Endovascular Interventions: A Case-Based Approach PDF
Preview Endovascular Interventions: A Case-Based Approach
Robert S. Dieter Raymond A. Dieter, Jr. Raymond A. Dieter, III Editors Endovascular Interventions A Case-Based Approach 123 Endovascular Interventions Robert S. Dieter (cid:129) Raymond A. Dieter Jr. Raymond A. D ieter III Editors Endovascular Interventions A Case-Based Approach Editors Robert S. Dieter , MD, RVT Raymond A. Dieter III , MD Loyola University Medical Center Cardiothoracic Surgery Edward Hines, Jr. VA Hospital University of Tennessee Medical Center Maywood Knoxville IL TN USA USA Raymond A. Dieter Jr. , MD, MS Thoracic and Cardiovascular Surgery Northern Illinois Center for Surgery Naperville IL USA Associate Editor Aravinda Nanjundappa , MD, RVT, MBA Interventional Cardiology, Vascular and Endovascular Medicine Charleston Area Medical Center Charleston WV USA ISBN 978-1-4614-7311-4 ISBN 978-1-4614-7312-1 (eBook) DOI 10.1007/978-1-4614-7312-1 Springer New York Heidelberg Dordrecht London Library of Congress Control Number: 2013946544 © Springer Science+Business Media New York 2014 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, speci fi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on micro fi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied speci fi cally for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher’s location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a speci fi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com) To my wonderful wife who has been patient and supportive through all my training and pursuits, My children who bring a smile to my face every day, My parents and family who taught me to always strive to do my best, To God who makes it all possible. Foreword Because of improvements in minimally invasive technologies, the endovascular approach is being increasingly used in the treatment of vascular diseases. By eliminating the need for an extensive incision, this approach avoids the trauma of conventional surgery, which can result in postoperative pain, prolonged hospitalization, and a protracted recovery. The mainstays of endovascular therapy are balloon angioplasty, stent grafting, and coiling. After a catheter carrying a compressed balloon, stent graft, or coil has been advanced to the diseased site, the device is expanded to reopen the vessel and keep it open. The current generation of interven- tional devices is enhanced by new optical fi bers, thromboresistant metals, biomembrane coat- ings, and other innovative materials. Endovascular therapy also bene fi ts from recent progress in ultrasonography, radiology, fl uoroscopy, and electronics. Potential disadvantages over con- ventional techniques include endoleak and device failure or dislocation. Also, the long-term results of endovascular treatment are not yet known. Nevertheless, this approach offers new hope for many patients who, because of advanced age or comorbidity, are at high risk for tra- ditional, open surgery. These days, the repair of vascular lesions is so much taken for granted, it is easy to forget that this specialty has a relatively brief history. Until the early 1950s, treatment of aneurysms was restricted to “indirect” methods, such as introducing wire into the aneurysm to promote blood clotting or wrapping the exterior of the lesion with cellophane to induce scarring and reinforce the wall. Although these techniques might keep the aneurysm from rupturing, they met with only limited success. Early in my surgical career, I was fortunate to participate in some of the initial direct aneurysm repairs. Until the advent of cardiopulmonary bypass, sur- geons had only a small window of time in which to make these repairs. Even the idea of attempting them was at fi rst considered revolutionary. Having retained a special interest in these lesions throughout my career, I am grati fi ed that minimally invasive technology has expanded the options for their treatment. It would be hard to fi nd a better guidebook to endovascular interventions than the present volume, which is edited by my colleague and friend Ray Dieter, Jr., and his sons. Ray is one of the pioneers of angiography, endovascular procedures, and hybrid surgical/endovascular pro- cedures. His sons Ray Dieter III and Robert Dieter are, respectively, a cardiothoracic and vascular surgeon and an interventional cardiologist with an emphasis on vascular disease. The book uses a practical, step-by-step approach that shows how the leading experts in endovascu- lar treatment manage their cases. It covers a wide variety of interventions―ranging from head to toe and including both arterial and venous lesions. Attractive and highly readable, the book should be a valuable resource for surgeons, cardiologists, and radiologists. For several years now, the three Dieters have been steadily producing a series of outstanding books on vascular disorders. E ndovascular Interventions is a welcome companion to their earlier works, P eripheral Arterial Disease (2009) and Venous and Lymphatic Diseases (2011), both published by McGraw-Hill. I am honored to have been asked to write the foreword for each of these volumes. As one who is well acquainted with the challenges of book publishing, I applaud the authors for their latest superb contribution to the vascular literature. Houston, TX, USA Denton A. Cooley, MD vii Introduction This has been a very exciting textbook to put together. The senior-most editor of the textbook, a cardiothoracic and vascular surgeon, can recall when he did the majority of the angiograms on his patients. Of course, many of the initial minimally invasive techniques such as embolec- tomy or “Dottering” of lesions have evolved into fully percutaneous treatment methods. It is incredible to contemplate this evolution, as aptly pointed out in the foreword by Dr. Denton Cooley, of vascular care. We are now in an age where percutaneous and hybrid treatments are thought of fi rst rather than open surgical techniques. Disease states, particularly vascular dis- eases, have forced the overlap of treatment by different disciplines. In this textbook, we have asked vascular specialists, regardless of their discipline, to con- tribute. Our previously published medical textbooks include Peripheral Arterial Disease (McGraw-Hill), V enous and Lymphatic Diseases (McGraw-Hill), and T horacoscopy for Surgeons: Diagnostic and Therapeutic (Igaku-Shoin Medical Publishers). The emphasis of the current textbook is, however, on the endovascular treatment of these diseases. We decided to take a case-based approach and have asked each contributor to walk us through how they would actually approach a case. This is of course a monumental task. We have included mul- tiple disciplines from around the world. We have attempted to maintain a basic format to the chapters, but of course, there will be variations and we hope that this adds to the quality of the textbook. In the end, we want you to be able to open this book and learn how to approach an actual case. There will be overlap and even some gaps. We have intentionally avoided empha- sis on pathophysiology—our fi rst two books with McGraw-Hill have emphasized that. Herein, though, is how to treat the patient in an endovascular fashion. Although we have attempted to maintain a uniform outline and presentation to our chapters, there are inherent differences from one chapter to the next. Some interventions demand a lengthier discussion than others. Furthermore, we recognized that no one interventionalist will be performing all the techniques described. This textbook is designed to be a reference for practicing clinicians, but it cannot be an exhaustive discussion of all cases and complications of the various territories involved. Regardless, it does attempt to present a variety of cases across the vascular system. Hopefully, the reader will be able to assimilate new techniques— possibly even from other vascular beds—and apply these to treating their patients. Some topics will be covered by multiple authors and sometimes with different techniques and discussion. This approach highlights the diversity of treating patients and lesions. It was never our intent with this textbook to present “the only way” of approaching a situation. Indeed, it is through the ingenuity of the authors that one can learn how to deal with actual patients. Once again, we thank you for your support in our endeavor to maintain the current state-of- the-art reference texts for vascular disease. Maywood, IL, USA Robert S. Dieter, MD, RVT Naperville, IL, USA Raymond A. Dieter Jr., MD, MS Knoxville, TN, USA Raymond A. Dieter III, MD ix
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