Comprehensive Review in Vascular and Endovascular Medicine 1st edition by David Paul Slovut,Steven Dean,Peter Schneider,Michael Jaff 9781935395607 1935395602

Part 1: Overview

1. Vascular Biology Overview

Vascular Anatomy

Endothelial Function

Endothelium-derived Vasodilators

Endothelium-derived Vasoconstrictors

Endothelium as a Regulator of Inflammation

Endothelium as a Regulator of Thrombosis and Thrombolysis

Pathology and Stages of Atherosclerosis

Endothelial Cell Activation and Lesion Initiation

Foam Cells and the Fatty Streak

Fibroproliferative Atheroma

Advanced Lesions

Risk Factors and Atherosclerosis

Low-density Lipoprotein Cholesterol

High-density Lipoprotein Cholesterol

Hypertension

Hyperglycemia and Diabetes Mellitus

Cigarette Smoking and Tobacco

Other Risk Factors

Clinical Methods of Assessing Vascular Function

Invasive Methods of Assessing Endothelium-dependent Vasomotor Function

Noninvasive Methods of Assessing Endothelium-dependent Vasomotor Function

Markers of Inflammation

Imaging of Atherosclerosis

Invasive Imaging of Atherosclerosis

Noninvasive Imaging of Atherosclerosis

2. Perioperative Management of Patients Undergoing Vascular Surgery and Endovascular Therapy

Cardiovascular Risks Associated with Vascular Surgery and Endovascular Therapy

Common Stress Response to Surgical Injury

Surgery-specific Factors

Anesthesia

Identifying Levels of Procedural Risks

Comorbid Conditions Associated with Increased Periprocedure Cardioascular Events

Major Clinical Predictors

Intermediate Clinical Predictors

Risk Prediction Indices

How Should Patients Be Assessed for Preprocedure Cardiovascular Risk?

Evaluate the Urgency of the Surgery

Exclude Hemodynamic Instability Associated with Active Cardiac Conditions

Identify the Risk of the Procedure

Evaluate Patient-specific Risk

What Periprocedural Therapies Should Be Offered for Patients Scheduled for Vascular Surgery or Endovascular Therapy?

Medical Therapy

Coronary Revascularization

Carotid Revascularization

Monitoring Patients Postoperatively for Development of Cardiovascular Events

Intraoperative and Postoperative Cardiac Surveillance

Perioperative Risk Reduction Strategy

Part 2: Cerebrovascular Disease

3. Approach to Patients with Extracranial Carotid Artery Disease

Introduction to Stroke

Prevalence of Extracranial Carotid Artery Disease

Causes of Extracranial Carotid Artery Disease

Basic Cerebrovascular Anatomy

Methods of Diagnosis

Physical Examination

Duplex Ultrasonography

Computerized Tomographic Arteriography

Magnetic Resonance Arteriography

Catheter-based Arteriography

Methods of Therapy

Medical

Carotid Endarterectomy

Carotid Stenting

Methods of Follow-up

Duplex Surveillance

4. Surgical and Endovascular Approach to Carotid Artery Revascularization

Overview of Options for Carotid Revascularization

Natural History of Carotid Stenosis

Results of Carotid Endarterectomy Versus Medical Management Trials

Asymptomatic Carotid Stenosis

Symptomatic Carotid Stenosis

Results of Carotid Endarterectomy Versus Carotid Artery Stenting Trials

SAPPHIRE

SPACE

EVA-3S

ICSS

CREST

Indications for Repair of Carotid Bifurcation Stenosis

Asymptomatic Patients

Symptomatic Patients

Special Indications

Patient Selection for CEA and CAS

Technical Aspects of Carotid Revascularization

Carotid Endarterectomy

Carotid Artery Stenting

Diagnosis and Treatment of Supraaortic Great Vessels

5. Subclavian, Upper Extremity, and Extracranial Vertebral Artery Disease

Vascular Anatomy of the Upper Extremity

Epidemiology of Subclavian and Upper Extremity Arterial Disease

Causes of Subclavian and Upper Extremity Arterial Disease

Diagnostic Evaluation

History and Physical Examination

Noninvasive Evaluation

Therapy

Medical Management

Surgical Management

Thoracic Outlet Syndrome

Anatomic Risk Factors

Neurogenic Thoracic Outlet Syndrome

Venous Thoracic Outlet Syndrome

Arterial Thoracic Outlet Syndrome

Diagnosis

Treatment

Vertebral Artery Disease

Epidemiology

Etiology and Clinical Features

Diagnostic Evaluation

Surgical Therapy

Catheter-based Therapy

Vertebral Artery Dissection and Trauma

Conclusion

Part 3: Aortic, Renal, and Mesenteric Vascular Disease

6. Diseases of the Thoracic Aorta and Aortic Arch

Anatomy of the Ascending Aorta, Aortic Arch, and Descending Thoracic Aorta

Common Pathologies of the Thoracic Aorta

Thoracic Aortic Aneurysm (TAA)

Dissection

Intramural Hematoma and Penetrating Aortic Ulcer

7. Abdominal Aortic Aneurysms: Diagnosis and Catheter-Based Approaches

Overview of Abdominal Aortic Aneurysm

Description of Disease

Rupture Risk

Epidemiology

Etiology

Physical Exam

Associated Conditions

Diagnostic Methods

Duplex Ultrasound

Computed Tomography Scan

Screening

Indications for Repair of AAA

Recommendations for Repair

Who Is at High Risk for AAA Repair?

Patient Selection for Open Versus Endovascular AAA Repair

Open Surgical AAA Repair—Transperitoneal Versus Retroperitoneal Approach

Technical Considerations

Postoperative Care

Long-term Surveillance and Secondary Intervention

Endovascular Repair of AAA

Assessment of Anatomy

Graft-related Technical Issues

Management of Endoleaks

Results of Trials

EVAR 1 and 2, DREAM, OVER, and US Medicare Patient EVAR Data

Ruptured Aneurysm

Endovascular Versus Open Repair

Technique of Endovascular Management of Ruptured AAA

8. Mesenteric Arterial Disease: Diagnosis and Treatment

Introduction

Acute Mesenteric Ischemia

Etiology-specific Considerations: Thrombosis

Etiology-specific Considerations: Nonocclusive Mesenteric Ischemia

Etiology-specific Considerations: Mesenteric Venous Thrombosis

Chronic Mesenteric Ischemia

Treatment of Chronic Mesenteric Ischemia

Differential Diagnosis of Chronic Mesenteric Ischemia

9. Renovascular Disease

Introduction

Etiologies

Fibromuscular Dysplasia

Diagnostic Methods

Angiography

Duplex Ultrasound

Captopril Renography

Serum Biomarkers

Treatment of Renal Artery Stenosis

Treatment of Hypertension

Treatment of Ischemic Nephropathy

Medical Therapy

Lifestyle Modification

Revascularization of Renal Artery Stenosis

Surveillance After Renal Artery Stenting

Renal Denervation

Part 4: Peripheral Artery Disease: Overview, Endovascular, and Surgical Approaches

10. Epidemiology and Natural History of Peripheral Artery Disease

Causes of Peripheral Artery Disease

Epidemiology of Peripheral Artery Disease

Risk Factors for Peripheral Artery Disease

Diagnostic Approach to Peripheral Artery Disease

Clinical Presentation

Physical Examination

Ankle-brachial Index

Noninvasive Physiologic Testing

Arterial Duplex Ultrasonography

Computed Tomographic Arteriography and Magnetic Resonance Arteriography

Angiography

Natural History of Peripheral Artery Disease

Limb Outcomes

Cardiovascular Outcomes

Conclusions

11. Peripheral Artery Disease: Medical Treatment and Risk Reduction Strategies

Prevalence of Peripheral Artery Disease and the Use of the Ankle-brachial Index

Risk Factors for Peripheral Artery Disease

Low Physician Awareness of PAD

Leg Symptoms and Quality of Life in PAD

PAD–Coronary Heart Disease Risk Equivalent

Modification of Systemic Cardiovascular Risk

Risk Factor Control

Treatment of Lower Extremity Symptoms

Exercise Rehabilitation

Pharmacotherapy

Other Therapies

12. Technical Issues: Arterial Access, Anatomy, Performing Diagnostic Angiography, Catheters, Guidewires, Balloons, and Stents

Introduction

Arterial Access

Access Strategy

Puncture Technique

Arterial Hemostasis

Nonselective Diagnostic Angiography

Selective Angiography

Carotid and Vertebral Angiography

Upper Extremity Angiography

Visceral Angiography

Tools for Intervention

Guidewires

Wire Caveats

Balloons

Stents

Embolic Protection Devices

Embolic Protection During Renal Artery Stenting

Embolic Protection in the Superficial Femoral Artery

Snares

Radiation Safety

Important Factors to Consider with the Use of Fluoroscopy

Patient Sequelae from Radiation Exposure

13. Aortoiliac Intervention

Assessment of Patients with Aortoiliac Disease

Clinical Presentation

Physical Examination

Ankle-brachial Index and Pulse Volume Recording

Noninvasive Imaging

Angiography

Overview of Treatment Options for Aortoiliac Disease

TransAtlantic Inter-Society Consensus Classification

Endovascular Technique

Endovascular Modalities

Hybrid Revascularization Procedures

Surgical Revascularization

Conclusion

14. Infrainguinal Intervention

Introduction

Framework for Evaluating Clinical Data on Infrainguinal Intervention

Endovascular Revascularization of the Lower Limbs

Approach

Specific Infrainguinal Endovascular Approaches and Techniques

Endovascular Superficial Femoral Artery and Popliteal Interventional Modalities

Niche Techniques

Below-the-knee Intervention

Complications

Surgical Revascularization of the Infrainguinal Vessels

15. Critical Limb Ischemia

Introduction

Clinical Features

Physical Examination

Diagnostic Evaluation

Management

Medical Therapy

Pain Control

Infection

Wound Care

Mechanical Therapies

Revascularization

Endovascular Approaches

Surgery

Follow-up/Surveillance

Amputation

16. Acute Limb Ischemia and Thrombolysis

Introduction

Etiology of Acute Limb Ischemia

Epidemiology of Acute Limb Ischemia

Clinical Presentation and Evaluation

Management of Acute Limb Ischemia

Treatment Options

Complications

Conclusion

17. Complications of Open and Endovascular Procedures

General Complications in the Vascular Patient

Anticoagulation

Cardiac Complications

Diabetes Mellitus

Open Surgical Complications

Cardiac Complications

Pulmonary Complications

Renal Complications

Stroke

Wound Complications

Graft Thrombosis

Gastrointestinal Complications

Endovascular Complications

Access Site

Treatment Site

Systemic Complications

Device-related Complications

Conclusions

Part 5: Venous and Lymphatic Disease

18. Venous Thromboembolic Disease

Introduction

Epidemiology

Etiology

Venous Thromboembolism Risk Factors

Clinical Presentation

Signs and Symptoms

Differential Diagnosis

Diagnosis of Deep Vein Thrombosis/Pulmonary Embolism

Clinical Assessment: Wells Criteria

D-dimer

Duplex Ultrasound

Advanced Imaging (Magnetic Resonance Venography, Computed Tomography Angiography and Venography, Pulmonary Angiography)

Thromboprophylaxis

VTE Prophylaxis in the Medical Population

VTE Prophylaxis in Surgery

Pulmonary Embolism Risk Stratification

Troponin

Echocardiography

Therapy—Acute Treatment of DVT/PE

Anticoagulation

Catheter-directed Thrombolysis and Percutaneous Venous Thrombectomy

Compression Therapy

Ambulation

Therapy—Chronic Treatment

Duration of Anticoagulation

Therapy in Cancer Patients

New Anticoagulants

Complications of Anticoagulation

Therapy—Inferior Vena Cava Filters

19. Chronic Venous Insufficiency and Lymphedema

Chronic Venous Insufficiency

Anatomy

Natural History

Pathophysiology

History

Physical Examination

Differential Diagnosis

Diagnostic Testing

Treatment

Lymphedema

Natural History

Pathophysiology

History

Physical Examination

Differential Diagnosis

Diagnostic Testing

Therapy

20. Endovascular and Surgical Treatment of Venous Disease

Introduction

Acute Deep Venous Thrombosis

Endovascular Intervention

Surgical Thrombectomy

Chronic Venous Disorders

Endovascular Management of Varicose Veins

Femoropopliteal Deep Venous Thrombosis

Iliofemoral Deep Venous Thrombosis

Inferior Vena Cava Obstruction

Axillosubclavian Vein Thrombosis

Superior Vena Cava Syndrome

Vena Cava Filters

Summary

Part 6: Special Topics

21. Leg Ulcerations and Wound Care

Introduction

Epidemiology

Etiology

Diagnosis

History

Physical Examination

Differential Diagnosis

Pathogenesis of Chronic Ulcerations

Diagnostic Testing

Therapy

General Principles

Prognostic Indices

Skin Grafts and Flaps, Tissue-engineered Skin

Advanced Wound Care Techniques

Management of Ulceration Pain

Wound Care Centers

22. Uncommon Vascular Diseases

Introduction

Vasculitis

Giant Cell Arteritis

Kawasaki Disease

Behçet’s Disease

Thromboangiitis Obliterans (Buerger’s Disease)

Vasculitis “Mimics”—Noninflammatory Vascular Disorders

Fibromuscular Dysplasia

Popliteal Artery Entrapment Syndrome

Cystic Adventitial Disease

External Iliac Artery Endofibrosis

Segmental Arterial Mediolysis

Warfarin and Heparininduced Skin Necrosis

Warfarin-induced Skin Necrosis

Heparin-induced Skin Necrosis

Vascular Anomalies

Vascular Tumors

Vascular Malformations

Syndromes Associated with Vascular Anomalies

23. Occupational and Environmental Disorders

Introduction

Vibration Injury

Epidemiology

Pathophysiology

Diagnosis

Therapy

Hypothenar Hammer Syndrome

Epidemiology, Pathophysiology,and Natural History

Diagnosis

Treatment

Raynaud’s Syndrome

Epidemiology, Pathophysiology, Natural History, Primary versus Secondary

Lab Assessment

Noninvasive and Invasive Evaluation

Therapy

Acrocyanosis

Epidemiology

Primary versus Secondary

Pathophysiology, Laboratory Assessment,and Noninvasive Evaluation

Natural History and Therapy

Livedo Reticularis and Racemosa

Livedo Reticularis and Racemosa

Livedo Reticularis versus Livedo Racemosa

Laboratory Assessment

Therapy

Pernio

Pathophysiology

Diagnosis

Natural History and Treatment

Frostbite

Pathophysiology

Natural History

Treatment

Trench Foot and Immersion Foot

Pathophysiology and Natural History

Diagnostic Evaluation

Therapy

Erythromelalgia

Pathophysiology

Diagnostic Evaluation

Therapy

Erythema Ab Igne

Pathophysiology

Natural History

Therapy