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Operative Techniques in Arterial Surgery

Operative Techniques in Arterial Surgery


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About the Book

This book is intended to provide a detailed account of the technical aspects of present day arterial surgery. It is hoped that the book will be more than just a manual of operative procedures and that it will provide the reader with an overall strategic plan when faced with a vascular problem. Emphasis has been placed throughout on careful preoperative assessment particularly at the sites of arterial involvement so that the most appropriate reconstruction technique can be selected. Meticulous attention to operative detail during each stage of a vascular reconstruc- tion remains the basis for success. For this reason the various procedures in this book are described in step-by-step fashion aided by a large number of drawings. An updated bibliography citing the work of other authors is also included. Vascular surgery by its very nature introduces changes in vessel compliance and geometry and these may be the starting point for subsequent complications. In addition, complications may occur as a result of progression of the underlying vascular disorder. An appreciable portion of this work has therefore been devoted to the prevention, recognition and treatment of these complications.

Table of Contents:
1. Basic Techniques.- Arterial mobilization.- Arterial control.- Heparinization.- Making and closing an arteriotomy.- Vascular sutures.- Basic suture technique.- End-to-end anasiomosis.- End-to-side anastomosis.- Patch graft angioplasty.- Endarterectomy.- Vascular grafts.- 2. Aneurysms of the Abdominal Aorta.- Preoperative assessment.- Preoperative preparation.- Intraoperative support measures.- Operative technique.- Inflammatory aneurysm.- Mycotic aneurysm.- Coexistent renal or visceral artery occlusive disease.- Accessory renal arteries.- Horseshoe kidney.- Aortic aneurysms involving the renal arteries.- Thoracoabdominal aortic aneurysms.- Ruptured infrarenal aortic aneurysm.- Unusual types of rupture.- 3. Aortoiliac Occlusive Disease.- Endarterectomy.- Bypass grafting.- Percutaneous transluminal angioplasty.- Preoperative assessment.- Aortofemoral bypass.- Variations.- Juxtarenal aortic occlusion.- Associated renal or visceral artery occlusive disease.- Retroperitoneal aortofemoral bypass.- Iliofemoral bypass.- Femorofemoral bypass.- Axillofemoral bypass.- Endarterectomy of the aorta and common iliac arteries.- Combined endarterectomy and bypass.- Iliofemoral endarterectomy.- 4. Surgery of the Common Femoral Bifurcation.- Pathology of the profunda femoris.- Exposure of the common femoral bifurcation and profunda femoris.- Techniques of reconstruction.- Common femoral aneurysms.- 5. Femoropopliteal Surgery.- General Considerations.- Essentials in femoro-distal bypass.- Graft material.- Bypass to the Popliteal Artery.- In situ vein bypass to the distal popliteal artery.- Variations.- Reversed vein bypass.- Bypass to the proximal popliteal artery.- Bypass to the isolated popliteal segment.- Femorotibial and Femoroperoneal Bypass.- Bypass to the posterior tibial artery.- Bypass to the anterior tibial artery.- Bypass to the peroneal artery.- Popliteal Aneurysms.- Surgical management.- Other Popliteal Conditions.- Popliteal entrapment.- Adductor canal syndrome.- Adventitial cystic disease of the popliteal artery.- Complications Of Femoropopliteal Surgery.- Wound complications.- Early graft occlusion.- Degenerative changes in vein grafts.- Late graft occlusion.- False aneurysm.- Infection.- 6. Arterial Embolization.- The management of major limb embolization.- Late embolectomy.- Advanced ischaemia.- Embolectomy in the presence of atherosclerosis.- Embolectomy in the upper limb.- Non-limb embolization.- Complications associated with use of the Fogarty catheter.- 7. Vascular Injuries.- General Considerations.- Operative management.- Late revascularization.- Traumatic false aneurysms.- Arteriovenous fistulae.- Regional Considerations.- Common femoral artery.- Popliteal artery.- Infrapopliteal vessels.- Vascular injuries associated with fractured pelvis.- Abdominal aorta.- Inferior vena cava and hepatic veins.- Carotid artery injuries.- Subclavian artery.- Axillary artery.- Brachial artery.- Radial and ulnar arteries.- Fasciotomy in the upper limb.- 8. Arteriovenous Fistulae.- Acquired Arteriovenous Fistulae.- Investigation.- Operative management.- Embolization.- Congenital Arteriovenous Fistulae.- Management.- 9. Surgery of the Carotid Bifurcation.- Carotid Endarterectomy.- Indications for surgery.- Contraindications to surgery.- Timing of operation.- Diagnostic studies.- Associated risk factors.- Cerebral protection during carotid surgery.- Technique of carotid endarterectomy.- Early postoperative complications.- Late postoperative complications.- The occluded internal carotid artery.- External carotid endarterectomy.- Internal Carotid Artery Bypass.- Indications.- Technique.- Other Lesions at the Carotid Bifurcation.- Kinking, coiling and tortuosity of the internal carotid artery.- Fibromuscular dysplasia.- Spontaneous dissection of the internal carotid artery.- Extracranial carotid artery aneurysms.- Carotid body tumours.- 10. Aortic Arch and Vertebral Revascularization.- Vertebral Artery Surgery.- Exposure of the vertebral artery.- Vertebral endarterectomy.- Reimplantation of the vertebral artery.- Subclavian-vertebral bypass.- Percutaneous transluminal angioplasty.- Revascularization of the distal vertebral artery.- Subclavian Artery Reconstruction.- Carotid-subclavian bypass.- Subclavian-carotid reimplantation.- Subclavian endarterectomy.- Crossover grafts.- Transluminal angioplasty.- Innominate Artery Reconstruction.- Ascending aorto-distal innominate bypass.- Innominate endarterectomy.- Transcervical bypass.- Common Carotid Artery Reconstruction.- Common carotid thromboendarterectomy.- Subclavian-carotid bypass.- Carotid-subclavian reimplantation.- Aorto-carotid bypass.- Multiple Arch Lesions.- Takayasu’s disease.- 11. Thoracic Outlet Syndrome and Upper Limb Revascularization.- Thoracic Outlet Syndrome.- Management.- Transaxillary resection of first rib.- Modification of the Roos technique.- Supplementary procedures.- Complications of transaxillary rib resection.- Alternative approaches for first rib resection.- Scalenectomy.- Arterial complications of the thoracic outlet syndrome.- Venous complications of the thoracic outlet syndrome.- Occlusive Arterial Disease of the Upper Limb.- Proximal disease.- Distal disease.- Upper Limb Aneurysmal Disease.- 12. Surgery of the Visceral Arteries.- Chronic Intestinal Ischaemia.- Bypass grafts.- Endarterectomy.- Reimplantation.- Transluminal angioplasty.- Coeliac artery compression syndrome.- Acute Intestinal Ischaemia.- Superior mesenteric artery embolization.- Superior mesenteric artery thrombosis.- Non-occlusive mesenteric ischaemia.- Superior mesenteric vein thrombosis.- Visceral Artery Aneurysms.- Splenic artery aneurysms.- Hepatic artery aneurysms.- Coeliac artery aneurysms.- Superior mesenteric artery aneurysms.- 13. Surgery of the Renal Arteries.- Renovascular surgery vs. transluminal angioplasty.- Pre- and intraoperative management.- Antegrade aortorenal bypass.- Retrograde aortorenal bypass.- Management of branch artery lesions.- Autotransplantation.- Other types of bypass.- Transaortic renal endarterectomy.- Combined aortic and renal artery surgery.- Coarctation of the abdominal aorta.- Renal artery aneurysms.- 14. Complications of Aortic Surgery.- Early Complications in the Reconstruction Zone.- Haemorrhage.- Thrombosis.- Arterial occlusion distal to the reconstruction.- Late Complications in the Reconstruction Zone.- Late graft occlusion.- Late endarterectomy failure.- False aneurysms.- Complications Outside the Reconstruction Zone.- Visceral ischaemia.- Renal and ureteric complications.- Sexual dysfunction.- Spinal cord ischaemia.- Infection in Aortic Surgery.- Management of infection in the groin.- Management of intra-abdominal graft infection.- Aortoenteric fistulae.- Prevention of infection in aortic surgery.- 15. Percutaneous Angioplasty.- Peripheral Angioplasty.- Indications.- Complications.- Technique.- Contralateral (crossover) angioplasty.- Angioplasty of vessels requiring selective Catheterization.- Renal angioplasty.- Angioplasty of other areas and of non-atheromatous lesions.- Fibrinolytic Therapy.

Review :
`This is an excellent text, full of sensible advice and a pleasure to read. The authors are fully justified in their claim that it will be valuable to vascular surgeons in training, to those general surgeons who from time to time are called upon to undertake vascular procedures and also to those who are more experienced in the field.' Annals of the Royal College of Surgeons of England


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Product Details
  • ISBN-13: 9780852003909
  • Publisher: Kluwer Academic Publishers Group
  • Publisher Imprint: Kluwer Academic Publishers
  • Language: English
  • Returnable: Y
  • ISBN-10: 0852003900
  • Publisher Date: 30 Jun 1986
  • Binding: Hardback
  • No of Pages: 444
  • Weight: 1250 gr


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