of the left subclavian artery

Intravascular ultrasound

Endograft selection

Endograft deployment

Postdeployment imaging

Postoperative Care

Postoperative Complications

Acknowledgments

  1. Endovascular Treatment of Thoracoabdominal Aneurysms

Historical Background

Indications

Preoperative Preparation

Endovascular Strategy

Hybrid Repair

Parallel Grafts

Fenestrated and Branched Stent-Grafts

Graft Selection and Sizing

Intraoperative Adjuncts

Strategies to Minimize Spinal Cord Injury

Endovascular Technique

Endovascular Toolkit

Perioperative Measures

Patient Positioning

Arterial Access

Endovascular Technique

Deployment of a Patient-Specific Four-Vessel Fenestrated Stent-Graft

Initial Imaging and Deployment of the Fenestrated Stent Graft Component

Cannulation of the Renal Vessels

Cannulation of the Celiac and Superior Mesenteric Arteries

Final Deployment of the Fenestrated Stent-Graft Component and Bridging Stents

Deployment of the Bifurcated Universal Device and Contralateral Limb Extension

Deployment of a Patient-Specific Fenestrated-Branched Stent-Graft

Access and Introduction of Brachial and Femoral Sheaths

Introduction of the Fenestrated-Branched Stent-Graft

Sequential Catheterization of Target Vessels

Deployment of the Distal Fenestrated-Branched Device and Bifurcated Component

Deployment of Covered Stents

Deployment of an Off-the-Shelf Multibranched Stent-Graft

Access and Introduction of Brachial and Femoral Sheaths

Deployment of the T-Branch Device and Distal Bifurcated Component

Sequential Catheterization of Target Vessels

Deployment of Bridging Stents

Placement of Iliac Limbs and Completion Angiography

Postoperative Care

Postoperative Complications

Section VI. Surgical and Endovascular Treatment of the Abdominal Aorta and the Iliac Arteries

  1. Direct Surgical Repair of Aneurysms of the Infrarenal Abdominal Aorta and Iliac Arteries

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Surgical Anatomy

Avoiding Injury to Anatomic Structures

Advantages

Disadvantages

Transperitoneal or Retroperitoneal Exposure

Advantages

Disadvantages

Vertical or Transverse Abdominal Incision

Division of The Renal Vein

Quality of The Infrarenal Aortic Neck

Distal Exposure and Control

Balloon Catheters for Vascular Control

Bleeding Suture Line

Colonic Perfusion

Ruptured Aneurysm

Inflammatory Aneurysm

Horseshoe Kidney

Transplanted Kidney

Venous Anomalies

Aortocaval Fistula

Chronic Dissection

Collagen Vascular Disorder

Transabdominal Repair of an Infrarenal Aortic Aneurysm

INCISION

Exposure of The Abdominal Aorta

Exposure of The Iliac Arteries

Proximal and Distal Control

Aortic Incision

Proximal Anastomosis

Reimplantation of An Inferior Mesenteric or Accessory Renal Artery

Distal Anastomosis

Graft Coverage

Closure

Retroperitoneal Repair of an Infrarenal Aortic Aneurysm

Incision and Exposure of The Abdominal Aorta

Closure

Acknowledgments

Repair of an Iliac Aneurysm

Postoperative Care

Postoperative Complications

  1. Direct Surgical Repair of Aneurysms of the Juxtarenal and Pararenal Abdominal Aorta

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Retroperitoneal or Transperitoneal Exposure

Selection of a Site for Proximal Aortic Control

Operative Technique

Control of the Suprarenal Aorta

Control of the Supraceliac Aorta

Operative Technique for Retroperitoneal Exposure

Incision for a Juxtarenal Abdominal Aortic Aneurysm

Incision for a Suprarenal Abdominal Aortic Aneurysm

Operative Technique for Repair of a Juxtarenal Aortic Aneurysm With Iliac Artery Involvement

Incision

Exposure of the Abdominal Aorta

Exposure of the Iliac Arteries

Division of the Renal Vein

Proximal and Distal Control

Aortic Incision

Proximal Anastomosis

Distal Anastomosis with Side Graft to External Iliac Artery

Graft Coverage

Operative Technique for Repair of a Suprarenal Aortic Aneurysm

Incision

Exposure of the Abdominal Aorta

Exposure of the Iliac Arteries

Proximal and Distal Control

Aortic Incision

Proximal Aortic Anastomosis

Distal Aortic Anastomosis

Closure

Acknowledgments

Postoperative Care

Postoperative Complications

  1. Endovascular Treatment of Aneurysms of the Infrarenal Aorta

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Endovascular Strategy

Selection and Sizing of an Endovascular Endograft

Access

Percutaneous Access

Femoral Artery Exposure

Use of an Iliac Artery Conduit

Adjunctive Iliac Angioplasty

Endovascular Technique

Endovascular Repair of an Abdominal Aortic Aneurysm

Percutaneous Access

SURGICAL Iliac Artery Conduit

Endovascular Iliac ARTERY Conduit

Sheaths

Guidewires

Specialty Wires

Catheters

Balloons

Specialty Balloons

Specialty Stents

Angiography of the Abdominal Aorta and Iliac Arteries

ENDOGRAFT Deployment and Cannulation of the Contralateral Gate

DEVICE Selection and Deployment

Excluder Endograft

Zenith Endograft

Endurant Endograft

AFX2 Endograft

Alto Endograft

Treo Endograft

Management of Intraoperative Complications

Rupture of the Aorta or Iliac Vessels

Arterial Dissection

Distal Embolization

Limb Occlusion

Renal Artery Occlusion

Bleeding

Endovascular Repair of an Abdominal Aortic Aneurysm With Iliac Artery Involvement

Deployment of AN Iliac Branch Endoprosthesis

Components of the Gore Excluder Iliac Branch Endoprosthesis

Access

Deployment of the Iliac Branch Component

Deployment of the Internal Iliac Component

Completion of EVAR Deployment

Internal Iliac Artery Embolization

External Iliac–to–Internal Iliac BYPASS

Acknowledgments

Postoperative Care

Postoperative Complications

  1. Special Problems in the Endovascular Treatment of Aneurysms of the Infrarenal Aorta

Historical Background

Preoperative Preparation

Pitfalls and Danger Points

Endovascular Strategy

Difficult Access Vessels

Hostile Aortic Neck

Narrow Aortic Bifurcation

Endovascular Technique

Deployment of An Aorto-Uni-Iliac Endograft

Treatment of an Iliac Artery Aneurysm

Embolization of the Internal Iliac Artery

Preservation of Flow to the Internal Iliac Artery

Treatment of an Endoleak

Type I Endoleak

Giant Palmaz Stent Placement

Endostaples

Type II Endoleak

Translumbar Embolization of a Type II Endoleak

Transarterial Embolization of a Type II Endoleak

Transcaval Embolization of a Type II Endoleak

Postoperative Care

  1. Endovascular Treatment of Aneurysms of the Juxtarenal and Pararenal Abdominal Aorta

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Endovascular Strategy

Selection of a Fenestrated or Branched Endograft

Intervention for a Failed Open or Endovascular Aortic Repair

Use of a Snorkel or Chimney Endograft

Consideration of a Physician-Modified Device

Zenith Fenestrated Abdominal Aortic Aneurysm Endovascular Graft

Assessment of Landing Zones

Selection of Fenestrations and Scallops

Adjunctive Stenting

Endovascular Technique for the Repair of a Juxtarenal Aortic Aneurysm

Deployment of a Zenith Fenestrated Abdominal Aortic Aneurysm Endovascular Graft

Access

Imaging

Steps in Deployment

Sheaths

Specialty Sheaths

Guidewires

Specialty Wires

Catheters

Specialty Catheters

Balloons

Stents

Endovascular Technique for the Deployment of Snorkel or Chimney Endograft

Access

Steps in Deployment

Endovascular Technique for the Repair of a Suprarenal Aortic Aneurysm

Deployment of a Branched Endograft

Access

Steps in Device Deployment

Acknowledgments

Postoperative Care

Postoperative Complications

  1. Direct Surgical Repair of Aortoiliac Occlusive Disease

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Surgical Anatomy of the Abdominal Aorta, Iliac and Femoral Arteries

Options for Revascularization

Selection of a Prosthetic Graft

Configuration of the Proximal Anastomosis

Totally Occluded, Calcified, and Small Aortas

Redo Groin Surgery

Operative Technique for Aortobifemoral Bypass

Incision

Exposure of the Femoral Arteries

Exposure of the Abdominal Aorta

Tunnel Construction

Aortic Division and Closure of the Distal Aorta

Proximal Graft Anastomosis

End-to-End Aortic Anastomosis

End-to-Side Aortic Anastomosis

Distal Graft Anastomosis

Femoral Anastomosis

Graft Coverage

Adjunctive or Alternative Procedures

Associated Renal or Visceral Lesions

Simultaneous Distal Lower Extremity Revascularization

Thoracic Aorta to Femoral Artery Bypass

Iliofemoral Bypass

Acknowledgments

Postoperative Care

Postoperative Complications

Late Complications After Aortic Surgery

  1. Extra-anatomic Repair for Aortoiliac Occlusive Disease

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Operative Technique for a Femoral-Femoral Bypass

Incision

Exposure of the Femoral Arteries

Creation of a Suprapubic Tunnel

Anastomosis

Closure

Operative Technique for an Axillofemoral Bypass

Selection of a Donor Artery

Incision and Exposure

Tunneling the Bypass Graft

Axillary Anastomosis

Femoral Anastomosis

Closure

Operative Technique for a Thoracofemoral Bypass

Incision and Exposure

Tunneling the Bypass Graft

Aortic Anastomosis

Distal Anastomosis

Closure

Operative Technique for an Aortoiliac Embolectomy

Incision and Exposure

Femoral Arteriotomy and Embolectomy

Closure

Acknowledgments

Postoperative Care

  1. Endovascular Treatment of Aortoiliac Occlusive Disease

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Endovascular Strategy

Initial Intraoperative Imaging

Assessing Hemodynamic Significance

Concomitant Common Femoral Artery Disease

Calcification

Lesions Above the Aortic Bifurcation

Endovascular Technique

Arterial Access

Sheaths

Guidewires

Crossing an Iliac Artery Lesion

Retrograde Approach

Antegrade Approach

Angiographic Catheters

Selective Catheters

Directional Support and Crossing Catheters

Balloons

Balloon-Expandable Stents

Self-Expanding Stents (0.035-Inch)

Balloon-Expandable Covered Stents (0.035-Inch)

Coexistent Common Femoral Artery Disease

Brachial Artery Access

Reentry Catheters

Aortic Bifurcation Disease

Concomitant Femoral Artery Endarterectomy

Selection of Balloon and Stent Dimensions

Postoperative Care

  1. Special Problems in the Endovascular Treatment of Aortoiliac Occlusive Disease

Historical Background

Preoperative Preparation

Pitfalls and Danger Points

Endovascular Strategy

Unfavorable Anatomic Features for Aortic Intervention

Unfavorable Anatomic Features for Common Iliac Artery Intervention

Unfavorable Anatomic Features for External Iliac Artery Interventions

Adjunctive Thrombolysis, Percutaneous Mechanical Thrombectomy, and Thromboaspiration Devices

Avoiding Embolization, Dissection, and Rupture

Role of a Reentry Device

Endovascular Treatment of an Aortic Occlusion

Sheath Placement

Crossing an Occlusion

Angioplasty and Stenting

Endovascular Treatment of a Common Iliac Artery Occlusion

Sheath Placement

Crossing an Occlusion

Angioplasty and Stenting

Endovascular Treatment of an External Iliac Artery Occlusion

Sheath Placement

Crossing a Lesion

Angioplasty and Stenting

Endovascular Treatment of Arterial Dissection, Embolization, Occlusion, and Rupture

Postoperative Care

Postoperative Complications

  1. Lumbar Spine Exposure

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Surgical Anatomy

Location of Incision

Operative Technique

Operative Technique for an Anterior Approach

Traversing the Abdominal Wall

Developing the Retroperitoneal Space

L3–S1 Lumbar Exposure

L2–L3 Lumbar Exposure

Mobilizing Vascular Structures and Maintaining the Corridor Pathway

L5–S1 Lumbar Exposure

L4–L5 and Above Lumbar Exposures

Closure and Inspection

Operative Technique for an Anterolateral Approach

Operative Technique for a Direct Lateral Approach

Operative Technique for an Oblique Anterior-to-Psoas Approach

Postoperative Care

Postoperative Complications

Section VII. Surgical and Endovascular Treatment of Late Aortic Graft Complications

  1. Surgical Treatment of an Aortic Graft Infection

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Complete or Partial Graft Resection

In Situ Reconstruction or Extra-anatomic Repair

Preparing the Allograft

Vascular Reconstruction With an Allograft

Postoperative Management

Axillofemoral, Axillopopliteal, or Obturator Bypass

Avoiding Injury to Ureter

Management of an Aortoenteric Fistula

Management of the Aortic Stump

Operative Technique for Total Graft Excision

Placement of a Supra-celiac AORTIC Clamp

Exposure of the Perirenal Aorta and Distal Clamp Sites

Preparing the Conduit

Graft Removal and Débridement

Management of the Aortic Stump

Management of the Duodenum

Sartorius and Rectus Femoris Muscle Flap

Acknowledgment

Axillopopliteal Bypass

Postoperative Care

Postoperative Complications

  1. Neoaortoiliac System for Treatment of an Aortic Graft Infection

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Selection of Conduit for in Situ Repair

Staging the NAIS Procedure

Operative Technique

Harvesting Femoral Vein

Construction of the Neoaortoiliac System

Proximal Anastomosis

Distal Anastomosis

Omental Flap

Sartorius Muscle Flap

Drains

Closure

Acknowledgments

Postoperative Care

Postoperative Complications

  1. Surgical Treatment of Pseudoaneurysm of the Femoral Artery

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Preparing the operative field

Extent of graft excision

Extraanatomic bypass or in situ reconstruction

Selection of a conduit

Minimizing cross-contamination

VASCULAR control in A SCARRED groin

Operative Technique for an Iliofemoral Obturator Bypass

Incision

Exposure of the Uninfected Proximal Prosthetic Limb

Obturator Bypass

Closure

Graft Excision

Sartorius Muscle Flap

Closure

Operative Technique for In Situ Reconstruction of an Anastomotic Femoral Artery Pseudoaneurysm

Exposure of the Proximal Graft and Common Femoral Artery

Exposure of the Superficial and Profunda Femoral Arteries

Placement of an Interposition Graft

Closure

Acknowledgments

Operative Technique for Thrombin Injection of an Iatrogenic Femoral Artery Pseudoaneurysm

Operative Technique for the Direct Surgical Repair of an Iatrogenic Femoral Artery Pseudoaneurysm

Postoperative Care

Postoperative Complications

Section VIII. Surgical and Endovascular Treatment of Renal Artery Disease

  1. Direct Surgical Repair of Atherosclerotic Renovascular Disease

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy for Renovascular Occlusive Disease

Surgical Anatomy of the Renal Arteries

Unilateral or Bilateral Renal Artery Repair

Exposure of the Pararenal Aorta

Renal Artery Bypass or Endarterectomy

Selection of an Inflow Source

Selection of a Conduit

Minimizing Renal Ischemia

Intraoperative Assessment

Operative Strategy for a Renal Artery Aneurysm

In Situ Reconstruction, Ex Vivo Repair, or Kidney Autotransplantation

Considerations for an Aneurysm at a Branch Vessel Bifurcation

Retroperitoneal or Transperitoneal Approach

Avoiding Injury to the Ureter During Ex Vivo Repair

Operative Technique for Aortorenal Bypass

Incision

Exposure of the Pararenal Aorta and Renal Arteries

Renal Artery Bypass: Proximal and Distal Anastomosis

Operative Technique for Renal Artery Endarterectomy

Exposure of the Pararenal Aorta

Endarterectomy

In Situ Repair of a Renal Artery Aneurysm

Incision

Exposure of a Renal Artery Aneurysm

Proximal and Distal Control

Aneurysmorrhaphy

Ex Vivo Renal Artery Repair

Incision

Exposure and Mobilization of the Kidney

Administration of Preservation Solution and Extraction of the Kidney

Ex Vivo Repair and Orthotopic Autotransplantation

Closure

Postoperative Care

Postoperative Complications

  1. Extra-anatomic Repair for Renovascular Disease

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

CO-EXISTENT ATHEROSCLEROTIC OCCLUSIVE DISEASE

ANATOMIC VARIANTS AND VULNERABILITIES

PHYSIOLOGIC CONSIDERATIONS

Operative Strategy

Surgical Anatomy of The Hepatic and Splenic Arteries

Selection of A Conduit

OPERATIVE EXPOSURE

Operative Technique for Hepatorenal Bypass

Incision

Exposure of The Right Renal Artery

Exposure of The Hepatic Artery

Proximal Anastomosis

Distal Anastomosis

Closure

Operative Technique of Splenorenal Bypass

Incision

Exposure of The Splenic Artery

Exposure of The Left Renal Artery

Splenorenal Anastomosis

Closure

Acknowledgment

Postoperative Care

Postoperative Complications

  1. Endovascular Treatment of Occlusive Renal Artery Disease

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Endovascular Strategy

Angiographic Anatomy

Unfavorable Anatomic Features for Renal Artery Angioplasty and Stenting

Considerations in the Treatment of Branch Vessel Disease

Considerations in the Presence of a Solitary Kidney

Selection of Antegrade or Retrograde Aortic Access for Treatment

Coaxial or Monorail Balloon Catheter Designs

Role of Balloon Predilation

Angioplasty or Primary Stenting

Selection of a Stent

Use of Embolic Protection

Treatment of Recurrent Stenosis

Endovascular Technique for Treatment of a Renal Artery Stenosis

Sheath Placement for Planned Intervention

Sheaths

Specialty Sheaths

Guidewires

Catheters

Balloons

Stents

Crossing a Lesion

In Situ Physiologic assessment Using a Pressure Wire

Angioplasty

Stent Placement

Completion Studies

Postoperative Care

Postoperative Complications

  1. Endovascular Treatment of Renal Artery Aneurysms

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Endovascular Strategy

Selection of an access site

Optimizing intraoperative angiography

Selection of an intervention

Treatment in the presence of multiple aneurysms

Endovascular Technique

Endovascular Treatment of a Renal Artery Aneurysm

Access

Sheaths

Specialty Sheaths

Guidewires

Catheters

Specialty Catheters

Balloons

Stents

Coils or Liquid Embolic Agents

Imaging

Deployment of a Stent Graft

Embolization

Acknowledgments

Postoperative Care

Postoperative Complications

Section IX. Surgical and Endovascular Treatment of Superior Mesenteric and Celiac Artery Disease

  1. Direct Surgical Repair for Occlusive Superior Mesenteric and Celiac Artery Disease

Historical Background

Indications

Acute Mesenteric Ischemia

Chronic Mesenteric Ischemia

Preoperative Preparation

Acute Mesenteric Ischemia

Chronic Mesenteric Ischemia

Pitfalls and Danger Points

Operative Strategy

Surgical Anatomy

EMBOLISM, THROMBOSIS, OR DISSECTION

ANTEGRADE OR RETROGRADE BYPASS

SELECTION OF VESSELS FOR REVASCULARIZATION

TYPE OF CONDUIT

Operative Technique for Superior Mesenteric Artery Embolectomy

Incision

Exposure of the Superior Mesenteric Artery

Embolectomy

Operative Technique for an Antegrade Aortomesenteric Bypass

Incision

Exposure of the Aorta

Exposure of the Superior Mesenteric Artery

Routing the Bypass Graft

Proximal Anastomosis

Distal Anastomosis

Closure

Operative Technique for a Retrograde Aortomesenteric Bypass

Exposure of Inflow and Outflow Vessels

Routing the Bypass Graft

Anastomoses

Operative Technique for an Aortohepatic Artery Bypass

Exposure of the Aorta, Celiac Axis, and Hepatic Artery

Proximal and Distal Anastomosis

Postoperative Care

Postoperative Complications

Acknowledgments

  1. Reconstruction of the Portal Vein and Hepatic Artery

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Portal Vein Repair or Replacement

Surgical Anatomy of the Porta Hepatis

Repair, Patch, or Replacement of the Portal Vein

Source and Size of Patch or Conduit: Jugular, Femoral or Saphenous Vein

Operative Strategy

Hepatic Artery Repair or Replacement

Surgical Anatomy of Hepatic Artery Variants and Implications for Reconstruction

Sources for Arterial Inflow

Operative Technique: Portal Vein Repair or Replacement

Incision

Exposure of the Porta Hepatis

Portal Vein Direct Repair

Portal Vein Patch Placement

Portal Vein Interposition Graft

Proximal Anastomosis

Distal Anastomosis

Closure

Operative Technique: Hepatic Artery Reconstruction

Incision

Exposure of the Hepatic Artery

Routing the Bypass

Proximal Anastomosis

Distal Anastomosis

Closure

Postoperative Care

Postoperative Complications

  1. Endovascular Treatment of Occlusive Superior Mesenteric Artery and Celiac Artery Disease

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Endovascular Strategy

Endovascular Technique

Brachial Approach

Sheaths

Specialty Sheaths

Guidewires

Catheters

Angiographic Catheters

Selective Catheters

Guiding Catheters (6 Fr)

Directional Support and Crossing Catheters

Balloons

Balloon Expandable Stents

Self-Expanding Stents (0.035 inch)

Balloon Expandable Covered Stents (0.035 inch)

Femoral Approach

Postoperative Care

Postoperative Complications

  1. Direct Surgical Repair for Visceral Artery Aneurysms

Historical Background

Indications

Preoperative Preparation

Imaging studies

Contributing medical conditions

Pitfalls and Danger Points

Operative Strategy

Surgical Anatomy

Operative Technique

Splenic Artery Aneurysm Repair

Incision

Exposure of the Splenic Artery

Ligation of a Splenic Artery Aneurysm

Operative Technique

Hepatic Artery Aneurysm Repair

Incision

Exposure of the Hepatic Artery

Routing of the Bypass

Proximal Anastomosis

Distal Anastomosis

Operative Technique

Celiac Artery Aneurysm Repair

Incision

Exposure of the Aorta

Exposure of the Celiac Artery

Routing of the Bypass

Proximal Anastomosis

Distal Anastomosis

Acknowledgments

Postoperative Care

Postoperative Complications

  1. Endovascular Treatment of Hepatic or Splenic Artery Aneurysms

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Endovascular Strategy

Angiographic Anatomy

Unfavorable Anatomic Features for Intervention

Selection of Embolic Agents

Selection of a Covered Stent

Endovascular Toolkit

Sheaths

Specialty Sheaths

Guidewires

Catheters

Specialty Catheters

Balloons

Stents

Coils and Liquid Embolic Agents

Endovascular Technique

Treatment of a Hepatic Artery Aneurysm

Treatment of Gastroduodenal and Pancreaticoduodenal Aneurysms

Treatment of a Splenic Artery Aneurysm

Completion Studies

Acknowledgments

Postoperative Care

Postoperative Complications

Section X. Surgical and Endovascular Treatment of Lower Extremity Arterial Disease

  1. Direct Surgical Repair of Femoral-Popliteal Arterial Occlusive Disease

Historical Background

Indications

Preoperative Preparation

Preoperative Phase

Intraoperative Phase

Postoperative Phase

Pitfalls and Danger Points

Operative Strategy

Surgical Anatomy of the Femoral and Popliteal Arteries

Selection and Assessment of Inflow

Selection and Assessment of Outflow

Preoperative Assessment of Vein Quality

Selection of a Conduit

In Situ, Nonreversed, or Reversed Vein Bypass

Clamping Versus Use of a Tourniquet

Intraoperative Assessment of the Bypass

Operative Techniques for Vein Harvest

Open Vein Harvest

Endoscopic Vein Harvest

Construction of a Spliced Vein Bypass

Vein Valve Lysis

Operative Technique for Femoral-Above Knee Popliteal Bypass

Positioning and Femoral Incision

Exposure of the Femoral Vessels

Exposure of the Above-Knee Popliteal Artery

Creation of a Tunnel

Construction of the Femoral Anastomosis

Construction of the Popliteal Anastomosis

Closure

Operative Technique for Femoral-Below Knee Popliteal Bypass

Operative Technique for Alternate Inflow Sources

Operative Technique for Femoral and Popliteal Thromboembolectomy

Postoperative Care

Postoperative Complications

  1. Surgical Bypass for Tibial-Peroneal Arterial Occlusive Disease

Historical Background

Indications

Preoperative Preparation

Clinical Presentation

Diagnosis

Assessment of Cardiovascular Risk Factors

Pitfalls and Danger Points

Intraoperative Troubleshooting

Inadequate Vein Conduit

Small Caliber Vein

Unexpected Inflow Disease

Unexpected Outflow Disease

Tunneling Problems

Anastomotic Stenosis

Special Considerations for a Reoperative Bypass

Operative Strategy

Selection of an Inflow Artery

Selection of an Outflow Target Artery

Assessment of Vein Quality

Conduit Selection

Conduit Configuration: In Situ or Reversed Saphenous Vein Graft

Considerations in the Presence of an Open Ulcer

Instrumentation and Tunnelers

Operative Anatomy

Surgical Anatomy of the Femoral, Popliteal, and Tibial Arteries

Operative Technique

Positioning and Draping

Harvest of Lower Extremity and Arm Veins

Construction of a Spliced Vein Bypass

Inflow Source

Femoral-Anterior Tibial Artery Bypass

Anatomic Tunneling

Lateral Tunneling

Femoral-Posterior Tibial Artery Bypass

Exposure of the Proximal Posterior Tibial Artery

Exposure of the Midportion of the Posterior Tibial Artery

Tunneling

Femoral-Peroneal Artery Bypass

Medial Exposure of the Peroneal Artery

Tunneling

Groin Wound Closure

Calf Incision Closure

Special Considerations

Intraoperative Bypass Graft Assessment

Wound Closure

Alternative Inflow Sources

Postoperative Care

Postoperative Complications

  1. Direct Surgical Repair of Popliteal Artery Aneurysm

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Selection of Approach

Conduit Selection

Surgical Anatomy

Avoiding Nerve Injury

Avoiding Venous Injury

Selection and Assessment of Inflow and Distal Outflow

Considerations in the Presence of Acute Thrombosis

Operative Technique

Equipment Needs

Medial Approach

Position and Incision

Proximal Exposure

Distal Exposure

Tunneling

Anastomosis

Aneurysm Ligation

Posterior Approach

Position and Incision

Exposure

Bypass or Interposition Grafting

Closure

Postoperative Care

Postoperative Complications

  1. Direct Surgical Repair of Popliteal Entrapment

Historical Background

Indications

Preoperative Preparation

Classification of Popliteal Artery Entrapment

Pitfalls and Danger Points

Operative Strategy

Surgical Anatomy of The Popliteal Fossa

Avoiding Nerve Injury

Avoiding Venous Injury

Considerations In The Presence of An Arterial Lesion

Operative Technique

Incision

Exposure of The Popliteal Artery

Division of Fascial and Muscular Bands

Popliteal Bypass or Patch Angioplasty

Completion Duplex

Closure

Acknowledgments

Postoperative Care

Postoperative Complications

  1. Endovascular Treatment of Femoropopliteal Arterial Occlusive Disease

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Endovascular Strategy

Angiographic Anatomy and Common Collateral Pathways

Unfavorable Anatomic Features for Interventions on the Superficial Femoral AND Popliteal Arteries

Access Selection

Vessel Preparation

Stent Selection

Endovascular Technique

Retrograde and Antegrade Femoral Approaches for Arterial Access

Sheaths

Guidewires

Catheters

Angiographic Catheters

Selective Catheters

Support and Crossing Catheters

Balloons

Angioplasty Balloons

0.035-Inch Platform

0.018-Inch Platform

0.014-Inch Platform

Drug-Coated Balloons

0.035-Inch Platform

0.018-Inch Platform

Self-Expanding Stents

0.035-Inch Platform

0.018-Inch Platform

Stentgrafts

Angiography of the Lower Extremity

Endovascular Treatment of Femoropopliteal Artery Stenosis

Endovascular Treatment of Femoropopliteal Artery Occlusion

Popliteal or Tibial Access for Treatment of Femoropopliteal Artery Occlusion

Thrombolysis of Acute Femoral and Popliteal Artery Occlusions

Acknowledgments

Postoperative Care

Postoperative Complications

  1. Endovascular Treatment of Tibial and Peroneal Occlusive Disease

Historical Background

Indications

Preoperative Preparation

Endovascular Strategy

Angiographic Anatomy and Common Collateral Pathways

Selection of Access

Contralateral Retrograde Femoral Access

Ipsilateral Antegrade Access

Retrograde Tibiopedal Access

Plaque Modification with Atherectomy or Lithotripsy

Stent Placement

Endovascular Technique

Positioning

Arterial Access

Identifying and Crossing the Lesion

Balloon Angioplasty

Sheaths

Guidewires

Catheters

Angiographic Catheters

Selective Catheters

Support and Crossing Catheters

Balloons

Angioplasty Balloons (0.018-Inch Platform)

Angioplasty Balloons (0.014-Inch Platform)

Postoperative Care

Postoperative Complications

Acknowledgments

  1. Endovascular Treatment of Popliteal Aneurysm

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Endovascular Strategy

Anatomic Features for Intervention

Selection of An Access Site

Selection of An Endograft

Endovascular Technique

Access

Intraoperative Imaging

Sheath Placement for Planned Intervention

Endograft Deployment

Completion Imaging Studies

Postoperative Care

Postoperative Complications

  1. Above- and Below-Knee Amputation

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Amputation in the Presence of Infection

Selection of an Amputation Level

Targeted Muscle Reinnervation

Operative Technique for an Above-Knee Amputation

Skin Incision

Division of the Femur

Wound Closure

Operative Technique for a Below-Knee Amputation

Skin Incision

Division of the Tibia and Fibula

Creation of a Posterior Myocutaneous Flap

Wound Closure

Operative Technique for a Through-Knee Amputation

Postoperative Care

Postoperative Complications

  1. Amputations of the Forefoot

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Selection of An Amputation Level

Choice of Anesthesia

Operative Technique

Transmetatarsal Amputation

Incision

Transection of The Metatarsals

Closure

Central Metatarsal Ray Resection

First and Fifth Ray Amputation

Incision

Transection of The Digit and Metatarsal Head

Acknowledgments

Transphalangeal Amputation

Postoperative Care

Postoperative Complications

  1. Upper and Lower Extremity Fasciotomy

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Unrecognized Compartment Syndrome

Failure to Release Extremity Compartments

Iatrogenic Injury

Inadequate Postoperative Surveillance

Operative Technique

Lower Leg Fasciotomy

Anterior Compartment

Lateral Compartment

Superficial and Deep Posterior Compartments

Thigh Fasciotomy

Anterolateral Extensor Compartment of the Thigh

Posterolateral Flexor Compartment of the Thigh

Medial Adductor Compartment of the Thigh

Upper Extremity

Flexor (Superficial and Deep) and Mobile Wad Compartments of the Arm

Extensor Compartment of the Arm

Postoperative Care

Postoperative Complications

Section XI. Surgical and Endovascular Treatment of Venous Disease

  1. Placement and Retrieval of Vena Cava Filters

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Endovascular Strategy

Selection of A Permanent or Retrievable Filter

Contrast Venography and Ultrasound Imaging

Avoiding Inadvertent Suprarenal Filter Placement

Special Considerations for the Pregnant Patient

Endovascular Technique

Filter Placement With Venography

BEDSIDE Filter Placement

Filter Placement With Transabdominal Ultrasound

Filter Placement With Intravascular Ultrasound

Intravascular Ultrasound System and Filter Choice

Preprocedural Imaging

Single Venous Access Technique

Dual Venous Access Technique

PLACEMENT OF A Superior Vena Cava Filter

Retrieval of a Vena Cava Filter

Postoperative Care

Postoperative Complications

Surgical Removal of a Vena Cava Filter

Operative Technique for Filter Removal

Hybrid TECHNIQUE FOR Filter Removal

Postoperative Care

Postoperative Complications

Acknowledgments

  1. Endovascular Treatment of Deep Venous Thrombosis and Pulmonary Embolism

Historical Background

Indications

Preoperative Preparation

Preoperative Imaging

Anticoagulation

Thrombophilia Evaluation

Pitfalls and Danger Points

Absolute Contraindications

Relative Contraindications

Endovascular Strategy: Iliofemoral Deep Venous Thrombosis

Timing of Intervention

VENOUS Access SITE

Use of an IVC Filter

Intravascular Ultrasound

THROMBECTOMY OR THROMBOLYSIS

Endovascular Technique: Treatment of Iliofemoral Deep Venous Thrombosis

Catheter-Directed Thrombolysis

Ultrasound-Accelerated Thrombolysis

Rheolytic Thrombectomy

Aspiration Thrombectomy

Angiovac System

Indigo System

Clottriever System

FlowTriever Aspiration System

Venous Stents

Endovascular Strategy: Pulmonary Embolism

VENOUS Access SITE

THROMBECTOMY OR THROMBOLYSIS

Type of Anesthesia

Extracorporeal Membrane Oxygenation

Endovascular Technique: Treatment of Pulmonary Embolism

Catheter-Directed Thrombolysis

Ultrasound-Accelerated Thrombolysis

BASHIR CATHETER THROMBOLYSIS

Aspiration Thrombectomy

Indigo System

FlowTriever Aspiration System

Postoperative Care

Postoperative Complications

  1. Surgical Reconstruction for Superior Vena Cava Syndrome

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Avoiding Intraoperative Bleeding

Avoiding Pulmonary Embolism

Selection of A Vascular Conduit

Selection of Venous Inflow and Outflow Sites

Choice of Unilateral or Bilateral Venous Reconstruction

Operative Technique

Choice of Anesthesia

Position and Incision

Dissection of The Innominate Veins and The Superior Vena Cava

Preparation of A Spiral Vein Graft

Performing the Anastomoses

Closure of The Median Sternotomy

Postoperative Care

Postoperative Complications

  1. Endovascular Therapy for Superior Vena Cava Syndrome

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Endovascular Strategy

Recanalization

Angioplasty or stenting

Stent selection

Covered stents

Parallel stents

Ensuring adequate inflow

Endovascular Technique

Patient Preparation

Access

Angiographic Imaging

Sheath Placement for Planned Intervention

Angioplasty and Stent Placement

Completion Studies

Access Kit

Sheaths

Specialty Sheaths

Guidewires

Specialty Guidewires

Multilooped Snare

Mechanical Thrombectomy and Thrombolysis

CTO Crossing Equipment

Balloon Catheters

Stents

Postoperative Care

Postoperative Complications

  1. Surgical Reconstruction of the Perihepatic and Inferior Vena Cava

Historical Background

Indications

Benign Ileofemoral Venous Occlusion

Malignant Iliocaval Venous Occlusion

Primary

Secondary

Secondary Tumors With Caval Thrombus

Preoperative Preparation

Pitfalls and Danger Points

Femoral-Femoral Venous Bypass

Reconstruction of the Inferior Vena Cava

Operative Strategy

Anatomy

Choice of Incision

Additional Considerations

Patch Closure or an Interposition Bypass Graft

Tumor Thrombus Within the Heart

Operative Technique

Reconstruction of the Inferior Vena Cava

Proximal and Distal Control

Reconstruction of the Vena Cava With an Interposition Graft

Reconstruction of the Pararenal Vena Cava

Replacement of the Retrohepatic Vena Cava

Systemic Heparinization

Resection of Pelvic and Sacral Tumors

Iliocaval Venous Bypass for Benign Disease

Femoral-Femoral Venous Bypass

Postoperative Care

Postoperative Complications

  1. Varicose Vein Stripping and Ambulatory Phlebectomy

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

General Considerations

Ensuring Completeness of Varicose Vein Removal

Preventing Recurrence

Avoiding Nerve Injury

Avoiding Arterial or Venous Injury

Hematoma, Ecchymosis, and Pain

Operative Technique

Anesthesia

Great Saphenous Vein Ligation and Stripping

Small Saphenous Vein Ligation

Acknowledgments

Stab or Ambulatory Phlebectomy

Postoperative Care

Postoperative Complications

  1. Endovenous Ablation of Saphenous Veins

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Endovascular Strategy

Great Saphenous Veins

Small Saphenous Veins

Superficial Tributaries

Perforator Veins

Pelvic Veins

Smaller Veins

Endovascular Technique

Room Setup and Supplies

Patient Position

Venous Access

Endovascular Technique for Thermal Saphenous Vein Ablation

Endovenous Laser Ablation

ENDOVENOUS RADIOFREQUENCY ABLATION

Endovascular Technique for Nonthermal Saphenous Vein Ablation

Endovenous Mechanochemical Ablation

Catheter Placement

Vein Treatment

ENDOVENOUS ADHESIVE ABLATION

Catheter Placement

Vein Treatment

Endovascular Technique for Thermal Perforator Vein Ablation

Endovenous Laser Ablation

ENDOVENOUS Radiofrequency Ablation

Acknowledgments

Postoperative Care

Postoperative Complications

  1. Treatment of Lower Extremity Deep and Perforator Vein Incompetence

Treatment of Incompetent Deep Venous Valves

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Proximal Venous Obstruction

Selection of A Valve Site For Repair

Avoiding Early Deep Vein Thrombosis

Anticoagulation

Avoiding An Incompetent Venous Valve Repair

Operative Technique

Internal Valvuloplasty

External Valvuloplasty

Angioscope-Assisted Valvuloplasty

Transcommissural Valvuloplasty

External Banding Valvuloplasty

Autologous Neovalve Construction

Vein Segment Transposition

Vein Valve Transplantation

Artificial Valve Implantation

Closure

Postoperative Care

Postoperative Complications

Treatment of Incompetent Venous Perforators

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Subfascial Endoscopic Perforator Surgery

Percutaneous Perforator Ablation

Operative Technique

Subfascial Endoscopic Perforator Surgery

Choice of Anesthesia

Incision

Port Insertion

Exploration of the Subfascial Space

Paratibial Fasciotomy

Distal Ankle Perforators

Closure

Concomitant Procedures

Percutaneous Endovenous Perforator Vein Ablation

Perforator Mapping and Access

Ablation Catheter Insertion and Ablation Procedure

Postoperative Care

Subfascial Endoscopic Perforator Surgery

Percutaneous Perforator Vein Ablation

Postoperative Complications

Subfascial Endoscopic Perforator Surgery

Percutaneous Perforator Vein Ablation

Treatment of Iliac Vein Stenosis

INDICATIONS

Preoperative Preparation

Pitfalls and Danger Points

Endovascular Strategy

Interventional Setting

Anatomy

Positioning and Access Sites

Procedural Phases

Endovascular Technique

Access

DIAGNOSTIC VENOGRAPHY

Crossing the Venous Lesion

Conventional Crossing Technique

Sharp Recanalization Technique

Imaging and Balloon Predilation

Stent Deployment

Stent Dilation

COMPLETION IMAGING

Venous Closure

Postoperative Care

Postoperative Complications

  1. Sclerotherapy

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Endovascular Strategy

Laser Light Therapy, Ohmic Thermolysis, and Sclerotherapy

Vein Illumination Technology

Selection of Suitable Technique for Varicose Veins, Telangiectasia, Spider Veins, and Reticular Veins

Sequence of Treatment of Superficial Veins

Selection of a Sclerosant Solution

Endovascular Technique: Sclerotherapy

Positioning

Liquid Sclerotherapy

Foaming the Sclerosant Solution

Injection of the Target Vein

Acknowledgments

Endovascular Technique: Laser Light Therapy and Ohmic Thermolysis

Postoperative Care

Postoperative Complications

Section XII. Arteriovenous Access for Hemodialysis

  1. Approach to Patients Presenting for Hemodialysis Access

Historical Background

Indications

Preoperative Preparation

Operative Strategy

Placement of a Tunneled Dialysis Catheter

Creation of an Arteriovenous Fistula or Graft

Radiocephalic Arteriovenous Fistula

Forearm Basilic Arteriovenous Fistula

Upper Arm Brachiocephalic Arteriovenous Fistula

Upper Arm Brachiobasilic Arteriovenous Fistula

Brachiobrachial Arteriovenous Fistula

Choice of an Arteriovenous Graft

Brachial-Axillary Arteriovenous Graft

Brachial-Antecubital Forearm Loop Arteriovenous Graft

Hemodialysis Reliable Outflow

Arteriovenous Access in the Lower Extremity

Chest Wall Arteriovenous Graft

  1. Upper Extremity Autogenous Arteriovenous Access: Arteriovenous Fistulas

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Selection of A Fistula Site

Creation of An Arteriovenous Fistula At The Wrist

Creation of An Arteriovenous Fistula at The Antecubital Fossa

Operative Field

Operative Technique Snuffbox, Brescia-Cimino, and RADAR Arteriovenous Fistulas

Incision

Operative Exposure of The Radial Artery and Cephalic Vein

Proximal and Distal Control

Anastomotic Technique

Closure

Brachiocephalic Arteriovenous Fistulas

Incision

Operative Exposure of The Cephalic Vein

Operative Exposure of The Brachial Artery

Anastomotic Technique

Closure

Brachial-Basilic Arteriovenous Fistula

Exposure of The Basilic Vein and Brachial Artery

Transposition of The Basilic Vein and Creation of The Arteriovenous Anastomosis

Postoperative Care

Postoperative Complications

Endovascular Technique Endovascular Arteriovenous Fistula

Ellipsys Endoavf System

Endoavf Procedure Using The Ellipsys System

Wavelinq Endoavf System

Endoavf Procedure Using The Wavelinq System

Acknowledgments

Postoperative Care

Postoperative Complications

  1. Upper Extremity Prosthetic Arteriovenous Access Grafts

Historical Background

Indications

Preoperative Preparation

History

Physical Examination

Ultrasound Imaging

Pitfalls and Danger Points

Operative Strategy

Operative Anatomy

Operative Technique for a Forearm Loop Arteriovenous Graft

Incision

Exposure

Tunneling

Anastomotic technique

Closure

Operative Technique for a Brachial Artery–Axillary Vein Interposition Arteriovenous Graft

Incision

Exposure

Tunneling

Anastomotic technique

Closure

Alternative approach

Postoperative Care

Postoperative Complications

  1. Tunneled Hemodialysis Catheters

Historical Background

Indications

Preoperative Preparation

Endovascular Strategy

Endovascular Technique

Insertion of A Tunneled Hemodialysis Catheter

Exchange of A Tunneled Hemodialysis Catheter with A New Exit Site

Exchange of A Tunneled Hemodialysis Catheter Without A New Exit Site

“Stuck Catheters”

Special Situations

Postoperative Care

  1. Approach to Patients With Complex Hemodialysis Access Needs

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Axillary Vein Occlusion

Central Vein Stenosis or Occlusion

Arterial Inflow Stenosis or Occlusion

Prior Access-Related Hand Ischemia

Obesity

Advanced Age

Increased Risk for Infection

Increased Risk for Thrombosis

Operative Technique

BRACHIAL-BRACHIAL ARTERIOVENOUS FISTULA

BRACHIAL-AXILLARY ARTERIOVENOUS FISTULA WITH TRANSLOCATED FEMOROPOPLITEAL VEIN

CHEST WALL AXILLARY-AXILLARY ARTERIOVENOUS GRAFT

HERO GRAFT

LOWER EXTREMITY COMMON FEMORAL ARTERY-COMMON FEMORAL VEIN ARTERIOVENOUS GRAFT

LOWER EXTREMITY SUPERFICIAL FEMORAL ARTERY-FEMOROPOPLITEAL VEIN ARTERIOVENOUS FISTULA

TUNNELED DIALYSIS CATHETERS

Postoperative Care

Postoperative Complications

  1. Management of Access-Related Hand Ischemia

Historical Background

Indications

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Operative Technique

Revision Using Distal Inflow Procedure

Proximalization of The Arterial Inflow Procedure

Distal Revascularization Interval Ligation Procedure

Patient Preparation

Exposure of the Brachial Artery

Exposure of the Distal Artery

Preparation of the Bypass Conduit and Tunnel

Arteriotomy and Bypass

Ligation of the Artery

Closure

Postoperative Care

Postoperative Complications

  1. Management of the Failing and Thrombosed Hemodialysis Access

Historical Background

Indications

Vascular Access Stenosis

Vascular Access Thrombosis

Vascular Access Aneurysm or Pseudoaneurysm

Vascular Access Infection

Central Vein Stenosis

Surgical Intervention for Failing Vascular Access

Preoperative Preparation

Pitfalls and Danger Points

Operative Strategy

Anesthesia Considerations

Operative, Endovascular, or Hybrid Approach

Identifying the Site of Stenosis

Graft Revision or Replacement

Avoiding Clot Embolization

Surgical Revision of an Arteriovenous Access Graft

Incision

Proximal and Distal Control

Thrombectomy

Surgical Revision

HYBRID APPROACH

Surgical Revision of an Arteriovenous Fistula

Incision and Exposure

Thrombectomy

Surgical Revision

Surgical Repair of an Aneurysm or Pseudoaneurysm

Incision and Exposure

Surgical Revision

Surgical Repair of an Infected Fistula or Graft

Incision and Exposure

Graft or Conduit Excision

Closure

Endovascular Intervention for Failing Vascular Access

Preoperative Preparation

Pitfalls and Danger Points

Endovascular Strategy

ANGIOPLASTY OR STENTING

SELECTION OF AN ACCESS SITE

IDENTIFYING THE STENOSIS

AVOIDING EMBOLOZATION

Avoiding Perforation

Endovascular Technique (Box 74.1)

TREATMENT OF AN ACCESS GRAFT STENOSIS

Access and Angiography

Angioplasty

Endograft Placement

Balloon Angioplasty

Stent Graft Placement

Thrombectomy

TREATMENT OF AN ACCESS GRAFT THROMBOSIS

Access and Sheath Placement

Pharmacomechanical Thrombectomy or Thrombolysis

Completion Study

TREATMENT OF AN ACCESS GRAFT PSEUDOANEURYSM

Access

Angiogram and Sheath Placement

Endograft Placement

TREATMENT OF AN ARTERIOVENOUS FISTULA STENOSIS

Access and Sheath Placement

Intervention

TREATMENT OF AN ARTERIOVENOUS FISTULA THROMBOSIS

Access and Sheath Placement

Angiography and Intervention

TREATMENT OF A CENTRAL VEIN STENOSIS OR OCCLUSION

Access and Angiography

Sheath Placement

Angioplasty and Stent Placement

Postoperative Care

Postoperative Complications

Recurrent Thrombosis

Embolization

Infection

Index

 

Author Editor: Elliot L. Chaikof