Fogarty / White Peripheral Endovascular Interventions

3rd Auflage 2010
ISBN: 978-1-4419-1387-6
Verlag: Springer
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 512 Seiten

This book offers a comprehensive review of the rapidly advancing field of endovascular therapy, written by internationally recognized authorities in the field, many of whom are the innovators of the techniques and devices involved. Broad in scope, topics covered range from how to obtain training in approved endovascular techniques to promising new lines of investigational therapies.

Autoren/Hrsg.

Fogarty, Thomas J.

White, Rodney A.

Inhaltsverzeichnis

1;Preface to the Third Edition;6
2;Preface to the Second Edition;8
3;Preface to the First Edition;10
4;Contents;12
5;Contributors;16
6;Part I Introduction;21
6.1;1Evolution of Endovascular Therapy: Diagnosticsand Therapeutics;22
6.1.1;First 30 Years: Era of Diagnostics (19291959);22
6.1.1.1;Arteriography---Dos Santos;23
6.1.1.2;Cardiac Catheterization---Forssmann and Cournand;23
6.1.1.3;Vascular Access---Seldinger;24
6.1.1.4;Coronary Angiography---Sones;24
6.1.1.5;Other Diagnostic Modalities;24
6.1.2;Second 30 Years: Era of Therapeutics (19601990);25
6.1.2.1;Embolectomy---Fogarty;25
6.1.2.2;Balloon AngioplastyüDotter/Grüntzig;25
6.1.2.3;Atherectomy---Simpson;26
6.1.2.4;Stents and Stent--Grafts;27
6.1.3;Future Developments;28
6.1.4;Conclusion;29
6.1.5;References;29
6.2;2 Pathophysiology of Vascular Disease;30
6.2.1;Atherosclerotic Process;30
6.2.2;Plaque Initiation;30
6.2.3;Plaque Progression;31
6.2.4;Artery Wall Responses;32
6.2.5;Plaque Regression;33
6.2.5.1;Animal Studies;33
6.2.5.2;Human Studies;33
6.2.6;Plaque Complication;34
6.2.7;Hemodynamic Influences in Atherosclerosis;35
6.2.8;Wall Shear Stress;36
6.2.9;Flow Field Changes;36
6.2.10;Particle Residence Time;38
6.2.11;Oscillation of Flow;38
6.2.12;Turbulence;38
6.2.13;Hypertension;39
6.2.14;Plaque Localization;39
6.2.15;Susceptible Regions of the Arterial Vasculature;39
6.2.15.1;Carotid Artery Bifurcation;39
6.2.15.2;Coronary Arteries;40
6.2.15.3;Abdominal Aorta;40
6.2.15.4;Superficial Femoral Artery;41
6.2.16;Aneurysm Formation;41
6.2.17;Arterial Enlargement;41
6.2.18;Medical Thinning;41
6.2.19;Mechanism of Aneurysm Formation in Atherosclerosis;42
6.2.20;Experimental Observations;43
6.2.21;Summary;44
6.2.22;References;44
7;Part II Components of an Endovascular Practice;48
7.1;3Training and Credentialing in Vascular and EndovascularSurgery;49
7.1.1;Training and Certification in Vascular Surgery;49
7.1.2;Specific Requirements for Vascular Surgery Residents;50
7.1.2.1;Vascular Surgery;50
7.1.2.2;Endovascular Interventions;50
7.1.2.3;Non-invasive Vascular Laboratory;50
7.1.3;Hospital Credentialing;50
7.1.3.1;New Vascular Graduates;50
7.1.3.2;Credentialed Surgeons;52
7.1.4;Maintenance of Certification;52
7.1.5;Turf Battles;52
7.1.6;Summary;52
7.1.7;References;52
7.2;4 Assessment of Vascular Patients and Indications for Therapy;54
7.2.1;History and Physical Examination of the Ischemic Lower Extremity;54
7.2.2;Chronic Arterial Insufficiency;54
7.2.2.1;Differential Diagnosis;55
7.2.3;Critical Limb Ischemia;55
7.2.4;Acute Arterial Insufficiency;56
7.2.5;Noninvasive Studies;57
7.2.5.1;Continuous-Wave Doppler;57
7.2.5.2;Ankle--Brachial Index and Segmental Pressures;57
7.2.5.3;Pulse Volume Recording;58
7.2.5.4;Transcutaneous Oximetry;58
7.2.5.5;Duplex Ultrasonography;58
7.2.6;Indications for Intervention;59
7.2.6.1;Asymptomatic Peripheral Arterial Disease;59
7.2.6.2;Symptomatic Peripheral Arterial Disease;60
7.2.7;References;61
7.3;5 Anesthesia Techniques for Endovascular Surgery;62
7.3.1;Local Anesthesia;63
7.3.2;Anesthesia Techniques to Aid Proximal Deployment of the StentGraft in TAAs;65
7.3.3;General Anesthesia for Endovascular Aortic Surgery;66
7.3.3.1;Advantages of a General Anesthetic;68
7.3.3.2;Disadvantages of a General Anesthetic;69
7.3.3.3;Preoperative Evaluation;69
7.3.3.4;Blood Pressure Evaluation, Monitoring, and Treatment;70
7.3.3.5;Induction of General Anesthesia;70
7.3.3.6;Maintenance of General Anesthesia;71
7.3.3.7;Summary;72
7.3.4;Regional Anesthesia and Analgesia for Endovascular Stent Grafting;72
7.3.4.1;Epidural Anesthesia;73
7.3.4.2;Spinal Anesthesia;73
7.3.4.3;Combined Spinal--Epidural Anesthesia;73
7.3.4.4;Postoperative Management;73
7.3.4.5;Advantages of Regional Anesthesia;74
7.3.4.6;Disadvantages of Regional Anesthesia;74
7.3.5;Summary;75
7.3.6;References;75
7.4;6 Intraprocedural Monitoring for Endovascular Procedures;79
7.4.1;General Monitoring;79
7.4.1.1;Electrocardiography;80
7.4.1.2;Pulse Oximetry;80
7.4.1.3;Temperature;80
7.4.1.4;Capnography;80
7.4.1.5;Arterial Blood Pressure;80
7.4.2;Advanced Cardiopulmonary Monitoring;81
7.4.2.1;Central Venous Catheter;81
7.4.2.2;Pulmonary Artery Catheter;82
7.4.2.3;Transesophageal Echocardiography;83
7.4.3;Advanced Vascular Monitoring;83
7.4.3.1;Angiography;83
7.4.3.2;Intravascular Ultrasound;84
7.4.3.3;Duplex Ultrasonography;85
7.4.4;Advanced Neurologic Monitoring;86
7.4.4.1;Transcranial Doppler;86
7.4.4.2;Cerebral Oximetry;86
7.4.4.3;Cerebrospinal Fluid Pressure Monitoring;87
7.4.4.4;Motor-Evoked Potential Monitoring;88
7.4.5;References;88
7.5;7 Safety Considerations for Endovascular Surgery;90
7.5.1;History;90
7.5.2;Fluoroscopic Image Production;91
7.5.3;Radiation Safety;92
7.5.4;Personnel Monitoring;93
7.5.5;Pregnancy;93
7.5.6;Laser Physics;94
7.5.7;Laser Safety;96
7.5.8;Blood Exposure;98
7.5.9;References;98
8;Part III Facilities and Equipment for Endovascular Intervention;99
8.1;8 Endovascular Intervention Suite Design;100
8.1.1;General Considerations;100
8.1.2;Portable System Versus Fixed Imaging System;100
8.1.3;Monitoring Equipment;104
8.1.4;Contrast Injectors;104
8.1.5;Equipping the Endovascular Suite;104
8.1.6;Ergonomics in the Endovascular Suite;104
8.2;9 Angioscopy: Instrumentation, Techniques, and Applications;106
8.2.1;Angioscopic Equipment;106
8.2.2;Basic Techniques of Angioscopy;108
8.2.2.1;Principles of Saline Irrigation;108
8.2.2.2;Techniques of Angioscopy;110
8.2.2.3;Interpretation;111
8.2.3;Clinical Applications;112
8.2.3.1;Indications;112
8.2.3.2;Infrainguinal Bypass Grafting;112
8.2.3.2.1;Vein Conduit Preparation;112
8.2.3.2.2;In Situ Vein Conduit Preparation;113
8.2.4;Arm Vein Preparation with Angioscope for Bypass Grafting;114
8.2.5;Angioscopy for Carotid Endarterectomy;116
8.2.6;Vascular Access Surgery;116
8.2.7;Thromboembolectomy;119
8.2.8;Venous Thrombectomy;119
8.2.9;Venous Valve Repair Without Venotomy;119
8.2.10;Percutaneous Applications of Angioscopy;119
8.2.11;Summary;120
8.2.12;References;120
8.3;10 Duplex-Guided Balloon Angioplasty from the Carotid to the Plantar Arteries;122
8.3.1;Infrainguinal Arterial Angioplasty;122
8.3.1.1;Preoperative Evaluation;122
8.3.1.2;Technique;123
8.3.1.3;Technical Success and Predictors of Technical Failure of Femoral--popliteal Duplex-Guided Balloon Angioplasty;125
8.3.1.4;Thromboembolic Complications;125
8.3.1.5;Follow-Up, Patency, and Limb Salvage;125
8.3.1.6;Adjunctive Infrapopliteal Balloon Angioplasty;125
8.3.2;Duplex-Guided Angioplasty of Infrainguinal Arterial Bypass Grafts;126
8.3.2.1;Patient Population;126
8.3.2.2;Preoperative Evaluation;126
8.3.2.3;Technique;127
8.3.2.4;Intraoperative Technical Success;127
8.3.2.5;Early Postoperative Complications;128
8.3.2.6;Duplex-Measured Hemodynamic Parameters;128
8.3.2.7;Patency and Limb Salvage Rate;128
8.3.3;Duplex-Guided Angioplasty of Failing or Non-maturing Arteriovenous Fistulas;128
8.3.3.1;Patients;129
8.3.3.1.1;Preoperative Evaluation;129
8.3.3.2;Technique;129
8.3.3.3;Technical Success;130
8.3.3.4;Comparison of Pre- and Postprocedure Duplex-Measured Hemodynamic Parameters;130
8.3.3.5;Complications and Mortality;130
8.3.4;Duplex-Assisted Internal Carotid Artery Angioplasty;130
8.3.4.1;Patient Population;131
8.3.4.2;Preoperative Imaging;131
8.3.4.3;Technique;131
8.3.4.4;Intraoperative Technical Findings;132
8.3.4.5;Postprocedure Mortality and Morbidity;132
8.3.4.6;Follow-Up;132
8.3.5;Summary;132
8.3.6;References;132
8.4;11 Intravascular Ultrasound Imaging;135
8.4.1;Catheter Design and Function;135
8.4.2;Imaging Techniques;137
8.4.2.1;Access;137
8.4.2.2;Image Acquisition;137
8.4.2.3;Rotational Orientation;137
8.4.2.4;Longitudinal Gray-Scale Imaging;137
8.4.2.5;Image Interpretation and Diagnostic Capabilities;137
8.4.2.6;Measurements;139
8.4.3;Therapeutic Interventions;139
8.4.3.1;Diagnostic;139
8.4.3.2;Balloon Angioplasty;140
8.4.3.3;Stent Deployment;140
8.4.3.4;Endoluminal Grafts for Abdominal Aortic Aneurysm;140
8.4.3.5;Thoracic Aorta;143
8.4.3.6;Thoracic Dissections;143
8.4.3.7;Thoracic Aneurysms, Ulcerations, and Transections;144
8.4.4;Post-procedural Assessments and Troubleshooting;145
8.4.4.1;Bedside Vena Cava Placement;147
8.4.4.2;Virtual Histology;148
8.4.5;References;148
9;Part IV Endovascular Instrumentation and Devices;150
9.1;12 Biomaterials: Considerations for Endovascular Devices;151
9.1.1;Guidewires;151
9.1.2;Angioplasty Balloons and Catheters;153
9.1.2.1;Balloon Mechanics;154
9.1.2.2;Balloon Materials;155
9.1.2.3;Angioplasty Catheters;155
9.1.3;Metallic Intravascular Stents and Caval Filters;157
9.1.3.1;Biocompatibility;157
9.1.3.2;Corrosion Resistance;157
9.1.3.3;Toxicity;158
9.1.3.4;Thromboresistance;158
9.1.3.5;Healing;159
9.1.4;Mechanical and Physical Properties of Specific Metals;160
9.1.4.1;Stainless Steel;160
9.1.4.2;Tantalum;160
9.1.4.3;Titanium;161
9.1.4.4;Nitinol;161
9.1.4.5;Cobalt--Chromium Alloys;162
9.1.5;Radiologic Considerations;162
9.1.6;Design Characteristics;163
9.1.6.1;Stents;163
9.1.6.2;Vena Caval Filters;164
9.1.7;Endoluminal Grafts;165
9.1.8;Prosthetic Graft Materials;165
9.1.9;Endograft Design and Structural Stability;169
9.1.10;References;170
9.2;13 Ancillary Endovascular Equipment: Catheters, Guidewires, and Procedural Considerations;174
9.2.1;Special Terminology of Guidewire and Catheters;174
9.2.1.1;Steerability;174
9.2.1.2;Trackability;174
9.2.1.3;Pushability;174
9.2.1.4;Units for Wires and Catheters;175
9.2.2;Guidewires;175
9.2.2.1;Coating;175
9.2.2.2;Diameter;175
9.2.2.3;Tip Property;175
9.2.2.4;Stiffness;175
9.2.2.5;Length;176
9.2.2.6;Sheathes and Catheters;176
9.2.2.7;Basic Material;176
9.2.2.8;Diameter;176
9.2.2.9;Length;176
9.2.2.10;Head Shapes;176
9.2.2.11;Special Features;178
9.2.3;Guidewire and Lesion Interaction;178
9.2.4;Vascular Access;178
9.2.4.1;Retrograde Femoral Artery Access;178
9.2.4.2;Antegrade Puncture of the Femoral Artery;179
9.2.4.3;Brachial Artery Access;179
9.2.4.4;Percutaneous Puncture of Prosthetic Grafts;180
9.2.4.5;Micropuncture Technique;180
9.2.4.6;Ultrasound-Guided Arterial Access;180
9.2.5;Vascular Closure Devices;180
9.2.6;Examples for Guidewire and Catheter Interventions;182
9.2.6.1;Catheter and Wire 101;182
9.2.6.2;Collect Your Thoughts Prior to Percutaneous Interventions;182
9.2.7;Accesses and Selective Guiding Catheters for Some Basic Interventions;182
9.2.7.1;Carotid Artery;182
9.2.7.2;Subclavian Artery;182
9.2.7.3;Celiac or SMA;182
9.2.7.4;Renal Artery;182
9.2.7.5;Infrarenal Aorta;183
9.2.7.6;Superior Femoral Artery;183
9.2.7.7;Tibial Arteries;183
9.2.8;Complications and Troubleshootings;183
9.2.8.1;Access Site Complications;183
9.2.8.1.1;Hematoma and Bleeding;183
9.2.8.1.2;Pseudoaneurysm Formation;183
9.2.8.1.3;Arterial Access Dissection;184
9.2.8.2;Complications During the Intervention;184
9.2.8.2.1;Arterial Wall Dissection;184
9.2.8.2.2;Arteriovenous Fistula Formation or Arterial Rupture;185
9.2.8.2.3;Distal Embolization;185
9.2.8.3;Complications Related to Vascular Closure Devices;185
9.2.9;Summary;186
9.2.10;References;186
9.3;14 Balloon Angioplasty;189
9.3.1;Mechanism;189
9.3.2;Indications;190
9.3.3;Lesion;190
9.3.4;Balloon Angioplasty Equipment;191
9.3.4.1;Introducer Sheaths;191
9.3.4.2;Guidewires;191
9.3.4.3;Catheters;192
9.3.4.4;Balloons;193
9.3.5;Technique;194
9.3.6;Site-Specific Interventions;196
9.3.6.1;Aortic Angioplasty;196
9.3.6.2;Iliac Artery Angioplasty;198
9.3.6.3;Femoral and Popliteal Artery Angioplasty;198
9.3.6.4;Infrapopliteal Angioplasty;199
9.3.6.5;Renal and Mesenteric Angioplasty;200
9.3.6.6;Brachiocephalic Vessels;202
9.3.6.6.1;Subclavian and Innominate Arteries;202
9.3.6.6.2;Carotid Artery;202
9.3.7;Complications;204
9.3.8;Summary;205
9.3.9;References;205
9.4;15 Endovascular Intervention for Lower Extremity Deep Venous Thrombosis;210
9.4.1;Diagnosis;210
9.4.1.1;Clinical Manifestations;210
9.4.1.2;Diagnostic Imaging and Hypercoagulable Evaluation;211
9.4.2;Conventional Treatment;211
9.4.2.1;Early Thrombus Removal: Initial Strategies;211
9.4.2.2;Endovascular Management of DVT;212
9.4.2.3;Endovascular Treatment Options;213
9.4.2.3.1;Catheter-Directed Thrombolysis;213
9.4.2.4;Ultrasound Accelerated Thrombolysis: Ekos EndoWave;214
9.4.2.5;Percutaneous Mechanical Thrombectomy;215
9.4.2.5.1;AngioJet Rheolytic Thrombectomy System---Pulse-Power Spray Technique;215
9.4.2.5.2;Trellis-8 Infusion System---Pharmacomechanical Thrombectomy;216
9.4.2.6;Adjunctive Endovascular Procedures;217
9.4.2.6.1;Use of Multiple PMT Devices or Adjunctive CDT;217
9.4.2.6.2;Adjunctive Venoplasty and Stenting;217
9.4.2.7;Follow-Up After Endovascular DVT Management;218
9.4.3;Conclusions;218
9.4.4;References;218
9.5;16 Remote Femoral and Iliac Artery Endarterectomy;221
9.5.1;Remote Endarterectomy;222
9.5.1.1;Remote Superficial Artery Endarterectomy;222
9.5.1.2;Remote Iliac Artery Endarterectomy;223
9.5.2;Benefits of Remote Endarterectomy;223
9.5.3;Patency Rates;225
9.5.4;Remote Iliac Artery Endarterectomy;226
9.5.5;Improving Treatment Outcome and Future Perspectives;227
9.5.6;Summary;228
9.5.7;References;228
9.6;17 Intravascular Stents;231
9.6.1;Indications for Stent Use;231
9.6.1.1;Stent Designs;232
9.6.2;Technical Considerations;236
9.6.3;Results;240
9.6.3.1;Aortic Stents;240
9.6.3.2;Iliac Artery Stents;241
9.6.3.2.1;Palmaz Stent;241
9.6.3.3;Wallstent;244
9.6.3.3.1;Miscellaneous Iliac Artery Stents;246
9.6.3.4;Femoropopliteal Stents;248
9.6.3.4.1;Palmaz Stent;248
9.6.3.4.2;Wallstent;249
9.6.3.5;Strecker Stent;250
9.6.3.6;Nitinol Stents;250
9.6.3.7;Infrapopliteal Stents;252
9.6.3.8;Visceral Artery Stents;253
9.6.4;Infectious Complications;255
9.6.5;Comments;255
9.6.6;Summary;258
9.6.7;References;258
9.7;18 Intravascular Laser Technologies;263
9.7.1;History and Evolution of Laser Atherectomy;263
9.7.2;Physics of 308nm Excimer Laser;265
9.7.3;Equipment;266
9.7.3.1;Spectranetics Laser Sheath;266
9.7.3.2;Using the Excimer Laser to Treat Peripheral Vascular Disease;268
9.7.4;Trials;271
9.7.4.1;Peripheral Excimer Laser Angioplasty (PELA) (1998--2002);271
9.7.4.2; Laser Angioplasty for Critical Ischemia (LACI Phase II) (2001--2002) ;272
9.7.4.3; CLiRpath Excimer Laser System to Enlarge Lumen Openings (CELLO) (2006--2008) ;274
9.7.4.4;Instent Restenosis Trial (PATENT), Ongoing;274
9.7.4.5;AMI Trial (TAAMI), Ongoing;275
9.7.4.6; EXCELLENT , Ongoing ;275
9.7.5;Summary;275
9.7.6;References;276
9.8;19 Endovascular Devices for Abdominal Aortic Aneurysms;278
9.8.1;Patient Selection;278
9.8.1.1;Imaging;278
9.8.1.2;Anatomic Evaluation;279
9.8.1.2.1;Aortic Neck and Iliac Arteries;279
9.8.1.2.2;Access Arteries;280
9.8.1.2.3;Aortoiliac Branches;280
9.8.2;Device Selection;280
9.8.2.1;Medtronic: AneuRx AAAdvantage;280
9.8.2.2; Cook 0 Zenith ;281
9.8.2.3; Endologix 0 Powerlink ;282
9.8.2.4;W.L. Gore---Excluder;283
9.8.2.5;Medtronic---Talent;283
9.8.3;Future of Endograft Technology;284
9.8.4;Conclusion;286
9.8.5;References;286
9.9;20 Endovascular Devices for Thoracic Aortic Aneurysms;287
9.9.1;Early Endografts;287
9.9.2;Current Devices Approved for Treatment of Thoracic Aortic Aneurysms;291
9.9.2.1;Gore TAG;291
9.9.2.2;Talent;293
9.9.2.3;Zenith TX2;294
9.9.3;Off-Label Use;296
9.9.3.1;Type b Dissection;296
9.9.3.2;Expanding into the Ascending Aorta and Arch;297
9.9.4;Conclusions;299
9.9.5;References;304
10;Part V Specialized Endovascular Techniques;306
10.1;21 Critical Limb Ischemia;307
10.1.1;Epidemiology;308
10.1.2;Clinical Presentation;309
10.1.3;Treatment;309
10.1.3.1;Balloons;310
10.1.3.2;Laser;310
10.1.3.3;Atherectomy;310
10.1.3.4;Stents;310
10.1.4;Surgical Bypass in Critical Limb Ischemia;311
10.1.4.1;Percutaneous Transluminal Angioplasty and/or Stenting in CLI;312
10.1.5;Laser Application in Critical Limb Ischemia;312
10.1.6;Plaque Excision in Critical Limb Ischemia;314
10.1.7;Orbital Atherectomy;314
10.1.8;Cryoplasty in Critical Limb Ischemia;314
10.1.9;Treatment Strategies;315
10.1.10;Summary;315
10.1.11;References;318
10.2;22 Renal Stents;321
10.2.1;Pathophysiology;322
10.2.1.1;Fibromuscular Dysplasia;322
10.2.1.2;Takayasu's Arteritis;323
10.2.2;Diagnosis of Renal Artery Stenosis;323
10.2.2.1;Diagnostic Tools;324
10.2.3;Endovascular Treatment of Renal Artery Disease;325
10.2.3.1;Patient Preparation;325
10.2.3.2;Access;326
10.2.3.3;Angiography;327
10.2.3.4;Renal Artery Cannulation;327
10.2.3.5;Angioplasty and Stenting;327
10.2.3.6;Stent Placement;329
10.2.3.7;Post Procedure Care and Follow-Up;329
10.2.3.8;Complications;329
10.2.4;Current Data and Results;330
10.2.4.1;Immediate Technical Results;330
10.2.4.2;Restenosis Rate;330
10.2.4.3;Randomized Controlled Studies;331
10.2.4.4;Case Series;332
10.2.4.4.1;Blood Pressure Control;332
10.2.4.4.2;Effects on Renal Function;332
10.2.4.5;Comparison with Surgery;333
10.2.5;Future Research;333
10.2.6;References;334
10.3;23Inferior Vena Cava Filters: The Impact of EndovascularTechnology;339
10.3.1;Retrievable Inferior Vena Cava Filters;340
10.3.1.1;Günther-Tulip Filter;340
10.3.1.2;Recovery Filter;340
10.3.1.3;OptEase Filter;340
10.3.2;Intravascular Ultrasound-Guided IVCF Deployment;341
10.3.3;Inferior Vena Cava Filter Retrieval;342
10.3.3.1;Phase I Study;343
10.3.3.1.1;Results;344
10.3.3.1.2;Discussion;346
10.3.3.2;Phase II Study;346
10.3.3.2.1;Results;347
10.3.3.2.2;Discussion;347
10.3.4;Generation Two Retrievable Filters;348
10.3.5;What Is on the Horizon?;348
10.3.6;Conclusion;349
10.3.7;References;349
10.4;24 Carotid Stenting;351
10.4.1;Evolution of Carotid Angioplasty and Stenting;351
10.4.1.1;Cerebral Protection;351
10.4.2;Technique: Carotid Angioplasty and Stenting with Distal Protection;352
10.4.2.1;Pre-procedural Evaluation;352
10.4.2.2;Femoral Access;353
10.4.2.3;Aortic Arch Angiogram;353
10.4.2.4;Selective Common Carotid Catheterization;354
10.4.2.5;Carotid Sheath Access;355
10.4.2.6;Filter Placement and Stenting;357
10.4.2.7;Completion Angiogram;358
10.4.2.8;Access Site Management;358
10.4.2.9;Post-operative Care and Follow-Up;358
10.4.2.10;Technique for Use of Distal Filters;360
10.4.2.11;Proximal Occlusion and Flow-Reversal Devices;360
10.4.3;Registry Trials;361
10.4.3.1;Randomized Trials;362
10.4.3.2;Ongoing Trials;364
10.4.4;Carotid Angioplasty and Stenting: Evolving Indications;365
10.4.4.1;High Risk for Carotid Artery Stenting;365
10.4.4.2;Summary of CAS Indications;366
10.4.5;Future Directions;367
10.4.6;Conclusion;367
10.4.7;References;368
10.5;25 Neuroendovascular Interventions;371
10.5.1;Intracranial Aneurysms;371
10.5.1.1;Arteriovenous Malformations;377
10.5.1.2;Dural Arteriovenous Fistulas;379
10.5.1.3;Endovascular Treatment of Acute Stroke;381
10.5.1.4;Angioplasty and Stenting for Intracranial Atherosclerosis;382
10.5.1.5;Carotid Angioplasty and Stenting;383
10.5.1.6;Preoperative Tumor Embolization;384
10.5.2;References;384
10.6;26 The Current Status of Hybrid Repair of Thoracoabdominal Aortic Aneurysms;390
10.6.1;Current Status of Open Repair;390
10.6.2;Endovascular Approaches to the Management of Thoracoabdominal Aortic Aneurysms;391
10.6.3;Massachusetts General Hospital Results;391
10.6.4;Discussion;393
10.6.5;References;396
10.7;27 Laparoscopic Aortic Surgery;398
10.7.1;Evolution of Laparoscopic Vascular Surgery;398
10.7.2;The Case for Laparoscopic Aortic Surgery;400
10.7.3;Current Status;405
10.7.4;Indications;405
10.7.5;The Technique;406
10.7.5.1;Operative Technique;406
10.7.6;Complications;408
10.7.7;The Future;408
10.7.8;Conclusion;408
10.7.9;References;408
10.8;28 Endovenous Surgery;411
10.8.1;Current Status: Diagnosis;411
10.8.2;Current Status: Treatment;412
10.8.2.1;Endoluminal Venous Stripping;413
10.8.2.2;Endoluminal Sclerotherapy;413
10.8.2.3;Endoluminal Endoscopy;414
10.8.2.4;Endovenous Obliteration;416
10.8.2.5;Endovenous Thrombolysis;418
10.8.2.6;Venous Stenting;419
10.8.2.7;Subfascial Endoscopy;420
10.8.3;Conclusion;422
10.8.4;References;422
10.9;29 Thoracic Outlet Syndrome: Endoscopic Transaxillary First Rib Approach023 Years Experience (198502008);424
10.9.1;Surgical Decisions;424
10.9.2;Historical Remarks;424
10.9.3;Anatomical Applications of the Cervical Bands and Scalenus Muscle into the First Rib During Endoscopic Transaxillary First Rib Resection;425
10.9.4;Surgical Procedure;427
10.9.4.1;Surgical Access;427
10.9.4.2;Engagement of the Robotics;427
10.9.4.3;Dissection of Soft Tissue, First Rib, and Space Invasion with Collapse of Lung;428
10.9.4.4;Disengagement of the First Rib and the Concept of Floater Rib;428
10.9.4.5;Closure;428
10.9.5;Results;428
10.9.6;References;429
10.10;30 Prevention of Lesion Recurrence in Endovascular Devices;430
10.10.1;Mechanisms of Lesion Recurrence;430
10.10.1.1;Types of Lesions;430
10.10.1.1.1;Intimal Hyperplasia---Reparative Response to Vessel Injury;431
10.10.1.1.2;Vascular Remodeling---Recoil and Chronic Vasospasm;433
10.10.1.1.3;Restenosis Due to Progression of Atherosclerotic Disease;434
10.10.2;Mechanisms of Prevention of Lesion Recurrence at the Local Level;434
10.10.2.1;Optimization to Decrease Injury to Vessel Wall;435
10.10.2.2;Local Drug Delivery;435
10.10.2.2.1;Actinomycin D;435
10.10.2.2.2;Paclitaxel;436
10.10.2.2.3;Sirolimus;437
10.10.2.3;Brachytherapy;437
10.10.2.4;Gene Therapy;438
10.10.2.5;VEGF;438
10.10.2.6;Nitric Oxide Synthase;439
10.10.2.7;Transcription Factor Decoy;440
10.10.2.8;Mutant MCP-1;440
10.10.3;Systemic Prevention of Progression of Atherosclerotic Disease;440
10.10.3.1;Statin Therapy;440
10.10.3.2;Anticoagulation/Antiplatelet Therapy;442
10.10.3.3;Risk Factor Modification;443
10.10.4;Conclusion;443
10.10.5;References;443
10.11;31 Management of the Percutaneous Puncture Site;447
10.11.1;Overview of Access Locations;447
10.11.1.1;Femoral;447
10.11.1.2;Brachial;448
10.11.1.3;Radial;449
10.11.1.4;Axillary;449
10.11.1.5;Popliteal;450
10.11.1.6;Cervical;450
10.11.2;Percutaneous Access Techniques;450
10.11.2.1;Femoral;451
10.11.2.2;Brachial;452
10.11.2.3;Radial;452
10.11.2.4;Axillary;452
10.11.2.5;Popliteal;452
10.11.2.6;Cervical;453
10.11.3;Closure of the Arteriotomy;454
10.11.3.1;Manual Compression;454
10.11.3.2;Seal and Plug Devices;456
10.11.3.3;Suture-Mediated Devices;457
10.11.3.4;Clip-Based Devices;459
10.11.4;Complications;460
10.11.4.1;Femoral;460
10.11.4.2;Brachial;462
10.11.4.3;Radial;463
10.11.4.4;Axillary;463
10.11.4.5;Popliteal;463
10.11.4.6;Cervical;464
10.11.5;Conclusion;464
10.11.6;References;464
10.12;32 Endovascular Practice in Asia-Pacific;469
10.12.1;Diversity;469
10.12.1.1;Maturity of Vascular Surgery as a Specialty;469
10.12.1.2;Health Statistics;470
10.12.1.3;Economy and Health-Care Structure;470
10.12.1.4;Language;470
10.12.1.5;Device Market;470
10.12.1.6;Government Regulations;470
10.12.1.7;Anatomy;471
10.12.2;China;471
10.12.3;Japan;472
10.12.4;Korea;473
10.12.5;India;473
10.12.6;Hong Kong;474
10.12.7;Singapore;474
10.12.8;Taiwan;474
10.12.9;Thailand;475
10.12.10;Malaysia;475
10.12.11;Philippines and Indonesia;475
10.12.12;References;475
10.13;33 Future Imaging and Guidance for Endovascular Procedures;476
10.13.1;Imaging;476
10.13.1.1;Magnetic Resonance Imaging;476
10.13.1.2;Dynamic Computed Tomography;479
10.13.1.3;DynaCT (Digital Subtraction Angiography CT);479
10.13.1.4;Intravascular Ultrasound;480
10.13.1.5;Thoracic Echocardiography;482
10.13.1.6;Transcranial Doppler Monitoring Endovascular Interventions;482
10.13.2;Robotics;483
10.13.2.1;Flexible Robotics;483
10.13.2.2;Surgical Robotics;484
10.13.2.3;Simulation;484
10.13.2.3.1;Virtual Procedure Rehearsal;484
10.13.3;Lessons from the Cardiac Catheterization Lab;485
10.13.4;Conclusion;486
10.13.5;References;486
11;Index;490