1600 John F Kennedy Blvd Ste 1800 Philadelphia, PA 19103-2899 COMPREHENSIVE VASCULAR AND ENDOVASCULAR   SURGERY, SECOND EDITION Copyright © 2009, 2004 by Mosby, Inc., an affiliate of Elsevier Inc ISBN: 978-0-323-05726-4 All rights reserved No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher Permissions may be sought directly from Elsevier’s Rights Department: phone: (+1) 215 239 3804 (US) or (+44) 1865 843830 (UK); fax: (+44) 1865 853333; e-mail: healthpermissions@elsevier.com You may also complete your request on-line via the Elsevier website at   http://www.elsevier.com/permissions Notice Knowledge and best practice in this field are constantly changing As new research and experience broaden our knowledge, changes in practice, treatment, and drug therapy may become necessary or appropriate Readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications It is the responsibility of the practitioner, relying on their own experience and knowledge of the patient, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions To the fullest extent of the law, neither the Publisher nor the Editors assume any liability for any injury and/or damage to persons or property arising out of or related to any use of the material contained in this book The Publisher Library of Congress Cataloging-in-Publication Data Comprehensive vascular and endovascular surgery/[edited by] John W Hallett … [et al.] 2nd ed p ; cm Includes bibliographical references and index ISBN 978-0-323-05726-4 1.  Blood-vessels Surgery 2.  Blood-vessels Endoscopic surgery.  I Hallett, John W [DNLM: 1.  Vascular Surgical Procedures 2.  Endoscopy methods 3.  Vascular Diseases surgery WG 170 C7377 2009] RD598.5.C644 2009 617.4’130597 dc22 Acquisitions Editor: Judith Fletcher Developmental Editor: Lisa Barnes Project Manager: Mary Stermel Marketing Manager: Radha Mawrie Printed in China Last digit is the print number:  9  8  7  6  5  4  3  2  2009008603 Contributors Donald T Baril, MD Fellow, Vascular and Endovascular Surgery Division of Vascular Surgery Department of Surgery University of Pittsburgh Medical Center Pittsburgh, Pennsylvania, USA Ginger Barthel, RN, MA, FACHE Vice President, Clinical Operations Advocate Lutheran General Hospital Park Ridge, Illinois, USA B Timothy Baxter, MD Professor Department of Surgery University of Nebraska Omaha, Nebraska, USA Jonathan D Beard, FRCS, ChM, Med Professor of Surgical Education University of Sheffield Consultant Vascular Surgeon Sheffield Vascular Institute Northern General Hospital Sheffield, United Kingdom Jean-Pierre Becquemin, MD, FRCS Professor of Vascular Surgery University of Paris XII Head of the “Pole” Cardiac Vascular and Thoracic Henri Mondor Hospital Creteil, France Michael Belkin, MD Associate Professor of Surgery Harvard Medical School Chief, Division of Vascular and Endovascular Surgery Brigham and Women’s Hospital Boston, Massachusetts, USA Thomas C Bower, MD Professor of Surgery Mayo Clinic College of Medicine Consultant Division of Vascular and Endovascular Surgery Mayo Clinic Rochester, Minnesota, USA Kevin G Burnand, MBBS, MS, FRCS Professor, Academic Surgery King’s College London Professor, Academic Surgery St Thomas Hospital London, United Kingdom Jaap Buth, MD, PhD Consultant Vascular Surgeon Department of Vascular Surgery Catharina Hospital Eind Hovem, The Netherlands John Byrne, MCh FRCSI (Gen) Assistant Professor of Surgery Division of Vascular Surgery Albany Medical Center Albany, New York, USA Richard P Cambria, MD, FACS Professor of Surgery Harvard Medical School Chief, Division of Vascular and Endovascular Surgery Massachusetts General Hospital Boston, Massachusetts, USA Christopher G Carsten, MD Assistant Program Director Academic Department of Surgery Greenville Hospital System University Medical Center Greenville, South Carolina, USA  vi Contributors Kenneth J Cherry Jr, MD Head, Division of Vascular Surgery Department of Surgery Professor of Surgery Chair, Vascular Surgery University of Virginia Hospital Charlottesville, Virginia, USA W Darrin Clouse, MD, FACS Associate Professor of Surgery The Uniformed Services University of the Health Sciences Bethesda, Maryland, USA Chief, Division of Vascular and Endovascular Surgery San Antonio Military Medical Center San Antonio, Texas, USA Marc Coggia, MD Professor of Vascular Surgery Versailles Saint-Quentin-en-Yvelines University Versailles, France Vascular Surgeon Department of Vascular Surgery Ambroise Pare University Hospital Boulogne-Billancourt, France Matthew A Corriere, MD Fellow Section on Vascular and Endovascular Surgery Wake Forest University School of Medicine Winston-Salem, North Carolina, USA David L Cull, MD Vice Chairman, Surgical Research Academic Department of Surgery Greenville Hospital System University Medical Center Greenville, South Carolina, USA Philippe Cuypers, MD, PhD Consultant Vascular Surgeon Department of Vascular Surgery Catharina Hospital Eindhovem, The Netherlands Michael D Dake, MD Chairman Department of Radiology University of Virginia Health System Charlottesville, Virginia, USA Alun H Davies, MA, DM, FRCS, ILTM Imperial College Imperial Vascular Unit Charing Cross Hospital London, United Kingdom Magruder C Donaldson, MD Associate Professor of Surgery Harvard Medical School Boston, Massachusetts, USA Chairman Adjunct Staff Department of Surgery Metro West Medical Center Framingham, Massachusetts, USA Department of Surgery Brigham and Women’s Hospital Boston, Massachusetts, USA Josée Dubois, MD Professor Department of Radiology, Radio-Oncology, and Nuclear Medicine University of Montreal Chair Department of Medical Imaging CHU Sainte-Justine Montreal, Quebec, Canada Walter N Durán, PhD Professor of Physiology and Surgery Director, Program in Vascular Biology Department of Pharmacology and Physiology   New Jersey Medical School University of Medicine and Dentistry of New Jersey Medical School Newark, New Jersey, USA Jonothan J Earnshaw, DM, FRCS Consultant Surgeon Department of Vascular Surgery Gloucestershire Royal Hospital Gloucestershire, United Kingdom James M Edwards, MD Professor of Surgery Portland Veterans Affairs Medical Center Oregon Health and Science University Department of Surgery Division of Vascular Surgery Portland, Oregon, USA Contributors Matthew S Edwards, MD Associate Professor of Surgery Department of Vascular and Endovascular Surgery Wake Forest University Health Sciences Assistant Professor of Surgery Department of Vascular and Endovascular Surgery Wake Forest University Baptist Medical Center Winston-Salem, North Carolina, USA Julie Freischlag, MD Chair Department of Surgery Surgeon-in-Chief Johns Hopkins Medical Institution Baltimore, Maryland, USA Mary E Giswold, MD Staff Surgeon Kaiser Permanente Sunnybrook Medical Office Clackamas, Oregon, USA Peter Gloviczki, MD, FACS Professor of Surgery Mayo Clinic College of Medicine Chair Division of Vascular and Endovascular Surgery Director Gonda Vascular Center Mayo Clinic Rochester, Minnesota, USA Olivier GoËau-Brissonnière, MD, PhD Professor of Vascular Surgery Versailles Saint-Quentin-en–Yvelines University Versailles, France Head Department of Vascular Surgery Ambroise Pare University Hospital Boulogne-Billancourt, France Manj S Gohel, MD, MRCS Honorary Research Fellow Faculty of Medicine Imperial College London Specialist Registrar Department of Vascular Surgery Charing Cross Hospital London, United Kingdom Bruce H Gray, DO GHS Clinical Professor of Surgery Department of Surgery Medical University of South Carolina Director of Endovascular Services Department of Vascular Surgery Greenville, South Carolina, USA Marcelo Guimaraes, MD Assistant Professor Department of Radiology—Heart and Vascular Center Medical University of South Carolina Charleston, South Carolina, USA Maher Hamish, MD, FRCS Senior Clinical Fellow Imperial Vascular Unit Charing Cross Hospital London, United Kingdom Kimberley J Hansen, MD Professor of Surgery and Section Head Section of Vascular and Endovascular Surgery Division of Surgical Sciences Wake Forest University School of Medicine Winston-Salem, North Carolina, USA Paul N Harden, MB, ChB, FRCP Consultant Nephrologist Oxford Kidney Unit The Churchill Hospital Oxford, United Kingdom Johanna M Hendriks, MD, PhD Consultant Department of Vascular Surgery Erasmus University Rotterdam, The Netherlands Norman R Hertzer, MD, FACS Emeritus Chairman Department of Vascular Surgery The Cleveland Clinic Cleveland, Ohio, USA vii viii Contributors Walter Huda, PhD Professor Department of Radiology Medical University of South Carolina Charleston, South Carolina, USA Glenn C Hunter, MD Staff Surgeon Department of Surgery Tucson Medical Center Tucson, Arizona, USA Daniel M Ihnat, MD, facs Assistant Professor of Clinical Surgery Department of Surgery University of Arizona Tucson, Arizona, USA Jeffrey A Kalish, MD Clinical Fellow in Vascular and Endovascular Surgery Beth Israel Deaconess Medical Center Boston, Massachusetts, USA Manju Kalra, MBBS Associate Professor of Surgery Mayo Clinic College of Medicine Mayo Clinic Consultant Division of Vascular and Endovascular Surgery Rochester, Minnesota, USA Edouard Kieffer, md Professor of Vascular Surgery and Chief Department of Vascular Surgery Pitie-Salpetriere University Hospital Paris, France Constantinos Kyriakides, MD, FRCS Consultant Vascular Surgeon Department of Surgery Barts and the London NHS Trust The Royal London Hospital Whitechapel, London, United Kingdom Frank A Lederle, MD Professor of Medicine Veteran Affairs Medical Center Minneapolis, Minnesota, USA Luis R Leon Jr, MD, RVT, FACS Chief of Vascular Surgery Department of Vascular and Endovascular Surgery Southern Arizona Veterans Affairs Health Care System Associate Professor of Surgery Department of Vascular and Endovascular Surgery University of Arizona Medical Center Tucson, Arizona, USA Benjamin Lindsey, MB BS, FRCSE Department of Vascular Surgery Royal Cornwall Hospital Cornwall, United Kingdom Nick J.M London, md, FRCS, FRCP Professor of Surgery Vascular Surgery Group University of Leicester Hon Consultant Vascular/Endocrine Surgeon Vascular Surgery UHoL, Leicester Royal Infirmary Leicester, United Kingdom William C Mackey, MD, FACS Andrews Professor and Chairman Department of Surgery Tufts University School of Medicine Surgeon-in-Chief Tufts New England Medical Center Boston, Massachusetts, USA Jason Mactaggart, MD Fellow in Vascular Surgery University of California, San Francisco San Francisco, California, USA Jovan N Markovic, MD Postdoctorate Department of Surgery Duke University Medical Center Durham, North Carolina, USA Catharine L McGuinness, MS, FRCS Consultant Vascular Surgeon Royal Surrey County Hospital Guildford, Surrey, United Kingdom Contributors Mark H Meissner, MD Professor Department of Surgery University of Washington School of Medicine Seattle, Washington, USA A Ross Naylor, MBChB, MD, FRCS Professor of Vascular Surgery Department of Vascular Surgery Leicester Royal Infirmary Leicester, United Kingdom Matthew T Menard, MD Instructor in Surgery Harvard Medical School Co-Director, Endovascular Surgery Division of Vascular and Endovascular Surgery Brigham and Women’s Hospital Boston, Massachusetts, USA Gustavo S Oderich, MD Assistant Professor of Surgery Mayo Clinic College of Medicine Consultant Division of Vascular and Endovascular Surgery Mayo Clinic Rochester, Minnesota, USA Virginia M Miller, PhD Professor Departments of Surgery and Physiology and Biomedical Engineering Mayo Clinic College of Medicine Rochester, Minnesota, USA Patrick J O’Hara, MD, FACS Professor of Surgery Cleveland Clinic Lerner College of Medicine Staff Vascular Surgeon Department of Vascular Surgery The Cleveland Clinic Foundation Cleveland, Ohio����� , USA Joseph L Mills Sr, md, facs Professor of Surgery Department of Surgery University of Arizona Health Sciences Center Chief of Vascular and Endovascular Surgery Division of Vascular Surgery University Medical Center Tucson, Arizona, USA Gregory L Moneta, MD Professor of Surgery Department of Surgery Oregon Health and Science University Chief of Vascular Surgery Oregon Health and Science University Hospital Portland Department of Veterans Affairs Hospital Portland, Oregon����� , USA Jonathan G Moss, mbchb, frcs, frcr Professor of Interventional Radiology University of Glasgow North Glasgow University Hospitals Glasgow Scotland, United Kingdom Joseph J Naoum, MD Division of Vascular Surgery  The Methodist Hospital  Cardiovascular Surgery Associates  Houston, Texas����� , USA Vincent L Oliva, MD Professor of Radiology Department of ��������� Radiology University of Montreal Assistant Chief Department of ��������� Radiology Centre Hospitalier de l’Université de Montreal Chief of Vascular and Interventional Radiology Division Department of ��������� Radiology Centre Hospitalier de l’Université de Montreal Montreal, Quebec, Canada Frank Padberg Jr, MD Professor of Surgery Division of Vascular Surgery Department of Surgery New Jersey Medical School University of Medicine and Dentistry of New Jersey Attending Vascular Surgeon Department of Vascular Surgery University Hospital Newark, New Jersey, USA Chief, Section of Vascular Surgery Department of Surgery Veterans Affairs, New Jersey Health Care System East Orange, New Jersey, USA ix  Contributors Luigi Pascarella, MD Resident Department of Surgery Duke University Medical Center Durham, North Carolina, USA Frank B Pomposelli Jr, MD Associate Professor of Surgery Harvard Medical School Chief of Vascular and Endovascular Surgery Beth Israel Deaconess Medical Center Boston, Massachusetts, USA Brendon Quinn, MD Vascular Fellow Academic Department of Surgery Division of Vascular Surgery Greenville Hospital System University Medical Center Greenville, South Carolina, USA Todd E Rasmussen, MD Associate Professor of Surgery Norman M Rich Department of Surgery The Uniformed Services University of the Health Sciences Bethesda, Maryland, USA Chief, San Antonio Military Vascular Surgery Wilford Hall United States Air Force Medical Center Lackland Air Force Base, Texas, USA Chief, San Antonio Military Vascular Surgery Brooke Army Medical Center Fort Sam Houston, Texas, USA John E Rectenwald, MD Assistant Professor of Surgery Department of Surgery University of Michigan Ann Arbor, Michigan, USA Amy B Reed, MD Director, Vascular Surgery Fellowship Division of Vascular Surgery Department of Surgery Staff Vascular Surgeon University Hospital Department of Surgery Cincinnati, Ohio, USA Linda M Reilly, MD Professor of Surgery Department of Surgery—Vascular Division University of California, San Francisco Professor of Surgery Department of Surgery University of California, San Francisco Medical Center Professor of Surgery Department of Surgery San Francisco VA Medical Center San Francisco, California����� , USA Robert Y Rhee, MD Clinical Director Division of Vascular Surgery Department of Surgery University of Pittsburgh Medical Center Pittsburgh, Pennsylvania����� , USA Jeffrey M Rhodes, MD Attending Physician Department of Vascular Surgery Rochester General Hospital Rochester, New York����� , USA Joseph J Ricotta II, MD Assistant Professor of Surgery Mayo Clinic College of Medicine Consultant Division of Vascular and Endovascular Surgery Mayo Clinic Rochester, Minnesota����� , USA David Rigberg, MD Assistant Professor of Surgery Division of Vascular Surgery University of California, Los Angeles Los Angeles, California����� , USA Claudio Schönholz, MD Professor of Radiology Radiology Heart and Vascular Center Medical University of South Carolina Charleston, South Carolina����� , USA Contributors Paritosh Sharma, MRCS Vascular Research Fellow Department of Surgery Barts and the London NHS Trust The Royal London Hospital Whitechapel, London, United Kingdom Amanda Shepherd, MrcS Doctor Imperial Vascular Unit Imperial College London, United Kingdom Cynthia Shortell, MD, FACS Professor of Surgery Chief of Vascular Surgery Program Director, Vascular Residency Division of Surgery Duke University Medical Center Durham, North Carolina����� , USA Frank C.T Smith, BSc, MD, FRCS Reader and Consultant Vascular Surgeon University of Bristol Bristol Royal Infirmary Bristol, United Kingdom Gilles Soulez, MD, MSc Professor Department of Radiology University de Montreal Interventional Radiologist, Director of Research Department of Radiology Centre Hospitalier de l’Universite de Montreal Montreal, Quebec, Canada James C Stanley, MD Professor of Surgery Department of Surgery University of Michigan Medical School Director Cardiovascular Center University of Michigan Ann Arbor, Michigan����� , USA Kong Teng Tan, md Assistant Professor of Radiology Interventional Radiology University of Toronto Toronto, Ontario, Canada Desarom Teso, MD Fellow in Vascular Surgery Section of Vascular Surgery Tufts Medical Center Boston, Massachusetts����� , USA Stephen C Textor, MD Professor of Medicine Departments of Nephrology and Hypertension Mayo Clinic College of Medicine Consultant Departments of Nephrology and Hypertension Rochester Methodist Hospital Consultant Saint Mary’s Hospital Rochester, Minnesota, USA Brad H Thompson, MD Associate Professor of Radiology Department of Radiology Roy J and Lucille A Carver College of Medicine Department of Radiology University of Iowa Hospitals and Clinics Iowa City, Iowa����� , USA Renan Uflacker, MD Professor of Radiology Department of Radiology—Heart and Vascular Center Medical University of South Carolina Charleston, South Carolina����� , USA Gilbert R Upchurch Jr, MD Professor of Surgery Section of Vascular Surgery Department of Surgery University of Michigan Ann Arbor, Michigan����� , USA Edwin J.R van Beek, MD, PhD Professor of Radiology, Medicine, and Biomedical Engineering Department of Radiology Carver College of Medicine Iowa City, Iowa����� , USA xi xii Contributors Marc R.H.M van Sambeek, MD, PhD Associate Professor Department of Anesthesiology Erasmus University Rotterdam, The Netherlands Consultant Vascular Surgeon Department of Vascular Surgery Catharina Hospital Eindhovem, The Netherlands John V White, MD Clinical Professor Department of Surgery University of Illinois Chicago, Illinois, USA Chairman Department of Surgery Advocate Lutheran General Hospital Park Ridge, Illinois, USA Frank C Vandy, MD Resident Department of Vascular Surgery University of Michigan Medical Center Ann Arbor, Michigan����� , USA Christopher L Wixon, MD, FACS Assistant Professor of Surgery and Radiology Mercer University School of Medicine Director and Chairman Department of Cardiovascular Medicine and Surgery Memorial Health University Medical Center Savannah, Georgia, USA Dierk Vorwerk, md Professor Department of Radiology University of Technology Chairman Department of Diagnostic and Interventional Radiology Klinikum Ingolstadt Ingolstadt, Germany Thomas W Wakefield, MD S Martin Lindeanuer Professor of Vascular Surgery Section Head Department of Vascular Surgery University of Michigan Medical Center Ann Arbor, Michigan����� , USA Nicole Wheeler, MD Vascular Surgery Bidwell Fellow Oregon Health and Science University Portland, Oregon, USA Kenneth R Woodburn, MB ChB, MD FRCSG (Gen) Honorary University Fellow Peninsula College of Medicine and Dentistry University of Plymouth Plymouth, United Kingdom Consultant Vascular and Endovascular Surgeon Vascular Unit Royal Cornwall Hospitals Trust Truro, Cornwall, United Kingdom Kenneth J Woodside, MD Clinical Lecturer in Surgery Division of Transplantation Department of Surgery University of Michigan Health System  Ann Arbor, Michigan����� , USA Index Operative protocols and prosthetic graft i ­ nfection, 689 Operative stroke, 622–623 Oral anticoagulants, 822–823, 822t Oral contraception as risk factor for venous thromboembolic disease, 812 thrombophilia and, 813 Oral contrast with spiral CTA, 482–483 Organs and reperfusion injuries, 280 Orificial endarterectomy, 559–560, 561f Orificial profunda disease, 181–182 Orthopedic implants and graft infection, 696 Osler-Weber disease, 843 Osteolysis, 853 Osteomyelitis, 221 Osteoporosis, 821–822 Oudot, Jacques, Outback reentry catheter, 155, 157f Outcomes assessment in evidence-based m ­ edicine, 58–60 Outflow bypass procedure, 226 Oxidative injury, 132 Oxidative stress and inflammation, 468 Oxygen measurement (transcutaneous) and amputation healing, 233 Oxypentifylline, 132 P PAD See Peripheral arterial disease (PAD) Paget-Schroetter syndrome diagnosis of, 327, 327–328f presentation of, 323 prognosis for treated, 334 prognosis for untreated, 334 TOS and, 321–322, 322f treatment for, 330–331 upper extremity deep venous thrombosis and, 815 wrestling and, 321–322 Pain abdominal and AMI, 339 acute leg ischemia and, 244 chronic ischemia and, 244 CMI and, 342 neurogenic TOS and, 322–323 phantom limb pain and preamputation, 236 recurrent abdominal and, 341 relief of after treatment for CMI, 348 Pallor acute leg ischemia and, 244, 244f profound leg ischemia and, 244, 244f Palma procedure deep venous obstruction and, 800–801, 801f results of, 803, 804t Palma-Dale procedure, 800–801 Palmar hyperhidrosis, 323–324 Palmaz stent chronic iliac occlusions and, 149 type I endoleak and, 490 Palmaz XXL stent, 143 Palmaz, Julio, 10, 10f Pancreatic cancer, 343 Pancreatic inflammatory disease, 359–361 Pancreatitis, 359–361 Papaverine-augmented intraoperative c ­ ompletion duplex scan, 200 Paraanastomotic aortic aneurysm, 671–672 Paraanastomotic aortic pseudoaneurysm, 671–672, 672f Paralysis acute leg ischemia and, 244 profound leg ischemia and, 244 Paraplegia and aortic segment debranching, 566 Pararenal aortic aneurysm classification of, 544, 545f Key Points, 543 natural history of, 546–547 operative management of, 551–555 Paré, Ambrose Parenchymal renal disease, 385 Paresthesia acute leg ischemia and, 244 neurogenic TOS and, 323 radiofrequency ablation and endovenous laser treatment and, 765, 765t, 777–778 Parkes Weber syndrome capillary malformations and, 843 description of, 843t, 857–858 lymphedema and, 867 Parodi antiemboli system, 633, 634f Parodi, Juan, 10, 10f Partially recanalized carotid artery and CEA, 621 Particle acceleration, 39–40 Parvus tardus waveform, 384–385, 385f Pascal’s principle definition of, 45–46, 46f regional pressure gradients within aneurysm sacs and, 46–47 Patch angioplasty, 180 Patent graft in vascular surgical interventions, 59 Pathology (intraabdominal) and AAA, 507–508 Pathophysiology of diabetic ischemia, 221–224 of diabetic neuropathy, 215–216 Patient education about neuropathy, 218 Patient evaluation for CLLI treatment, 193 of IC effects, 123 Patient preparation for CE-MRA, 89 for MDCTA, 80 Patient-reported assessment See Also Short form–36 as part of complete evaluation, 59–60, 60t clinical outcome compared to, 59 value of, 60 Patriot trial, 139 Peak arterial enhancement in CE-MRA, 91 Pectoralis minor syndrome, 322 Pedal artery aneurysm, 586 Pedal bypass in diabetics, 226 infrainguinal, 204, 204f, 205f Pediatric Amblyopia Risk Investigational Study, 169–170 Pediatric hemodialysis access, 448–449 Pedicle of omentum and AAA repair, 500–501, 503f Pedobarography, 217, 217f Pelvis sequential branch grafting in AAA repair, 500, 502f Penetrating carotid artery injury classification, 628 Penetrating ulcer (atheromatous), 520, 520f Penile edema, 871 Perceived health on QOL survey instrument, 60 Percusurge GuardWire system, 633, 633f, 637, 638f Percutaneous access sites, 154–155 Percutaneous aortography, 178 Percutaneous femoral aneurysm, 583–584 Percutaneous intervention aorta and, 141–142 complications of in iliac arterial disease, 150 iliac arteries and, 141 to iliac arterial lesions, 141 901 Percutaneous mechanical thrombectomy acute limb ischemia and, 273 deep vein thrombosis and, 820 Percutaneous renal revascularization risks, 412, 412t Percutaneous selective vascular catheterization, 74–75, 74f Percutaneous thrombectomy AV access and pharmacological thrombolysis and, 450, 452f steps for treatment of, 451, 452f pharmacological thrombolysis and acute MVT and, 355, 355f AV access and, 450, 452f risks of, 451 vs surgical treatment of thrombosed AV access, 451 Percutaneous thrombolysis, 231 Percutaneous Transluminal Angioplasty (PTA) See also Renal PTA aortoiliac disease and, 140, 141–142, 142f, 148�� ����� atheromatous disease and stent vs angioplasty in, 405 therapy for, 403–404 CLI and femoropopliteal disease and, 161, 162f long-segment SFA and, 163 vs bypass surgery, 162 complications of, 150 femoropopliteal disease and bare metal stents and, 166 CLI and, 161, 162 cold balloon, 163 cryoplasty, 163 drug-coated balloon and, 163 revascularization options for, 161 standard, 162 iliac artery and, 147 iliac occlusive disease and stent placement and, 144–145 treatment of, 144–147, 144f, 145f lesion morphology and, 139, 139f long-segment SFA and, 141 postirradiation stenosis and, 305 renal, 405–407, 405t renovascular disease and, 403, 406 results with, 144 stent placement and, 144, 146 stent reobstruction and, 148 stent trials and, 166, 166t tibial disease and, 171 vs bypass surgery, 162 vs stent in, 405 Percutaneous transluminal coronary angioplasty (PTCA), 508–509 Percutaneous transluminal renal angioplasty (PTRA), 417, 427 Percutaneous treatment aortoiliac disease and indications for, 142 technical aspects of, 142–143 claudication and, 140 CMI and, 343–344 for claudication lesions, 138–139, 139f lesion classification for, 139 Perforating vein incompetence, 803 Perforating veins anatomy of, 731, 786–787, 786f location of, 772 significance of, 787–788 Perforator ablation, 790–793, 791t Perforator incompetence, 788 Perforator vein ablation, 789–790 Perforator vein endoscopy, 789, 790f 902 Index Perforator vein incompetence and chronic venous insufficiency, 787–788 Perforator vein interruption chronic venous insufficiency and, 786–793 clinical results of open surgical technique for, 790–793, 791t contraindications for, 788 indications for, 788 open surgical technique for, 788–789 postthrombotic syndrome and, 797–798 preoperative evaluation for, 788 Perforator vein ligation See also Perforator vein interruption Perfusion pressure renovascular hypertension and, 374–375 TAA repair and, 570 Perfusion scan acute pulmonary embolism and, 824–825, 825f venous malformation and, 848, 848f Periarterial inflammation and hepatic artery aneurysm, 362 Perigraft fibrosis and ureteric obstruction, 675 Perigraft fibrous tissue ingrowth, 667 Perigraft seroma, 674–675, 675f Perioperative antibiotics for prosthetic graft infection, 696 Perioperative bleeding in prosthetic vascular grafting, 668–669 Perioperative hemorrhage and TAA repair, 568–569 Perioperative infection in prosthetic vascular grafting, 689 Perioperative mortality aortic and renal reconstruction and, 424 atherosclerotic renal artery repair and, 423, 425f renal and aortic reconstruction and, 424 Perioperative renal insufficiency and TAA repair, 569, 569t Peripancreatic pseudoaneurysm, 359 Peripheral aneurysm See also Popliteal aneurysm; Femoral aneurysm Key Points, 579 Peripheral arterial disease (PAD) ACE inhibitors and, 128 acute leg ischemia and, 250 amputation and, 229–230 angiogenic growth factors and, 133 antiplatelet agents and, 129 antiplatelet therapy and, 130, 130f as risk factor in AIOD, 178, 178f aspirin and, 131 categories of, 121, 121t clinical course of, 122–123 diabetes and, 127 diagnosis of, 121, 177, 178, 178f hyperhomocysteinemia and, 126 hypertension and, 127 lipid metabolism as risk factor for, 125 MDCTA for, 124–125, 125f peripheral vascular laboratory and, 65 prevalence of, 121–122 prognosis for, 122–123 smoking and, 128 ticlopidine and, 130 treatments for, 133, 178–179, 229 vascular laboratory for, 64–65 Peripheral arterial duplex scanning, 69, 69f Peripheral arterial emboli and thrombophilia screening, 248 Peripheral arterial involvement in femoropopliteal disease, 161 Peripheral arterial occlusion, 273 Peripheral arterial reconstruction, Peripheral arterial stenosis classification, 71, 71t Peripheral arteriogram complications, 79 Peripheral artery stents, 94, 161 Peripheral CTA scan acquisition, 81–83 Peripheral directed catheter, 163 Peripheral endograft, 678–679 Peripheral microembolization, 488 Peripheral neuropathy and hemodialysis access, 456 Peripheral occlusive disease, 94–95 Peripheral phlebography and venous malformation, 849 Peripheral vascular disease (PVD) atherosclerotic renal artery disease and, 394–395 DSA and, 74 endovascular treatment recommendations for, 151 MRA for, 124, 124f risks of carotid surgery for, 622 surgery considerations before, 195 recommendations for, 137 vascular morphology and, 74 Peripheral vascular resistance failure of, 47 role of, 47–48 Perishing cold and acute leg ischemia, 245 Peritoneal apron videoscopic technique, 533–534 Peritoneal dialysis (pediatric), 448–449 Peritonitis, 354 Perivascular cuff, 739–740 Peroneal artery and infrainguinal bypass, 201–203, 202f, 203f, 204f Persistent sciatic artery, 120 Persistent venous obstruction, 744 Phantom limb pain amputation and, 236 epidural catheter and, 233 Pharmacogenomics, 17 Pharmacological therapy infrainguinal arterial disease and, 157 venous thromboembolic disease and, 836 Pharmacological thrombolysis, 355, 355f Pharmacology of thrombolytic agents, 269–270 Phase-contrast MRA description of, 88 for specific vascular areas, 91 Phlebectomy, 762–763, 764f, 768 Phlebographic patterns of venous malformation, 842–861, 849f Phlebography vascular malformation and, 846, 847f venous malformation and direct percutaneous, 849 venous malformation and peripheral, 849 Phlebolith and venous malformation, 843–844, 844f, 846 Phlebothrombosis and venous malformation, 846 Phlebotome and perforator vein interruption, 789 Phlebotropics, 751 Phlegmasia alba dolens, 253–254 Phlegmasia cerulea dolens acute leg ischemia and, 253–254, 254f deep vein thrombosis and, 833–834, 835f pathophysiology of, 833–834 treatment of, 834 Photon energy, 110, 111t Photoplethysmography venous reflux and, 735–736 waveform in, 66, 66f Phrenic nerve supraclavicular scalenectomy and, 330, 330f TOS repair and, 320 Physical therapy and TOS, 328–329 Physiological anticoagulant mechanisms, 23 Physiological clot formation, 24 Pickering, George, Picotamide chronic lower-extremity ischemia and, 132 infrainguinal arterial disease and, 157 Pierre Robin syndrome, 863 Pigtail catheter, 155 Pioneer reentry catheter, 155, 158f Pitting and lymphedema, 866–867 Plantar arch status in infrainguinal bypass, 195 Plaque atherosclerotic, 196, 203 carotid difficulties with understanding of, 595 duplex ultrasound and, 599–600, 599–600f neurological event risk and, 596–598, 597t risks with treatment for, 640, 641f stent failure and angioplasty for, 641 MRA and, 105, 110f vulnerable, 105 Plasma renin activity and renovascular h ­ ypertension, 382–383 Plasmin, 24–25 Plasminogen activation, 24 Plasminogen activator, 269, 269t Plasticity defined, 44, 44f Platelet aggregation of, 32 disorders of, 33–34 function of, 33–34 granules, 34 hyperactive, 32 plug (hemostatic), 22, 23f release disorders of, 34 Platelet-activating factor and reperfusion, 288 Plethysmographic test for venous obstruction, 738 Plethysmography chronic venous insufficiency and, 784–785 description of, 65 lower extremity arterial occlusive disease and, 65 Pneumatic compression therapy for varicose veins, 750 Pneumatic cuff, 67–68 Pneumoperitoneum and abdominal aorta v ­ ideoscopy, 534 Podoconiosis, 865 Poiseuille, Jean Léonard Marie, 49 Poiseuille’s Law, 49–51 Poiseuille-Haganbach equation, 49–51, 51f PolarCath, 163, 172 Pole test, 123–124 Polyarteritis nodosa, 586 Polycythemia, 652 Polycythemia vera, 352 Polyethylene terephthalate See Dacron Polyglycolic acid scaffold, 682 Polymorphisms AAA and, 466, 466t prothrombin 20210A, 32 Polytetrafluoroethylene (PTFE) as prosthetic AV access conduit, 433t, 439–440, 458 prosthetic access with hemodialysis and, 444 Polytetrafluoroethylene (PTFE) graft deep venous bypass and, 803 deep venous obstruction and, 801–802, 802–803f Index Polyurethane as prosthetic AV access conduit, 440 Polyurethane graft evaluation of, 680 hemodialysis and, 679–680 Popliteal aneurysm diagnosis of, 580 history of, 579–580 management of, 580, 581f signs of, 580 symptoms of, 580 thrombosed, 263, 264f Popliteal artery above-knee, 201, 202f below-knee, 201, 202f bypass graft and, 225 exclusion of, 579 intervention of, 170, 170f occlusion of, 250 Popliteal artery disease, 250 Popliteal artery entrapment syndrome, 120 Popliteal embolectomy, 266–267, 268f Popliteal endovascular exclusion, 579 Popliteal exploration, 266–267, 268f Popliteal surgical bypass, 579 Population dynamics in research studies, 56-61 Population subgroups in research studies, 56-57 Portal hypertension with splenomegaly, 359 Portomesenteric venous system, 351, 352f Portosystemic shunt, 679 Port-wine stain See Capillary malformation Posterior artery and hemodynamic vertebrobasilar insufficiency, 652, 655f Posterior circulation peculiarities, 651–652, 655f Posterior tibial perforating veins, 786–787, 786–787f Posterolateral thoracotomy, 556–558 Postgadolinium sequences and venous m ­ alformation, 849 Postimplant syndrome, 488 Postmastectomy edema, 871 Postoperative anticoagulation in acute leg i ­ schemia, 256 Postoperative carotid thrombosis, 623 Postoperative causalgia, 333 Postoperative Horner’s syndrome, 333 Postoperative hydronephrosis, 675 Postoperative mortality and EVAR, 488–489 Postoperative renal insufficiency, 569, 569t Postoperative scarring in recurrent TOS, 332 Postoperative stroke and CEA, 622–623 Postoperative stump pain and epidural catheters, 236 Postoperative vasospasm, 333 Postpartum period See Puerperium Postphlebitic occlusionab, 196,197f Postprocessing MIP for MDCT, 83–84 workstation for MDCT, 83 Postradiation angioplasty and carotid stenting, 643–645 Postreconstruction arteriography and femorodistal bypass graft, 200 Postreconstruction quality control for infrainguinal bypass, 200 Postreconstruction thrombosis and prosthetic grafts, 669 Postthrombotic limb abnormalities, 734, 735f Postthrombotic syndrome graduated compression stocking and, 823 natural history of, 744–745 perforator vein interruption and, 797–798 description of, 730 Posture and neurogenic TOS, 322 Power suction phlebectomy, 763, 768 Preamputation phantom limb pain, 236 Predilatation and carotid angioplasty, 637 Preglomerular pressure, 379 Pregnancy as risk factor for deep vein thrombosis, 812 as risk factor for pulmonary embolism, 812 as risk factor for venous thromboembolic disease, 812 pulmonary embolism and, 834–835 splenic artery aneurysm and, 360–361 thrombophilia and, 813 varicose veins and, 18, 743 vascular effects of repeated, 359 venous thromboembolism and, 834–835 Premenstrual edema and lymphedema, 867 Preoperative angiography for infrainguinal bypass, 199 Preoperative depression, 334 Preoperative renal insufficiency, 569 Prereconstruction intraoperative arteriography for infrainguinal bypass, 199 Pressure ambulatory venous chronic venous insufficiency and, 783, 787–788 measurement of, 786 aortic dissection and management of, 521 arterioles and, 47 blood vessels and, 41–42 concepts of, 40–41 conversion of standard units of, 40, 41t definition of, 40, 41f diagnostic catheter toleration of, 76 disease and gradients, 153, 154f endothelial cells affected by, 14 expression of, 40 gradient and iliac artery repair, 147 iliac artery repair and, 147 inflow artery and early graft thrombosis and, 209 intraarterial for determining infrainguinal bypass inflow sites, 199 infrainguinal arterial lower extremity veins and, 771 lymphatic system and, 863–864 measurement of compartmental, 282, 282f venous obstruction and, 737–738 plethysmography and, 66 Raynaud’s syndrome and finger, 313, 313t smooth muscle cell replication alteration under, 15 within the vascular system, 41 Pressure sink at arteriovenous anastomosis, 48 Pretracheal carotid–carotid bypass, 300, 303f Primary chronic venous disease, 743–744 Primary endoleak, 489 Primary infected arterial aneurysm, 715 Primary intestinal lymphangiectasia, 871–872 Primary lymphedema classification of, 864–865 clinical features of, 865–867 lymphatic reflux and, 864, 866 subdivisions of, 864–865, 864f Primary MVT, 352 Primary study defined, 54, 54t Primary valvular incompetence definition of, 783 repair of, 793–798, 797t Primary venous disease, 734 Primary venous disorders defined, 730 Probe in diabetic foot diagnosis, 219 Probucol Qualitative Regression Swedish Trial, 125 903 Profound leg ischemia and acute aortic t ­ hrombosis, 244 Profunda disease, 181–182 Profunda femoris artery aneurysm in classification of, 583–584 treatment strategy for, 585–586 infrainguinal bypass and, 201 exposure of, 200, 200f, 201f Profundaplasty CLLI and operative techniques for, 200–202f surgical strategy for, 197–198 in aortobifemoral bypass surgery, 181–182, 184f Program on the Surgical Control of the H ­ yperlipidemias Trial, 125 Progressive systemic sclerosis, 311 Prophylactic antibiotics and prosthetic graft infection rates, 689 Prophylactic carotid endarterectomy for a ­ symptomatic disease, Prophylactic renal revascularization, 409–412, 412t, 414 Propionyl levocarnitine, 133 Prospective Investigation of Pulmonary E ­ mbolism Diagnosis study, 824 Prostaglandins AAA and, 468 chronic lower-extremity ischemia and, 133 Prosthesis leg amputation and, 232 terms for endovascular, 481 Prosthetic antimicrobial-impregnated conduit, 696 Prosthetic AV access cervical placement sites for, 442, 444f placement technique for, 442–443 chest wall placement sites for, 442, 444f placement technique for, 442–443 conduits for, 440, 443t hemodialysis and, 439–440 loop graft configuration of, 440, 442f lower extremity placement sites for, 441, 444f placement technique for, 441–442 straight graft configuration of, 440, 442f surgical vs percutaneous treatment of thrombosed, 451, 454t U graft configuration of, 440, 442f upper extremity placement sites for, 441, 442f placement technique for, 441 Prosthetic axillary–axillary loop AV access, 443, 444f Prosthetic axillofemoral graft, 696, 696f Prosthetic bypass (infrainguinal), 204, 207f Prosthetic graft aspirin and, 205–206 early thrombosis and, 209 for infrainguinal bypass, 199 in situ replacement of, 697 late thrombosis and, 210 material for, 181–182 popliteal aneurysm and, 583 surveillance of, 207–208 venous, 679 Prosthetic graft patency enhancement, 676 Prosthetic vascular graft See also Dacron graft; ePTFE graft anastomotic femoral pseudoaneurysm and, 673–674 chronic complications of, 669–676 complications of, 668–676 904 Index Prosthetic vascular graft (Continued) desirable qualities for, 665 discussion of, 666–680 endothelialization of, 677 etiology of dilation of, 670–671, 671f healing characteristics of, 667 indications for use of, 667–668 infected in situ arterial allograft replacement and, 697–698, 698f in situ graft replacement and, 697 in situ venous allograft replacement and, 698–700, 699f, 703t in situ venous autograft replacement and, 698 preservation of, 699–700 removal of, 696–697, 700–701, 703t infection and adjunctive techniques in the management of, 707–709 bacteriology and, 689 demographics of, 688–689 diagnosis of, 692–694, 692t extracavitary, 690 intracavitary, 690–692, 691t, 692f introduction to, 688 Key Points, 688 operative preparation for treatment of, 695 pathogenesis of, 689–690 presentation of, 690–692 prevention of, 689 treatment approaches for, 696 large diameter vessels and, 665–666 polyurethane evaluation of, 680 hemodialysis and, 679–680 search for ideal, 665 small diameter failure of, 676, 676f late failure of, 677 reducing thrombogenicity of, 676–677 tissue engineered, 682 small diameter vessels and, 665–666 treatment-infected, 695–700 venous system and, 679 Prosthetic vein in infrainguinal bypass, 194 Prosthetic-enteric erosion, 690–692 Prosthetic-enteric fistula, 690–692 Proteases and AAA, 468–469 Protein C deficiency of, 252 thrombosis and deficiency of, 30–31 venous thromboembolic disease and, 813–814 Protein S deficiency of, 252 thrombosis and deficiency of, 30–31 venous thromboembolic disease and, 813–814 Protein-losing enteropathy and lymphatic malformation, 853 Proteinuria and diabetes, 218 Proteus syndrome, 858 Prothrombin 20210A polymorphism, 32 Proximal anastomosis, 176–191 Proximal anastomotic technique for open AAA repair, 499, 501f in aortobifemoral bypass surgery, 181–182 Proximal aortic-graft anastomosis, 344 Proximal arterial occlusion and pulse volume waveform, 65–66, 66f Proximal debranching, 565–566 Proximal disease great vessel occlusive disease and, 296 subclavian steal syndrome and, 295–296 upper extremity ischemia and, 293 Proximal lymphatic occlusion, 866 Proximal nodal lymphatic occlusion, 865–866 Proximal occlusive disease and pulse volume waveform, 65–66 Proximal profunda disease, 181–182 Proximal subclavian artery aneurysm, 587 Proximal vertebral artery reconstruction, 656–657, 658f Pruitt-Inahara shunt, 615, 616f, 621–622, 622f Pseudoaneurysm AV access and, 454 femoral, 586 formation of, 673, 674f suture failure and, 674 Pseudo-angina, 323 Pseudomonas, 689–690 PSV ratio and stenosis classification, 71 Psychological effects of AAA screening, 476–477 Psychological well-being as category of QOL survey instrument, 60 PTA See Percutaneous Transluminal A ­ ngioplasty (PTA) PTCA See Percutaneous transluminal coronary angioplasty (PTCA) PTFE graft isolated popliteal segment and, 199 vein cuff and below-knee, 199 Puerperium as risk factor for deep vein thrombosis, 812 as risk factor for pulmonary embolism, 812 as risk factor for venous thromboembolic disease, 812 thrombophilia and, 813 Pulmonary angiography, 825–826, 826f Pulmonary complications in EVAR, 488 Pulmonary embolism classification of, 815, 815t clinical features of, 815–816 CTEPH and, 816 D-dimer assay and, 816 deep vein thrombosis and, 807 diagnostic strategies for, 826–828, 829–830f documentation of recurrent, 828 epidemiology of, 808 hemodynamic consequences of, 811, 811f investigation of suspected, 823–826 modalities useful in the diagnosis of acute, 823–825 pathophysiological consequences of, 810 pregnancy and, 834–835 presentation of, 807–808 prevention of, 812t, 832t, 835–836 pulmonary consequences of, 810–811 risk factors for, 811–813 severity of, 807 summary regarding, 836 thrombosis and, 808 treatment of, 828–832 vascular imaging and, 95f, 103–104, 103f Pulmonary thromboembolic disease (Key Points), 807 Pulse defined, 41–42 Pulse examination and TOS, 324–325 Pulse spray thrombolysis, 271, 272f Pulse volume recordings diabetic foot ischemia and, 224, 224f plethysmography and, 65–66 Pulse volume waveform normal definition of, 65–66, 66f evaluation of, 65–66 plethysmography and, 65–66 Pulselessness in acute leg ischemia, 244–245 Puncture site hematoma in venous stenting, 799–800 PVD See Peripheral vascular disease (PVD) Pyrexia, 814–815 Q QOL See Quality of life Quality control (postreconstruction) in i ­ nfrainguinal bypass, 200–204 Quality of life EVAR and, 491 generic survey instruments for evidence-based medicine and, 60-61, 60t limitations of, 60-61 IC and questionnaire for, 123 in outcomes assessment, 58-60 varicose vein surgery and, 776 R Radial artery in infrainguinal bypass, 176–191 Radial–basilic transposed AV access (pediatric), 449 Radial–cephalic direct AV access (pediatric), 449 Radial–cephalic direct wrist access general considerations of, 433t, 434–435 technique for, 435–436, 436f Radiation background sources of, 112, 113t definition of absorbed dose of, 110 dose of definition of absorbed, 110 effective ionizing, 113–114, 112t threshold, 112–113, 113f total patient, 112–113, 113f effective dose of ionizing, 113–114, 113t frequencies of electromagnetic, 110, 111t threshold dose of, 110–111, 113f total patient dose of, 113f Radiation arteritis, 625 Radiation exposure 256-slice CT scanner and, 80 dynamic-volume CT scanner and, 80 Radiation safety vascular imaging and, 110–115 vascular imaging and (Key Points), 73 Radiation-induced cancer rates, 112, 112t Radiation-induced stenosis, 295 Radiocephalic fistula See Autogenous radial– cephalic direct wrist access Radiofrequency ablation complications of, 765, 765t endovenous laser treatment and, 764, 778 incompetent perforator veins and, 789–790, 791f long-term results of, 766, 766t types of failure of, 766, 767f varicose veins and as treatment for, 776–778 complications of, 777–778 description of, 757–758 outcomes of, 777–778 short-term results of, 764–765, 765t surgical procedure for, 776–777, 777f technique for, 759–761, 762–763f Radiofrequency-powered segmental thermal ablation varicose veins and, 778 Radiography diagnosis of AAA and, 475 in diabetic foot diagnosis, 219–220 lymphatic malformation and, 853 MVT diagnosis and, 353–354 skin and, 110, 112t splenic artery aneurysm and, 359, 360f vascular malformation and, 843–844, 844f Radiological examination ARVD and, 395 distribution of energy during, 113 Index Radionuclide testing, 383 Radiotherapy and lymphedema, 865 Randomized clinical trial description of, 55-56 treatment effects and, 57-58 RAS See Renal artery stenosis (RAS) Raynaud’s syndrome acute leg ischemia and, 253–254, 254f Buerger’s disease and, 312 characteristics of obstructive, 310, 310f characteristics vasospastic, 310, 310f clinical presentation of, 313–314 description of, 309–310 evaluation of, 313–314, 313t fibromuscular disease and, 313 frostbite and, 313 grouping of patients with, 310, 316 hypersensitivity angiitis and, 312–313 malignancies and, 313 MCTD and, 312 obstructive, 310, 310f pathophysiology of, 310–311 pharmacological agents and, 311 prognosis for, 315–316 rheumatoid arthritis and, 311–312 scleroderma and, 311 secondary, 589–590 Sjögren’s syndrome and, 312 small vessel arteriopathies with, 311–313, 316 summary of, 316 systemic lupus erythematosus and, 311 treatment for, 314–315 UCTD and, 312 vibration arterial injury and, 312 Reactive hyperemia, 14–15 Real-time bolus in 3D CE-MRA, 91 Reanastomosis, 571 Recanalization postthrombotic syndrome and, 744, 744f secondary chronic venous disease and, 744, 744f Recombinant tissue plasminogen activators (r-tPA), 270, 819 Recurrent deep vein thrombosis, 819 Recurrent pulmonary embolism documentation, 828 Recurrent thrombotic events postthrombotic syndrome and, 744 secondary chronic venous disease and, 744 venous reflux and, 744 Recurrent varicose veins, 767–768, 775, 778 Redundant endarterectomy zone, 621, 621f Reendothelialization, 16 Reentry catheter, 155, 157f, 158f Reflex sympathetic dystrophy, 331–332 Reflux primary venous disease and, 734, 735t varicose veins and, 739 venous See Venous reflux Rehabilitation after amputation, 236–237 Release reaction and platelet activation, 22 Reliability in generic QOL survey instruments defined, 60 Renal angiography indications for, 106 live donors and, 106, 109f Renal angioplasty small-platform type, 399 standard-platform type, 398–399 technique for, 398 Renal artery hypothermic perfusion of, 552f, 569 lesion of coronary artery disease and, 386–387 functional significance of, 412–413 Renal artery (Continued) hemodynamic effects of, 383 hypertension and, 386–387, 411, 413–414 intervention and, 414 physiological effects of, 379–380, 381f renin inhibitors and, 378, 379f narrowing of, 107 occlusive disease, 377–378 perforation of, 406, 406f reimplantation of, 417 renovascular hypertension and ultrasound and, 384–385, 385f vascular imaging and, 105–107 Renal artery atherosclerosis See Also A ­ therosclerotic renal artery disease Renal artery branch vessel repair, 417 Renal artery bypass end-to-end, 415–416, 418f end-to-side, 415–416, 418f Renal artery disease, 413–421 Renal artery repair See also Atherosclerotic renal artery disease; Atherosclerotic renal artery repair branch, 425 empirical, 413 failed PTRA and, 427 intraoperative doppler and, 421, 424t secondary consequences of, 425–427 failure of, 425–427 Renal artery stenosis (RAS) causes of, 397 consequences of, 374, 375f CTA and, 386 degrees of, 379f, 380–381 description of, 397 Doppler ultrasound and, 106–107 factors for irreversible tissue injury, 378f, 379–380 FMD and, 106, 110f manifestations of, 379–382 MDCT and, 106–107, 110f nonatherosclerotic, 106–107 renovascular hypertension and, 106, 375–376, 378f with ischemic nephropathy, 387 Renal complications in TAA repair, 569, 573t Renal damage and CIN, 76–77 Renal disease end-stage chronic hemodialysis and, 429 comorbidities of, 430 increase of, 429–430 gadolinium-based contrast agents and, 90–91 Renal duplex sonography (RDS) ischemic nephropathy and, 412 prospective studies in atherosclerotic renal artery disease and, 410, 411t renovascular hypertension and, 412 Renal dysfunction and TAA, 548–549 Renal failure chronic pediatric, 448 diabetic foot ischemia and, 223 effect of on treatment for CLLI, 179–180 revascularization and, 404, 404f risk factors for contrast-induced, 77, 77t Renal fossa and ex vivo reconstruction, 419–420 Renal function atherosclerotic renal artery repair and failed PTRA and, 427 response to surgery for, 423, 426t significance in surgery for, 423, 426f renovascular hypertension and, 383, 411 ureteric obstruction and, 675 905 Renal insufficiency atherosclerotic renal artery disease and, 412 angiotensin II and acute, 378–379, 380f atheromatous disease therapy and, 404–405, 404f carotid treatment and, 640 MRA and, 89 TAA repair and perioperative in, 569, 569t postoperative in, 569, 569t preoperative in, 569 Renal protection device and stenting, 402–403 Renal PTA complications of, 405–407, 405t endovascular complications and management of, 406 prevention of, 406 perforation of renal artery in, renal PTA and, 406, 406f Renal reconstruction blood pressure significance in, 424 management philosophy of, 423–424 results of, 424, 426t, 427 Renal revascularization as prophylactic repair, 409–412, 412t, 414 complementary, 507, 508f hepatorenal bypass and, 417, 421–422f hydration and, 398–399 mortality rate with surgery for, 412, 412t noninvasive imaging and, 398, 398f percutaneous, 412, 412t preoperative preparation for, 398–403 renovascular hypertension and, 374 splanchnorenal bypass and, 417 splenorenal bypass and, 417, 423f technique for, 398–399 Renal stenting complications of, 405–406, 405t nonatheromatous lesions and, 401 nonbranch lesions and, 401 postprocedure for, 401 renal insufficiency and atheromatous disease and, 404 renal revascularization and, 398 small-platform technique, 400 standard-platform technique, 399f, 400, 400t stent types for, 400, 401t techniques for, 399–403, 399f troubleshooting, 400–401 Renal supply rejection for AAA surgery and, 481 Renal vasculature imaging of, 383–387 MRA and, 385–386, 386f Renal vein mobilization in abdominal aneurysm repair, 551, 554–555f Renal vein renin assays of, 412–413 renin levels of, 382–383 Renal vein thrombosis and cava filter placement, 832, 833f Rendu-Osler-Weber syndrome, 858 Renin inhibitor, 378, 379f Renin release and hypertension, 374–375 Renin–angiotensin system components of, 374, 375f functional studies of, 382–383 glomerular filtration and, 378–379 glomerular perfusion and, 392, 393f physiological studies of, 382–383 Renography (captopril), 384, 384f Renovascular disease See also Renovascular hypertension arteritides as therapy for, 403 complications of, 405–407 endovascular therapy for (Key Points), 397 906 Index Renovascular disease (Continued) glomerular perfusion and renin–angiotensin system and, 392, 393f lipid-lowering therapy and, 394–395, 394t medical therapy for (Key Points), 391 medical treatment aims of, 391, 392t PTA and, 403 renovascular hypertension and, 411 selection of therapy for, 403–405 summary of, 407 target blood pressure for, 393–395, 394t Renovascular hypertension See also Renovascular disease ACE inhibitors and, 378 angiotensin II and, 378 atherosclerotic renal artery stenosis and, 106 description of, 374 essential hypertension and, 379–380 evaluation of, 382–389 evaluation of (Key Points), 373 fibromuscular dysplasia and, 381–382 FMD and, 106 goals of intervention in, 382, 382t individual renal function testing and, 383 management of, 387–389, 388f mechanisms raising, 376–378 MRA and, 385–386 one-kidney vs two-kidney, 375–376, 376f pathophysiology of Key Points, 373 summary of, 387–389 phases of experimental, 376–377, 379f prevalence of, 379–382 RDS and, 412 renal artery imaging and, 384–385, 385f renal function and, 411 renal vasculature imaging and, 383–387, 387f renin–angiotensin system and, 382–383 therapeutic options for, 395 two-kidney vs one-kidney, 375–376, 376f Renovascular imaging and renovascular h ­ ypertension, 383–387 Renovascular intervention and hypertension, 427 Renovisceral occlusive disease, 548–549, 559–560, 561f Reperfusion acute limb ischemia and chemical mediators for, 288 diagnosis of, 281 leukocytes and, 288 management of, 281 microvascular dysfunction after, 287–288 pathophysiology of, 280 preventive strategies and, 288–289 signaling molecules and, 288 summary of, 289 endothelial cells and, 287–288 inflammation and, 288 vascular cells and, 287–288 Repetitive motion injury and neurogenic TOS, 322 Research methodologies of evidence-based medicine, 54-55 Resection arteriovenous malformation and, 857 hepatic artery aneurysm and, 364 Resilient Trial, 166–166t RESIST Trial, 402–403 Respiratory disorder risks with carotid treatment and, 640 Respiratory insufficiency and TAA repair, 569 Restenosis after PTA in iliac occlusive disease, 146 aortoiliac disease and, 140 carotid treatment and, 643 Restenosis (Continued) CMI and, 347 Doppler ultrasound and renovascular h ­ ypertension and, 384–385, 385f femoropopliteal disease and, 140–142 renal stenting and, 400, 401f, 402 popliteal artery intervention and, 170, 170f superficial femoral artery intervention and, 145–147 Restoring force, 42 Retavase, 159 Reteplase, 270 Rethrombosis and venous reflux, 744 Reticular veins definition of, 730, 730t, 752 sclerotherapy and, 752–753 Retractile force within a blood vessel, 45 Retraction TAA repair and self-retaining, 556–558, 559f TOS repair and, 319f, 333 Retroaortic left renal vein and AAA repair, 504, 506f Retroesophageal carotid–carotid bypass, 300, 303f Retrograde femoral artery access, 141 Retrograde graft, Retrograde popliteal artery approach, 137–150 Retrograde transfemoral access to iliac arterial lesions, 141 Retrograde transfemoral approach, 154, 156 Retroperitoneal approach aortic paraanastomotic aneurysm and, 672 aortic paraanastomotic pseudoaneurysm and, 672 Retroperitoneal endoscopic ligation and type II endoleak, 490 Retroperitoneal incision and AAA repair, 498, 499f, 504, 505f, 508 Retroperitoneal tunnel, 181 Retroperitoneal–thoracoabdominal approach, 551–553, 556f Retroperitoneoscopic (RP) videoscopic approach AAA repair and, 541 abdominal aortic surgery and, 533–537, 533f process of, 536–537, 537f Retroperitoneum and graft coverage in AAA repair, 500–501, 503f Revascularization See also Debranching Renal revascularization acute limb ischemia and contraindications for, 287 results of, 269 summary of, 289 AMI and SMA and, 341 amputation and, 231 aortic branch vessel occlusive disease and, 300–301 aortoiliac (Key Points), 176 arteries and complete proximal occlusions and, 299–300 as response to injury, 16 atheromatous disease and endovascular vs surgical, 405 PTA and, 405 risk for kidneys with, 405 selection of therapy for, 403–405 surgical vs endovascular, 405 CMI and outcomes for patients with, 347–348, 347–348t summary of, 348–349 conduit for lower extremity, 224–226 diabetic foot ischemia and, 223 direct transsternal repair and, 299–300 effect of renal failure on lower limb, 194 Revascularization (Continued) femoropopliteal disease and, 161–170 great vessel occlusive disease and, 293–294 in lower extremities, 65 open surgical and infected aortic aneurysm, 716–717 postoperative status of CLLI and, 179 renal failure and, 404, 404f tibial disease and, 143 transsternal, 299–300, 301f Reversible ischemic neurological deficit (RIND), 596 Reynolds criteria, 48 Reynolds number definition of, 51 turbulent blood flow and, 51, 51f Rheumatoid arthritis and Raynaud’s syndrome, 311–312 Rheumatoid vasculitis and rheumatoid arthritis, 311–312 Rib (cervical) and TOS, 320, 320–321f Rich, Norman, Rifampin bonding, 689 Rigid elastic modulus of water molecules, 41 Rigid stump dressing, 236, 236–237f Rivaroxaban, 35 Rob, Charles, 8, 8f Robertson’s giant limb, 867 Role function on generic QOL survey instrument, 60 Rotablator, Rotational atherectomy, 141 RP See Retroperitoneoscopic (RP) videoscopic approach Runoff acute leg ischemia and, 265–266 in infrainguinal bypass, 189–190 isolated popliteal segment and, 189 lower limb bypass graft and, 195 score and arterial system imaging and, 196 Rupture AAA rates of, 496, 497t chylous reflux and, 871–872 early repair of AAA and, 497 femoral aneurysm and, 584 infected arterial aneurysm and, 714–715, 715f infected arterial aneurysm and, 714–716, 715f of celiac artery aneurysm, 366 of gastric artery aneurysm, 367 of gastroepiploic artery aneurysm, 367 of hepatic artery aneurysm, 362–364 of splanchnic artery aneurysm, 358 of splenic artery aneurysm, 359–362 of superior mesenteric artery aneurysm, 365 prosthetic vascular graft and, 673 risk of in TAA, 546–548, 547f, 548t subclavian–axillary aneurysm and, 588 TAA and SCI and, 570–571 type B aortic dissection and, 522 Ruptured AAA repair technique, 501, 504f Rutherford classification, 138 Rutosides, 750–751 S Saccular aneurysm, 365 Saccular dilations, 739 Saddle embolus, 142 Salmonella infected aortic aneurysm and, 716–717 infected arterial aneurysm and, 715 Saphenofemoral junction, 772–773, 773f Saphenopopliteal bypass and deep venous obstruction, 800 Index Saphenous vein aortorenal bypass and, 415 cryopreserved, 681 endovenous thermal ablation of, 757–761 infrainguinal bypass and nonreversed and, 204, 206f reversed, 204, 205f, 206f nonreversed and infrainguinal bypass, 204, 206f reflux ablation, 757 reversed autogenous vein bypass and, 198 infrainguinal bypass and, 204, 205f, 206f stripping and, 765 transposition and deep venous obstruction, 800–801, 801f venous anatomy and, 731 Saphenous vein graft carotid–subclavian bypass and, 668 femoropopliteal, 667 infrainguinal, 667 Sartorius muscle flaps, 707 Sartorius myoplasty, 698–699, 699f Scalene block in TOS, 326 Scalene muscles and neurogenic TOS, 329 Scalenus anticus syndrome, 318–319 Scan acquisition with MDCTA, 81–83 with peripheral CTA, 81–83 Scan parameters for MDCTA, 83, 83t Scan protocol for computed tomography, 81, 81t MDCTA and, 81, 81t Schillinger SFA stent trial, 166, 166t Scintigraphy and captopril renography, 384 Scleroderma, 311 Sclerosing agents, 752, 779–780 Sclerotherapy branch varicosities and, 763 clinical results of, 792–793 complications of, 753–754 contraindications of, 753–754 duplex-guided, 753 foam as treatment for varicose veins, 779–781 conclusions regarding, 768 great saphenous vein and, 761–762 incompetent perforator veins and, 789–790 long-term results of, 768 major complications of, 765 outcomes of, 780–781 results following, 753 short-term results of, 765 surgical procedure for, 780, 780f venous malformation and, 850 introduction to, 752–753 lymphatic malformation and, 853–854 results of, 753 reticular veins and, 752–753 small veins and, 752–753, 752–753f thread veins and, 752–753 varicose veins and, 750–753 venous malformation and, 849–851, 852f Screening program criteria for AAA for Scrotal edema, 870–871, 872f Sealant grafts, 666 Sealing zone rejection for AAA repair, 481 Secondary chronic venous disease, 744–745 Secondary endoleak, 489 Secondary infected arterial aneurysm, 715 Secondary lymphedema classifications, 864 Secondary MVT, conditions associated with, 352, 353t Secondary Raynaud’s phenomenon, 589–590 Secondary study definition of, 31, 31t design of, 56 Secondary venous disorders defined, 730 Sedation and DSA, 79 Seeley, S F., 4-5 Segmental limb pressures, 67–68 Segmental thermal ablation and varicose veins, 778 Seldinger technique, 74–75, 74f, 154–155, 776–777, 777f Seldinger, Sven Ivan, 74–75 Seldinger, Sven-Ivan, Self-expandable endoprosthesis, 146 Self-expanding stent aortoiliac disease and, 140, 143 femoropopliteal disease and, 141 iliac arterial disease and, 149 iliac artery and, 147, 145f Self-induced lymphedema, 865, 866f Semms-Weinstein monofilament, 217, 217f Sensation loss in foot neuropathy, 217, 217f Sensory neuropathy and diabetes, 216 SEPS See Subfascial endoscopic perforator vein surgery (SEPS) Sepsis in ischemic leg, 231 Seroma formation in aneurysm sac, 46, 47f muscle flaps and, 708 Serratus anterior atrophy, 323–324 Serum cholesterol and statins, 125–126 Serum homocysteine as risk factor for ARVD, 395 Severe digital ischemia prognosis for, 316 treatment for, 315 Severe intrarenal disease, 398–399, 399f Severe whole limb lymphedema, 869–870 Sex-based medicine, 16–17 SF-36 See Short form–36 SFA nitionol stent, 166, 166t Shaded surface display and MRA, 91–93 Shaw, Robert, Shear stress blood vessel luminal diameter and, 51 dangers of, 51 definition of, 50–51, 51f endothelial cells and, 14–15, 15f, 51 Sheath in infrainguinal arterial disease, 137–150 Sheet-based tissue engineering, 682 Short form–36 claudication and, 60, 61f Medical Outcomes Study and, 60, 61f Short segment extraanatomical bypass carotid–subclavian, 300, 302f results for, 301–302, 305t Shunting aortoinnominate bypass and, 299–300, 300f CEA and, 614–615, 616f inline mesenteric and TAA repair, 550–551, 552f, 556 Shuttle catheter in carotid angioplasty, 637, 637f Sidearm graft axillofemoral bypass and, 185–186f femoral aneurysm and, 584–585, 585f TAA repair and, 560–561, 561f Side-branch extension graft renovisceral vessels, 566–567, 567f Signaling molecules and reperfusion, 288 Silastic balloon, 10 SilverHawk plaque excision system, 163–164, 165f Simeone, Fiorindo, SimpliRED (whole-blood agglutination testing) , 816 907 Simpson atherectomy catheter, 141, 148 Simvastatin, 126 Single balloon technique, 143 Single port technique, 789 Single stent technique, 143 Sinography, 691t, 694 Sinus tachycardia and acute pulmonary e ­ mbolism, 823 Sistrunk operation, 870 Sjögren’s syndrome, 312 Skew flap and transtibial amputation, 233–235, 235f Skin interventional radiology and, 110–112, 112t necrosis and oral anticoagulant therapy, 822 Skin flap necrosis and lymphedema surgery, 870 Skin substitute in varicose veins, 750 SLE See Systemic lupus erythematosus (SLE) Slow-flow vascular malformation and associated syndromes SMA See Superior mesenteric artery (SMA), 857 Small artery occlusive disease (Key Points), 309 Small saphenous vein high ligation and stripping, 757 Small vessel disease and amputation, 230 Small-platform renal angioplasty, 399 Small-platform renal stenting technique, 400 Smoking AAA and, 465, 475f, 476 as risk factor for ARVD, 395 as risk factor for chronic lower-extremity ischemia, 122 chronic lower-extremity ischemia and, 128, 129f CMI and, 342 effect of CLLI on treatment for, 194 TAA repair and, 569 Smooth muscle cell depletion of, 468 gene expression changes, 15 replication of, 15 Snuffbox fistula See Autogenous radial–cephalic direct wrist access Soft-tissue anomaly and TOS, 320–321, 321f, 321t Soft-tissue edema and phlegmasia cerulea dolens, 834 Soft-tissue vascular malformations (Key Points), 842 Somatosensory evoked potentials (SSEP), 326, 327f Sonography and pregnancy, 834 Sorbitol and diabetic neuropathy, 215–216 SOS Omni catheter, 398–399, 399f Southern Association for Vascular Surgery, 6, 6f Spencer, Frank, 4, 4f Spider filter, 635, 635f, 639f Spinal compression of vertebral artery, 649–650 Spinal cord ischemia (SCI) TAA repair and, 568t, 570–572 TEVAR and, 564 Spiral computed tomography and deep vein thrombosis, 818 Spiral computed tomography angiography (CTA) AAA and, 482–483, 483–484f as diagnostic vascular imaging, 79–86 Spiral thoracoabdominal incision, Splanchnic artery aneurysm See also Splenic artery; Hepatic artery Superior mesenteric artery; Celiac artery; Gastric artery; Gastroepiploic artery endovascular interventions for, 358 incidence of, 358–359, 359t Key Points, 358 908 Index Splanchnic artery aneurysm (Continued) overview of, 358 rupture and, 358 summary of, 368 therapy for, 358 Splanchnorenal bypass, 417 Spleen and splenic artery aneurysm, 361–362 Splenic arteriovenous fistulae, 360 Splenic artery aneurysm, 359–362 Splenorenal bypass, 417, 423f Spontaneous hemorrhage and thrombolysis, 819 Square toes and lymphedema, 867 SSEP, 326, 327f St Thomas’ Trial, 125 Stab avulsion of varicosities, 762–763, 764f perforator vein interruption and, 789 varicose vein stripping and, 757, 775–776 Staged CEA CABG, 611–612, 612t Standard aortobifemoral bypass, 186 Standard-platform renal angioplasty, 398–399 Standard-platform renal stenting technique, 399f, 400, 400t Stanford classification of aortic dissection, 517, 519f Stanford aortic dissection type A, 98, 99f type B, 98, 99f Staphylococcus and infected aortic aneurysms, 716–717 Staphylococcus aureus infected arterial aneurysm and, 715, 719–722 prosthetic graft infection and, 689–690 Staphylococcus epidermidis and prosthetic graft infection, 689–690 STAR trial, 397–398 Stasis (venous) and thrombosis, 809, 809f Static obstruction and malperfusion syndrome, 521 Statins chronic lower-extremity ischemia and, 125–126 definition of, 125, 126f, 126t renovascular disease and, 395 Stellate ganglion, 320 Stemmer’s sign, 603, 867 Stenosis See also specific types anastomotic and human umbilical vein graft, 680 bilateral carotid, 298–299, 299f bilateral renal artery repair and, 413 carotid CEA benefit for, 610–611 detection of, 100t, 104–105, 106–107f neurological event risk and degree of, 596–598 overlying thrombus and, 609–610, 609f radiation and, 625 carotid artery measurement criteria, 104, 106f carotid disease and contrast angiography of, 602–603 duplex ultrasound and, 599–600, 599f, 600t MRA and, 595, 599–604, 599–601f, 601 CEA patient selection and, 608–609 classification of, 71, 71t CO2 angiogram and, 77 critical defined, 49–50 distal anastomotic, 670, 670f Doppler analog waveform analysis and, 69 endovascular treatment of common carotid, 301, 304, 306t of innominate, 301, 304, 306t of severe carotid, 630 Stenosis (Continued) femoropopliteal disease and, 161 hemodynamic significance of, 50, 50f hemodynamically significant, 95–96 iliac artery internal, 146 treatment of, 145–146 ischemia and intermittent claudication and, 119–120, 120f IVUS and, 73–116, 92f MRA and, 73–116, 92f multiple distal arterial, 391, 392f postirradiation and PTA, 305 prosthetic vascular graft and, 670 PTA and focal bifurcational aortic, 142 radiation-induced, 295 renal artery consequences of, 374, 375f manifestations of, 379–382 renovascular hypertension and degrees of, 379–382, 379f stent placement for aortic, 144 subclavian artery and, 301, 304, 306t superior mesenteric artery and, 343–344, 343f thrombosis and AV access and venous, 449, 450f, 452f time-of-flight MRA and, 88 turbulent blood flow and, 51–52 vascular occlusive disease and, 96, 96f vein grafts and, 207–208, 207–209f visceral arteries and, 342 Stenotic iliac lesion stent placement, 144–145, 145f Stent See also specific types atheromatous disease and angioplasty and, 405 surgery and, 405 carotid angioplasty and, 631–633, 632–633f endovascular, 140 endovascular intervention and, 226 femoropopliteal disease and balloon-expandable, 166 bare metal, 166–167 covered, 168–169 drug-eluting, 168 fracture of, 166, 167f grafts and, 168–169, 169f self-expanding, 166 trials of SFA nitionol and, 166, 166t iliac arterial disease and, 150 implantation of aortoiliac disease and, 148–150 iliac artery and, 147–148 insertion of, 143 intraoperative angioplasty and, 300, 304f intravascular, 451 metallic, 146 occlusion of, 148 percutaneous, 365 placement of iliac, 148–149 stenotic iliac lesions and, 144–145, 145f postirradiation stenosis and, 305 renal available types of, 400, 401t complications of, 405–406, 405t nonatheromatous lesions and, 401 nonbranch lesions and, 401 postprocedure for, 401 renal revascularization and, 398 techniques for, 399–403, 399f troubleshooting, 400–401 SMA and, 343 tibial, 172 TOS and, 331 Stent for the Treatment of SFA Disease (SIROCCO) trial, 168 Stent graft aortic dissection and, 523–525, 527, 528 aortoiliac disease and, 140–141 attachment systems for, 484–485 branched, 492 celiac artery aneurysm and repair of, 367, 367f characteristics of ideal, 484, 484t design of, 485 endoluminal popliteal aneurysm and, 582 infected aortic aneurysm and, 717–718, 717f endotension and, 490 endovascular available commercial, 484, 485t endoleaks and, 489–490 EVAR and complications in, 488 deployment-related complications and, 487–488 failure of in, 490 insertion of in, 486–487, 487f selection for, 484–485 fenestrated, 492 fixation types for, 485 hepatic artery aneurysm and, 364 infection in, 490 limb thrombosis and, 490 limitations of commercial, 492 materials for, 484 selection for AAA, 484–485 type I endoleak and, 489 type III endoleak and, 489 type IV endoleak and, 489 uncomplicated type B aortic dissection and, 530 dissections and, 529–530 Stent reobstruction iliac arterial disease and complications of, 150 results for, 149 technical considerations for, 148 Stenting carotid anesthesia and, 636 medication and, 636 monitoring and, 636 operating room setup for, 635–636, 635f patient choice and, 640, 641f summary of, 645 training in, 645 carotid disease and, 642–645, 642t carotid treatment and high-risk patients and, 643 in CMI, 348 routine, 638–639 severe carotid disease and, 630–631 techniques of, 638, 640f Stenting and Angioplasty with Protection in Patients at High Risk for Endarterectomy (SAPPHIRE) Trial, 642–643 Stent-Supported Percutaneous Angioplasty of the Carotid Artery versus Endarterectomy (SPACE) Trial, 642–643 Stepped PTFE graft, 440 Stepped tip dialysis catheter, 446, 447t Stepping table DSA, 78 Stewart-Treves syndrome, 867, 867f Sticky platelet syndrome, 252 Stochastic radiation risk, 112–113 Stoney, Ronald, Storage pool disorder, 34 Strecker stent, 149 Index Streptococcus and infrapopliteal infected arterial aneurysm, 722–723 Streptokinase, 270, 819 Stress positioning and neurogenic TOS, 322–323 String sign contrast angiography and, 602–603 Stroke aortic arch disease and, 611 atherosclerosis of carotid artery and, 606 CABG and, 611 carotid disease and, 596, 630 causes of, 8–9 CEA and evolution of, 609f, 610 intraoperative, 617, 619–620 management of operation-related, 622–623 patient selection and, 609, 609f postoperative, 617 prevention of, 623 risk reduction of, 609–610, 610f risks of, 607, 608t, 609–610 definition of, 596 endovascular therapy and, 641–642 expedited CEA and, 610 hyperperfusion and carotid surgery, 622 imaging tools for, 604 intraarterial thrombolysis and, 274 ischemic and population subgroups, 56-57 operative, 622 prevention of, 612 Reverse-staged (CABG-CEA) procedures and, 611–612 TAA and, 548–549 TEVAR and, 564 vertebrobasilar hemodynamic vertebrobasilar insufficiency and, 652 mortality rates and, 651 Stryker needle, 282, 282f Study See also Clinical research method; specific study type identifying best, 57, 58t Study of Infections in Diabetic Feet Comparing Efficacy, Safety, and Tolerability of Ertapenem versus Piperacillin–Tazobactam, 220 Study of Thoracic Aortic Aneurysm Repair with the Zenith TX2 TAA Endovascular Graft (STARZ) trial, 565 Stump pain, 236 Sturge-Weber syndrome, 857 Subclavian artery aneurysm in, 586–587 See also Proximal s ­ ubclavian artery aneurysm; Subclavian–axillary aneurysm; Aberrant subclavian artery aneurysm atherosclerotic lesions of, 648–649 cervical rib and TOS and, 320 compression of cervical ribs and, 318, 587, 587f TOS and, 323 infected arterial aneurysm and, 718 stenosis of, 301, 304, 306t thoracic outlet and, 319–320, 319f Subclavian artery disease, 298 Subclavian steal syndrome, 295–296 Subclavian vein and thoracic outlet, 319–320, 319f Subclavian–axillary aneurysm causes of, 587, 587f description of, 587 diagnosis of, 588 management of, 588 outcome of surgery for, 588–589 signs of, 587–588 symptoms of, 587–588 Subclavian–carotid transposition, 301–302, 305t Subclinical limb ischemia, 121 Subcritical ischemia, 121 Subcutaneous injection of low-molecular-weight heparin, 821–822 Subfascial endoscopic perforator vein surgery (SEPS) clinical results of, 790-793, 792t perforator ligation and, 788 techniques of, 789, 790f Subintimal angioplasty and long-segment SFA, 137–150 Subintimal traversal technique, 157–158f, 161 Superficial femoral artery aneurysm in, 583–584 summary of intervention for, 170, 170f Superficial reflux ablation complications of, 765 long-term results of, 766–768 short-term results of, 763–765 Superficial thrombophlebitis and thromboembolic disease, 812 Superficial veins anatomy of, 731, 732f location of, 772 Superficial venous anatomy, 437, 438f Superior mesenteric artery (SMA) acute thrombosis of, 339 aneurysm in, 364–365 blood flow within, 340–341 CMI and brachial approach with, 343, 344f reconstruction of, 344–345, 345f short retrograde graft and, 345, 346f treatment for, 343 embolic occlusion of, 340 reconstruction of, 349 stenosis in, 343–344, 343–344f Superior mesenteric vein thrombectomy, 354–355 Supraaortic artery and vascular imaging, 104–105 Supraclavicular approach, 588 Supraclavicular scalenectomy, 330, 330f Suprarenal aortic aneurysm Key Points, 543 operative management of, 551–555 Surface hypothermia and ex vivo reconstruction, 419 Surface morphology and duplex ultrasound, 599f, 600 Surface reconstruction as postprocessing MRA technique, 91–93 Surgery abdominal aneurysm and aortic clamping for, 553–555 considerations for, 551 retroperitoneal–thoracoabdominal approach for, 551–553, 556f transperitoneal approach with medial v ­ isceral rotation for, 551, 554–555f transperitoneal approach with supraceliac clamping for, 551, 553–554f abdominal aortic TPD and, 540–541, 540f TPRC and, 540–541, 540f acute leg ischemia and, 264, 264t acute type B aortic dissection and, 522 AMI and, 340 amputational, 232–233 aortic dissection and, 520–521 as risk factor for deep vein thrombosis, 812, 812t as risk factor for pulmonary embolism, 812, 812t 909 Surgery (Continued) as risk factor for venous thromboembolic disease, 812, 812t atheromatous disease and, 405 atherosclerotic renal artery disease and m ­ ortality and, 422–423 atherosclerotic renal artery repair and blood pressure response to, 423, 425f, 425t blood pressure significance in, 423 renal function response to, 423, 426t renal function significance in, 423, 426f results of, 421–423 summary of, 422, 424t bypass, 162 cardiac, 253 carotid complications of, 622–624 selection of patients for, 608–612 carotid artery, 620–622 carotid disease and benefits of, 599 evidence for, 642–645, 642t Key Points, 606 risks of, 640 summary of, 645 carotid treatment of high-risk patients and, 643 case report for, 55 CEA and, 613 celiac artery aneurysm and, 366 chronic type B aortic dissection and aneurysms and, 523 technique tips for, 523, 524f chronic venous insufficiency and, 783–784, 786–803 CLLI and factors affecting outcome of, 193–194 operative techniques for, 200–204 quality of life after, 193 CMI and, 344–345 conditions for atherosclerotic renovascular disease, 409 considerations before peripheral vascular disease, 195 deep venous obstruction and, 800–803 extensive TAA and, 552f, 555–561 femoral aneurysm repair and, 584–585 for AIOD, 179 for AIOD (Key Points), 176 for atherosclerotic renal artery disease, 414 great saphenous vein stripping technique, 775–776 infrarenal AAA and See Abdominal aortic aneurysm (AAA), open repair of infrarenal laparoscopic abdominal aortic See Abdominal aortic surgery, laparoscopic lesion classification for, 139 lower extremity arterial occlusive disease and, 138 lymphatic malformation and, 854 natural history of carotid disease and, 598–599 neurogenic TOS and, 328–329, 329f, 333 objective of acute MVT, 354 outflow bypass procedures and, 226 Paget-Schroetter syndrome and, 331 patch infection treatment and, 623–624 popliteal aneurysm and, 581–583 PTA and renovascular disease and, 406 renal revascularization and, 398–403 severe whole limb lymphedema and, 869–870 splenic artery aneurysm and, 359–362 strategy for CLLI and, 176–191 subclavian–axillary aneurysm and, 588 superior mesenteric artery aneurysm and, 365 910 Index Surgery (Continued) TAA and complications and, 567–573, 568t operative characteristics of, 560–561, 562t overview of, 544 process of, 549–561 results and, 567–573, 568t SCI and, 571 selection for treatment of, 547–549 thrombolytic therapy and, 274–276, 275f thrombosed AV access and, 450, 452f varicose veins and, 751, 756–763, 773–775, 774f, 774t vascular See Vascular surgery vs medical therapy for renal artery disease, 413 vs percutaneous treatment of thrombosed AV access, 451 Surgery or Thrombolysis for the Ischemic Lower Extremity (STILE) trial analysis of thrombolysis versus surgery in, 264, 275f, 276 comparison of urokinase and r-tPA in, 271 Surgical block dissection and lymphedema, 865 Surgical outcome communications, 55 Surgical resection and venous malformation, 851 Surgical revascularization for great vessel occlusive disease, 293–294 for renovascular disease, 407 Surgical thrombectomy, 820–821, 820f Surgical wound complications in EVAR, 488, 488t prosthetic graft infection and debridement of, 709 exploration of, 709 Survey instruments disease-specific, 61 for leg ischemia, 61, 61t for lower extremity arterial occlusive disease, 61, 61t generic quality-of-life, 60-61, 60t limitations of non-disease-specific QOL, 60-61 Suture line failure in prosthetic vascular graft, 674 Sutureless anastomoses, 674 Sweden embolic disease in, 249, 249f incidence of acute leg ischemia in, 248, 248f Syme’s amputation, 232 Sympathetic adrenergic neurotransmission, 12–13, 13f Symptomatic carotid artery disease natural history of, 598–599 velocity criteria and patient selection, 600 Synchronous CEA CABG, 611–612, 612t Syncope and aortic dissection, 519 Syndactilization and femoral aneurysm, 584–585 Synthetic graft beginnings of, Dacron as, Syphilis (cardiovascular), 718 Systemic arterial fibrodysplasia, 359 Systemic drug therapy for varicose veins, 751 Systemic lupus erythematosus antiphospholipid antibodies and pulmonary embolism and, 812–813 venous thromboembolic disease and, 812–813 Raynaud’s syndrome and, 311 Systemic pressure waveform in aneurysm sac, 46, 47f Systemic–pulmonary artery shunt and ePTFE grafts, 668 Systolic amplification, 39–52 T TAA See Thoracoabdominal aortic aneurysm (TAA) Takayasu’s arteritis acute leg ischemia and, 253–254 aneurysms and, 546 arch aortography and, 296–297, 297f ASO and, 295 classification of, 624–625, 624t description of typical patient with, 295 discussion of, 624 distribution of disease in, 294, 294t endovascular treatment for, 304 etiology of, 294 in great vessel occlusive disease, 294–295 infected arterial aneurysm and, 718 pathophysiology of, 295 renovascular disease and, 403 renovascular hypertension and, 381–382 summary of, 306 vertebral artery and, 649 Tapered PTFE graft, 440 TASC II report (2007), 248 T-bar phenomenon in splenic artery aneurysms, 361–362 TCD See Transcranial Doppler (TCD) TEE See Transesophageal echocardiography Telangiectasias definition of, 730, 730t, 752 hereditary hemorrhagic, 843 heredity and, 743 pregnancy and, 743 Temporal arteritis, 649 Temporary vascular shunt, Tenecteplase (TNK-tPA), 270 Tensile strength defined, 43–44, 44f Testing atherosclerotic renal artery disease and, 412 diabetic foot ischemia and noninvasive, 224 Testosterone and vascular biology, 16–17 TF See Tissue factor (TF) Th0 cytokine response, 467–468 Th1 cytokine response, 467–468 Th2 cytokine response, 467–468 Therapeutic intervention, value of, 58-59 Therapy See also specific types ARVD and, 395 endovascular aortic branch vessel occlusive disease and, 300 for claudication, 140 for great vessel occlusive disease, 293–294 nonoperative and TAA, 549 thrombolytic evidence for in acute limb ischemia, 274–276 femoropopliteal disease and, 162, 164f Thienopyridine, 130 Thigh perforating veins, 732 Thompson, Jesse, Thompson’s reduction, 870 Thoracic aneurysm See Thoracoabdominal aortic aneurysm (TAA) Thoracic aorta and vascular imaging, 97–103 Thoracic aortic aneurysm with abdominal a ­ neurysm, 101–102, 102f Thoracic aortic false lumen, 520 Thoracic aortic stent grafting See Thoracic endovascular aneurysm repair (TEVAR) Thoracic duct and TOS repair, 320 Thoracic endovascular aneurysm repair (TEVAR) device trials for, 564–565 infrarenal aortic aneurysm and, 561–567 procedural aspects of, 562–564 Thoracic lymphatic malformation, 853 Thoracic outlet anatomy, 319–320 Thoracic outlet syndrome (TOS) See also Neurogenic TOS; Arterial TOS; PagetSchroetter syndrome arterial complications in, 323 complications of treatment for, 332–333 diagnosis of, 323–328 history of, 318–319 Key Points, 318 neurogenic presentation of, 322–323 summary of, 334 trauma and, 322 treatment of, 328–330, 329f objective testing for, 325–328 overview of, 318 pathophysiology of, 320–322 patient history of, 323–325 physical examination for, 323–325 presentation of, 322–323 prognosis for patients with, 333–334 recurrent, 332 Thoracic sympathectomy, 315 Thoracoabdominal aortic aneurysm (TAA) AAA and, 543 aortic dissection and, 543–546 CE-MRA for diagnosis of, 91 classification of, 544, 545f etiology of, 544–546 gender and, 543–544 history of imaging and, 549 Key Points, 543 natural history of, 546–547 operative characteristics of repair of, 560–561, 562t operative management of, 549–561 prognosis for, 547, 548t selection for treatment of, 547–549 surgery for, 544 surgical complications and, 567–573, 568t surgical results and, 567–573, 568t symptoms of, 548 TEVAR and, 562–565 Thoracoabdominal exposure in TAA repair, 556–558, 559f Thoracoabdominal incision (spiral), Thoracoretroperitoneal incision in AAA repair, 498–499, 499f, 504, 508 Thoracoscopic first-rib resection, 330 Thread veins and sclerotherapy, 752–753 Threatened leg (category II) acute leg ischemia and, 246, 246f, 263, 263f, 281 angiography for, 247 Three P’s of acute leg ischemia clinical e ­ xamination, 244–245 3D contrast-enhanced magnetic resonance a ­ ngiography (CE-MRA) data sets for evaluation of, 93 multiple views of, 93, 94f introduction to, 89 synchronization of contrast injection and a ­ cquisition in, 91 3D half-Fourier fast spin-echo MRA, 88 Three-dimensional (3D) rotational angiography, 78 3D time-resolved imaging of contrast kinetics (TRICKS), 91 Threshold dose of radiation, 110–112, 113f Thrill, 51–52 Index Thrombectomy AV access and surgical, 450, 452f comparison of types of, 820 deep vein thrombosis and, 820–821 percutaneous mechanical, 273, 820 reversed vein graft and, 209, 210f superior mesenteric vein and, 354–355 surgical, 820–821, 820f Thrombectomy devices and AV access, 450–451, 452f Thrombin action of, 22 inhibition of, 23 inhibitors deep vein thrombosis and, 822 direct, 35 platelet plug and, 22, 23f Thromboangiitis obliterans See Buerger’s disease Thrombocytopenia heparin-induced, 252, 821 low-molecular-weight heparin and, 822 Thrombocytosis, 652 Thromboembolectomy AMI and, 340–341, 340–341f aortoiliac and AIOD, 179–180 catheter for, Thromboembolic disease and e ­ lectrocardiography, 823 Thromboembolic event, 244 Thromboembolic vertebrobasilar insufficiency, 650–651, 653 Thromboembolism adjuvant therapy for, 231–232 CEA and, 617f, 619–620, 619f subclavian artery aneurysm and, 587 vertebrobasilar insufficiency and, 650–651 atherosclerotic renal artery disease and, 416–417, 418–420f for chronic intestinal ischemia, infrainguinal bypass and, 200–201, 202f Thrombogenesis, 808–811 Thrombolysis See also specific types acute limb ischemia and, 264 acute massive pulmonary embolism and, 829, 830f AMI and, 340 catheter-directed thrombolysis, 820 clot formation and, 24 contraindications to, 819 deep vein thrombosis and, 819–820 intraarterial See Intraarterial thrombolysis intraoperative, 266, 266–267f intravenous, 819–820 percutaneous, 231 popliteal aneurysm and, 581f, 582–583, 583t preoperative, 588 surgery and, 274–276, 275f Thrombolysis or Peripheral Arterial Surgery (TOPAS) Trial, 255–256, 264 Thrombolysis-resistant thrombus, 331 Thrombolytic agent acute limb ischemia and, 269–271, 269t AV access and infusion of, 450, 452f properties of, 269, 270t Thrombolytic therapy acute MVT and, 355, 355f evidence for, 274–276 for femoropopliteal disease, 162, 164f Thrombolytics, 24–25, 25f Thrombophilia acute leg ischemia and, 252 inherited clinical features of, 813 deep vein thrombosis and, 815 Thrombophilia (Continued) epidemiology of, 813, 813t investigation for suspected, 814 venous thromboembolic disease and, 813–814, 813t mechanisms of thrombosis in, 813–814, 814–815f screening for, 247–248 Thrombophilic disorder, 352 Thrombosed AV access, 449–451, 452f Thrombosed carotid artery, 621 Thrombosed popliteal aneurysm, 263, 264f Thrombosis See also specific types activation and acceleration of, 22 acute arm ischemia and, 257 acute lower extremity arterial and ischemia, 250–252 acute nontraumatic arm ischemia and, 257 adjuvant therapy for, 231–232 after treatment for aortoiliac disease, 144 amputation and deep vein, 232 aortic dissection and false lumen, 521 aortic dissection and, 519–520 arterial vs venous, 27–28 arterial, 27–28, 28f bovine heterografts and, 681–682 conclusions regarding, 35 defects with high risk for, 29–31 defects with lower risk for, 31–32 defects with variable risk for, 32 early prosthetic graft limb prevention, 669 elements required for initiation of, 27–28 endoleak sealing and, 489–490 femoral aneurysm and, 584 femoropopliteal disease and, 161, 161f, 162, 164f formation of mesenteric, 354, 354f hemodialysis and, 449–451, 452f human umbilical vein graft and, 680 hypercoagulable states and venous, 252 inflammation and, 21–22, 26–27, 27f Key Points, 21 local inflammatory response to, 26–28, 27f management of graft, 208 normal, 21 percutaneous treatment of acute, 146–147 popliteal aneurysm and, 580, 582 postreconstruction with prosthetic graft and, 669 postthrombotic syndrome and, 744 prevention of postoperative carotid, 623 prosthetic graft as acute complication, 668–669, 669f as chronic complication, 670, 670f secondary chronic venous disease and, 744 subclavian–axillary aneurysm and, 588 symptomatic prosthetic graft limb and, 670 tests of, 28–29, 29t venous vs arterial, 27–28 vs embolism life expectancy of patient with, 254 lower limb prognosis with, 255 Thrombotic disease changing patterns of, 249, 249f timing of presentation of, 249–250 Thrombus evolution of venous, 744 laminated within an aneurysm sac, 47 organization of, 809–810, 810f percutaneous disruption of, 450–451, 452f rejection for mural in AAA repair, 481 surgical thrombectomy and clearance of, 821 Through-knee amputation selection of level of, 232 techniques of, 235 911 Tibial artery aneurysm in, 586, 586f infrainguinal bypass and anterior, 201, 202–203f posterior, 201, 202–203f interventions for, 170–172 lesion assessment of, 153–154f Tibial bypass and prosthetic vascular graft, 667 Tibial disease See also Infrainguinal arterial disease anatomical principles of, 171 assessment of, 171 classification for SFA and, 170, 171f incidence of, 170 patient selection for intervention for, 170–171 treatment for, 170f, 171–173 Tibial embolectomy, 267 Tibial intervention arterial occlusive disease and (Key Points), 151 for lower extremity arterial occlusive disease (Key Points), 192 Tibial lesion and balloon angioplasty, 225f, 226 Tibial stent, 172 Tibial transection, 234 Ticlopidine chronic lower-extremity ischemia and, 130–131 infrainguinal arterial disease and, 157 Timed Morley and Eden studies, 324 Time-of-flight MRA description of, 88 for specific vascular areas, 91 technology, 600–602 Tirofiban hydrochloride, 157–158 Tissue damage with coagulation initiation, 22–23 Tissue engineered grafts, 682 Tissue factor (TF), 22–23, 23f Tissue factor pathway inhibitor, 23 Tissue plasminogen activators (tPA) acute limb ischemia and, 270 infrainguinal arterial disease and, 159 Tissue preservation techniques in prosthetic graft infection, 696 Tissue-transfer techniques in prosthetic graft infection, 696 TNF See Tumor necrosis factor (TNF) Toe amputation, 232 Top of the basilar syndrome, 650 TOPAS Trial, 275t, 276 Topoismerase I antibody (anti-Scl-70), 311 TOS See Thoracic outlet syndrome (TOS) Tourniquet and infrainguinal bypass, 200 TPD See Transperitoneal direct (TPD) videoscopic approach TPRC See Transperitoneal retrocolic (TPRC) videoscopic approach TPRR See Transperitoneal retrorenal (TPRR) videoscopic approach Traditional endarterectomy, 615, 616–617f Transaortic endarterectomy, 8, 416–417, 419–420f Trans-Atlantic Inter-Society Consensus (TASC I and II) documents, 152, 152–153f Trans-Atlantic Inter-Society Consensus (TASC) Working Group, 59–60, 178–179, 226 Transaxillary first-rib resection complications of, 332–333 neurogenic TOS and, 329–330, 330f prognosis for, patients after, 333–334 supraclavicular scalenectomy and, 330 TOS and, 319 TOS-related arterial disease and, 331 Transbrachial access to iliac arterial lesions, 141 Transcapillary pressure and glomerular filtration, 379 912 Index Transcranial Doppler (TCD) carotid disease and, 600 CEA and as monitoring technique, 617, 619 thrombosed carotid artery and, 621 Transcutaneous oxygen measurement and amputation healing, 233 Transesophageal echocardiography (TEE) and aortic dissection, 519 Transfemoral access to iliac arterial lesions, 141 Transfemoral amputation selection of level of, 232 techniques of, 233 through-knee amputation and, 235 Transfer functions in MDCTA, 84–85, 85f Transient ischemic attack (TIA), 596 Transient myocardial ischemia presentation, 250 Transluminal Extraction Catheter (TEC), 164 Transmetatarsal amputation selection of level of, 232 techniques of, 235–236 Transmural pressure gradient, 41–44 Transperitoneal approach with medial visceral rotation, 551, 554–555f with supraceliac clamping, 551, 553–554f Transperitoneal direct (TPD) videoscopic approach AAA repair and, 540–541, 540f abdominal aortic surgery and, 533–537, 533f preparation for, 534–536 process of, 536, 536f Transperitoneal retrocolic (TPRC) videoscopic approach AAA repair and, 540–541, 540f abdominal aortic surgery and, 533–537, 533f preparation for, 534–536 process of, 534–535, 535f, 540f Transperitoneal retrorenal (TPRR) videoscopic approach AAA repair and, 537–541, 538–539f abdominal aortic surgery and, 533–537, 533f preparation for, 534–536 process of, 535–536, 535–536f Transposition AV access techniques for, 438–439, 440f types of, 437 general considerations for, 437–438 Transrenal endarterectomy, 416–417, 418f Transsternal revascularization, 299–300, 301f Transsternal surgical repair, 301–302, 305t Transthoracic echocardiography (TTE), 247–248 Transthoracic repair of aortic branch vessel occlusive disease, 302 Transtibial amputation selection of level of, 232–233 techniques of, 233–235 Trauma acute nontraumatic arm ischemia and, 257 amputation and, 231 carotid artery and, 628 celiac artery aneurysm and, 366 chronic splenic artery aneurysm and, 359 civilian acute leg ischemia and, 253 acute nontraumatic arm ischemia and, 257 coagulation in, 22–23 hepatic artery aneurysm and, 362 iatrogenic, 253 military acute leg ischemia and, 253 acute nontraumatic arm ischemia and, 257 neurogenic TOS and, 322–323 Paget-Schroetter syndrome and, 323 prognosis for TOS and, 334 secondary lymphedema and, 865 vertebral artery and, 649 Treatment response observational studies and, 58 population subgroups and, 57 randomized clinical trials and, 57–58 Trendelenburg test, 735–736 Trial See specific name TRICKS See 3D time-resolved imaging of c ­ ontrast kinetics (TRICKS) Trousseau syndrome, 257 TrueFISP See Balanced steady-state free p ­ recession MRA Tube graft implantation, 537–539, 538–539f Tumescent anesthesia and radiofrequency a ­ blation and, 759, 776, 776f Tumor embolus and thromboembolectomy, 179 Tumor necrosis factor (TNF) and thrombosis, 26 Tuohy-Borst adaptor, 401 Turbulent blood flow, 51–52, 51f Turner syndrome, 843, 863 2D time-resolved test bolus, 91 256-slice CT scanner, 80 Two-port technique, 789, 790f U U.K Prospective Diabetes Study 3867, 127 U.K Small Aneurysm Trial (UKSAT), 496–497, 498t UCTD See Undifferentiated connective tissue disease (UCTD) Ulcer aortic dissection and penetrating a ­ theromatous, 520, 520f perforator vein interruption and recurrence rate, 789–791 venous See Venous ulcer Ulceration and chronic venous disease and, 730–731 Ulnar–basilic direct AV access (pediatric), 449 Ultrasound AAA and confirmation of, 474–475 cost effectiveness of, 476 diagnosis and, 475, 475f, 482 screening with, 473 blood flow velocities and, 70, 70t celiac artery aneurysm and, 366 deep vein thrombosis and, 817, 817f disadvantages of, 817 hepatic artery aneurysm and, 363 lymphedema and, 868 lymphatic malformation and, 853, 855f pseudoaneurysm diagnosis and, 586 varicose vein surgery and, 777, 778f Unadjusted aortic diameter and AAA, 474, 474t Uncuffed dialysis catheter placement of, 446 use of, 445 Undifferentiated connective tissue disease (UCTD), 312 Unenhanced MRI technique and renal disease, 90–91 Unfractionated heparin, 821 Unilateral iliofemoral bypass, 179 Unilateral vertebral artery disease, 651–652, 655f Upper extremity aneurysm in distal, 589–590 history of, 586–587 aortic arch, 305–306 contrast media in, 90 duplex ultrasound vein mapping technique, 430–431 infected arterial aneurysm and, 719–722, 719f Upper extremity ischemia anatomy of, 294–295 aortic arch (Key Points), 293 management of, 298–305 pathology of, 294–295 prevalence of, 309 prognosis for, 298–305 proximal disease and, 293 small artery occlusive disease Key Points, 309 summary of, 316 Upper extremity prosthetic AV access placement sites for, 441, 442f placement technique for, 441 Upper limb edema, 871 Upper limb tension test and TOS, 324 Upper plexus and supraclavicular scalenectomy, 330, 330f Ureteric obstruction and prosthetic vascular graft and, 675 Urokinase, 159, 270 V VAC See Negative pressure wound therapy (VAC) Vacuum-assisted closure, 708–709 Validity in generic QOL survey instruments defined, 60 Valsalva maneuver defined, 774 Valve damage and deep vein thrombosis, 819 Valve transplantation, 796–798, 797f, 798t Valve transposition, 796, 796f, 798 Valvular incompetence chronic venous insufficiency and, 783–784, 785t definition of, 783 factors contributing to, 744, 744f repair of, 798 varicose veins and, 738–739 Valvuloplasty PVI and, 793–796, 794–796f results of, 797–798, 797t Varicose disease, 18 Varicose veins chronic venous disease and, 741–742 clinical studies in, 751 compression therapy for, 749–751 definition of, 729–730, 730t, 771 endovascular management of conclusions regarding, 781 Key Points, 771 laser ablation and stripping of, 779 endovenous treatment of conclusions regarding, 768 Key Points, 756 genetics and, 18 goals of treatment for, 773 hemodynamics of, 771–772 indications for treatment of, 773–781, 773t introduction of, 756, 771 medical management of conclusions regarding, 754 conservative measures for, 749 introduction to, 749 Key Points, 749 medication for, 751 nonsurgical therapy costs of, 754 other treatments for, 754 pathophysiology of, 738–739 pathophysiology of (Key Points), 729 perforator ligation and, 788 primary chronic venous disease and, 743–744 Index Varicose veins (Continued) recombinant growth factors and, 750 recommendations for treatments for, 768 recurrent, 767–768, 775, 778 reflux and, 734 removal of, 762–763 risk factors for, 743, 743t sclerotherapy and, 751–754 summary regarding, 745 superficial reflux ablation and, 763–768 surgical management of conclusions regarding, 768, 781 Key Points, 756, 771 preoperative mapping for, 775, 775f quality of life and, 776 topical growth factors and, 750 treatment options for, 756–763, 773–781 venous ulceration and, 750 Vasa vasorum, 617f, 619–620, 619f Vascular access See also Hemodialysis access autogenous and nonautogenous AV access and, 432, 434f autogenous brachial–cephalic direct general considerations for, 436 results for, 433t, 436 technique for, 437 autogenous radial–cephalic direct wrist general considerations of, 433t, 434–435 technique for, 435–436, 436f clinical outcome goals for, 432–434, 435t cost of, 429–430 DOQI clinical practice guidelines for implications of, 434 introduction to, 432–434 limitations of, 434 evidence-based data related to, 431–432 ideal system for, 429 methods of for hemodialysis, 430, 430t morbidity and, 429–430 nonautogenous and autogenous AV access and, 432, 434f reporting standards for, 431–432, 432t transposition AV general considerations for, 437–438 techniques for, 438–439, 440–441f types of, 437 Vascular anastomosis, Vascular anomaly categories, 842 Vascular biology basic anatomy for, 12–13 Key Points, 12 menopause and, 16–17 of hemodynamic forces, 14 sex-based considerations for, 16–17 uses of, 12 Vascular calcification and hepatic artery a ­ neurysms, 363 Vascular catheterization, 74–75, 74f Vascular circumferential stretch, 14 Vascular deformation smooth muscle cell replication alteration under, 15 vascular biology and, 14 Vascular disease aortic wall calcifications in, 85–86, 87f catheter angiography and diagnosis of, 74 evolution of management of, 10 genetic considerations for, 16–18, 17t genetic variation in, 17, 17t need for evaluative tools for asymptomatic, 61 vascular imaging and nonatherosclerotic, 94 Vascular evaluation in diabetic foot ischemia, 223–224 Vascular graft complications of (Key Points), 665 healing characteristics of (Key Points), 665 search for ideal prosthetic, 665 Vascular hemodynamics definition of, 39 historical perspective on, 39–40 Key Points, 39 Vascular imaging abdominal aorta and, 97–103 angiographic technique for, 75 aortic aneurysms and, 99–102 aortic occlusive disease and, 102 carotid arteries and, 104–105 clinical applications of, 93–107 conclusions regarding, 107–108 considerations of, 108 contrast media and, 75–78 curved planar reconstruction and, 85, 85f DSA and, 78–79 enhancement of, 82–83 lower extremities vascular occlusive disease and, 94–97 MIP and, 83–84 MPR and, 85 MRA and, 86–93 MRI and, 86–87 nonatherosclerotic vascular disease and, 94 peripheral artery stents, 94 pulmonary embolism and, 95f, 103, 104f radiation safety and, 110–114 radiation safety and (Key Points), 73 renal arteries and, 106–107 results comparison of types of, 93–107 supraaortic arteries and, 104–105 thoracic aorta and, 97–103 virtual angioscopy and, 85, 86f VR and, 84–85 Vascular imaging techniques See also specific types invasive, 74–79 noninvasive, 74 Vascular injury body armor and, closure devices for repair of, 253 commercially engineered tourniquets and, management with autologous vein, renal artery occlusive disease and, 377–378 vascular procedures and, 253 Vascular laboratory noninvasive importance of, 64–65 objectives of, 65 Raynaud’s syndrome and, 313–314, 313t summary of, 72 peripheral, 65 data for AIOD, 178 patient feedback compared to, 59 Vascular lesion uniqueness, 39 Vascular ligation in World War II, Vascular malformation classification of, 843, 843t conclusions regarding, 859 definition of, 842 genetics of, 843 histology of, 843 investigation of, 843–846 low-flow, 846–854 soft-tissue (Key Points), 842 syndromes associated with high-flow, 857–858 syndromes associated with slow-flow, 857 Vascular mechanism genetic variation, 17, 17t Vascular morphology and PVD, 74 913 Vascular occlusive disease imaging and of lower extremities and, 94–97 renovascular hypertension and one-kidney, 375, 376f Vascular pathology defined, 12 Vascular physics areas of, 39 governing principles of, 39, 40t Vascular physiology Bernoulli’s principle and, 48, 49f drug metabolism and, 17, 17t pressure and, 40 Vascular procedures appropriate assessment of, 59 purpose of, 59 Vascular reconstruction in Korean War, Vascular resistance failure of peripheral, 47 role of peripheral, 47–48 Vascular response to injury, 13–16 Vascular stains, syndromes associated with, 857–858 Vascular Study Group of Northern New England, 509–510 Vascular surgery as evolving specialty, 54 evolutions in Key Points, overview of, military, 3–5 See also Military vascular surgery videoscopy and benefits of, 532 training in, 532–533 Vascular system effect of arteriovenous fistula on, 47, 48f energy conversion in, 48 energy within, 41, 42f Vascular Talent Thoracic Stent Graft System for the Treatment of Thoracic Aortic A ­ neurysms (VALOR) trial, 565 Vascular testing utilization optimization, 72 Vascular tone modulation, 13 Vascular treatment and generic QOL survey instruments, 60 Vascular tumor defined, 842 Vascular wall injury, 22 Vascular wall, 12–13, 13f, 287–288 Vasculogenesis defined, 16 Vasoactive factors, endothelium-derived, 14f Vasodilator function, 131 Vasospasm Raynaud’s syndrome and cold-induced, 313 thoracic sympathectomy and digital artery, 315 TOS repair and postoperative, 333 Vasospastic disorder, 253–254 Vasospastic Raynaud’s syndrome characteristics, 310, 310f Vectra graft and hemodialysis, 679–680 Vein autogenous, 198, 204, 205–206f autogenous saphenous, 224 autologous, 194 cephalic, 437, 439f circumferential left renal, 504 composite arm, 194–195 contralateral long saphenous, 194 dialysis catheter insertion and, 445 diameter of in infrainguinal bypass, 195 femoropopliteal, 194 for lower limb bypass graft, 195 hemodialysis and maturation of, 443–444 in situ, 198 mobilization of left renal, 204, 206f 914 Index Vein (Continued) nonreversed saphenous, 176–191 prosthetic, 194 quality of for infrainguinal bypass, 195, 198 renal and AAA repair anomalies in, 504, 506f retroaortic left, 504, 506f revascularization of, 507, 508f reversed saphenous autogenous vein bypass and, 198 infrainguinal bypass and, 204, 205–206f reversed vs in situ, 198 saphenous, 415 sclerotic, 437, 439f source of for infrainguinal bypass, 194–195 thrombosed, 437, 439f treatment of chronically occluded, 331 Vein bypass greater saphenous, reversed greater saphenous, Vein cuff below-knee PTFE graft and, 199 prosthetic vascular graft and modification of, 677, 678f types of, 204, 207f Vein graft abnormal smooth muscle cell gene expression and, 15 arterial duplex and, 71–72, 71f early thrombosis and, 1–11 late thrombosis and, 210 recommended regimen for, 71–72 saphenous and popliteal aneurysm, 583 shear stress and, 15 stenosis histology, 207–208, 207–209f Vein incompetence (perforating), 803 Vein patch modification, 677, 678f Vein spatulation autogenous brachial–cephalic direct access and, 436f, 437 autogenous radial–cephalic direct wrist access and, 435–436, 436f Vein valve reconstruction conclusions regarding, 803 results of, 797–798, 797t Velocity recordings angle-corrected, 69 normal, 70, 70t Velocity waveform patterns and stenosis, 71 Vena cava and AAA repair, 504, 505f Vena cava filter See Inferior vena cava filter Vena caval obstruction and prosthetic vascular graft, 679 Venoactive drugs, 751 Venoactive medication, 751 Venography chronic venous insufficiency and, 785–786 deep vein thrombosis and, 816–817, 816f disadvantages of, 816–817 Paget-Schroetter syndrome and, 327, 328f Venoplastic procedures and PVI, 793 Venous allograft replacement in situ, 698–700, 699f, 703t Venous autograft in human arterial circulation, in peripheral circulation, in situ replacement of, 698 Venous bypass cryopreserved vein and, 681 vena caval obstruction and, 679 Venous catheterization complications, 446–447, 447t Venous claudication, 731 Venous congestion and CEA, 613, 614f Venous disease angioscopically assisted in situ bypass and, 198–199 medical management of, 754 medication for, 751 surgical effect on, 59 Venous disorder costs, 754 Venous edema and lymphedema, 867 Venous enhancement in lower extremities, 89, 89t Venous gangrene acute leg ischemia and, 253–254, 254f deep vein thrombosis and, 833–834, 835–836f pathophysiology of, 833–834 thrombolysis and, 819 Venous grafting, 6, 800–803 Venous hypertension chronic venous insufficiency and, 740, 740f, 787–788 definition of, 749 histological findings associated with, 739–740 TOS and, 331 varicose veins and, 751 Venous injury and TOS, 331 Venous insufficiency chronic See also Chronic venous insufficiency Key Points, 729 surgical treatment of (Key Points), 783 Venous anatomy of lower extremities, 731–732 Venous malformation clinical presentation of, 846, 847f introduction of, 846–851 pathology of, 846 treatment of, 849–851 Venous obstruction diagnostic tests, 737–738 Venous occlusion See Paget-Schroetter syndrome Venous outflow and hemodialysis access, 430–431 Venous pressure determination of ambulatory, 733–734, 734f exercise and, 733, 734f Venous prosthetic graft, 679 Venous reflux See also Deep venous reflux: Saphenous vein reflux ablation of axial superficial, 756–762 chronic venous disease and, 730–731, 744 CVI and, 774–775 diagnostic tests for, 735–737 duplex ultrasound and diagnosis of, 774–775, 774f endovenous ablation of saphenous, 757–762 postthrombotic syndrome and, 744–745 recanalization and, 744, 744f recurrent thrombotic events and, 744 secondary chronic venous disease and, 744–745 Venous segment transfer and deep venous reflux, 796, 796f Venous sinus, 732 Venous stasis, 809, 809f Venous stenosis and AV access, 449, 450f, 452f Venous stenting and deep venous obstruction, 799–800, 799f Venous system endovascular therapy and imaging of, 196 energy conversion in, 47 lower extremity anatomy of, 772–773, 772t terminology of, 772–773, 772t Venous thromboembolic disease clinical features of, 814–816 D-dimer assay and, 816 epidemiology of, 808 incidence of, 808 inherited thrombophilia and, 813–814 low-molecular-weight heparin and, 821–822 methods of prophylaxis for, 835–836 pathophysiology of, 808–816 risk factors for, 811–813 summary regarding, 836 thrombophilia (inherited) and, 813–814 Venous thromboembolism (VTE) See also Deep vein thrombosis; Venous t ­ hromboembolic disease deep vein thrombosis and, 811 pregnancy and, 834–835 prevention of, 835–836 pulmonary embolism and, 811 treatment of, 34 venous thromboembolic disease and, 811 Venous thrombosis hypercoagulable states and, 252 Key Points, 807 mesenteric Key Points, 351 See also Mesenteric venous thrombosis (MVT) natural history of, 809–810, 810f sites of, 808 vs arterial thrombosis, 27–28 Venous thrombotic disease and thrombophilia, 813–814 Venous thrombus evolution, 744 Venous tone and varicose veins, 739 Venous ulcer multisystem incompetence and, 788 recurrence rate of sclerotherapy and, 792–793 SEPS and, 790–793 Venous ulceration chronic graduated compression for, 750 multilayer compression for, 750–751 epidemiology of, 742 varicose veins and, 750 Venous ulcers chronic venous disease and, 730–731 clinical studies in, 751 multisystem disease and, 734 nonvenoactive drugs and, 751 reflux and, 734, 735t Ventilation scan and acute pulmonary embolism, 824–825, 826f Ventricular aneurysm, 252 Vertebral arterial aneurysm, 719 Vertebral artery anatomical lesions of, 648–650 arteritis and, 649 compression of, 649–650, 650t diseases of extrinsic, 649–650 intrinsic, 648–649 reconstruction of hemodynamic vertebrobasilar insufficiency and, 658–659 vertebrobasilar insufficiency and, 654, 656–657f segmental occlusion of, 650–651 surgery of V1 segment of, 656–657 V2 segment of, 657–658 V3 segment of, 657f, 658, 659f V4 segment of, 658 surgical anatomy of, 648, 648f Index Vertebral artery (Continued) surgical history of, 647 surgical indications for, 653–654 trauma and, 649 Vertebral artery flow, compromising factors of, 651–652, 654t Vertebral artery reconstruction anatomical indications for, 654 techniques for, 654–658 Vertebrobasilar insufficiency conclusions regarding, 658–659 Key Points, 647 pathophysiology of, 650–652 surgical indications for, 653–654 Vertebrobasilar stroke mortality rates, 651 Vessel exposure during infrainguinal bypass, 201–203, 202f Vessel wall mechanics of, 41–44 reason for discussion of fluid mechanics and, 39 Vestibular nucleus, 652 Veterans Administration Cooperative Trial, 597 Veterans Administration Aneurysm Detection and Management (ADAM) Trial, 496–497, 498t Veterans Affairs Cooperative Study, 207 Viable leg (category I) acute leg ischemia and, 245, 246f, 263, 281 angiography for, 247 Vibration arterial injury, 312 Videoscopic aneurysmorrhaphy and AAA repair, 537–540, 538f Videoscopy AAA repair and, 535, 537–541 abdominal aortic surgery and approach choice in, 537 approaches to, 533–537, 533f operating room setup for, 534, 534f patient position for, 534, 534f conversion to ODR from, 541, 541f surgery for AIOD and, 534–535 suturing and, 533 training in, 532–533 vascular surgery and, 532 Vietnam Vascular Registry, Vietnam War and military vascular surgery, Virchow, Rudolf, 27–28, 808 Virchow’s triad, 808–809, 808f Virtual angioscopy in MDCTA, 85, 86f Visceral aortic segment debranching and, 565–566 endograft repair and, 566–567, 567f Visceral arteries asymptomatic patients and CMI and, 342 infected arterial aneurysm and, 722 915 Visceral ischemia, 356 Visceral perfusion by catheter arrangement, 552f, 555 Visceral segment endarterectomy, 559–560, 561f Visceral supply and rejection for AAA surgery, 481 Vitamin K antagonists and prevention of venous thromboembolic disease, 836 Vollmar, Jorg, 480 Volume Rendering (VR) aneurysms and, 94f, 99–100, 102f in CTA, 84–85 peripheral artery stents and, 94, 95f Volumetric data acquisition and CTA, 82 Von Willebrand disease (VWD) acquired, 33 description of, 32–33 diagnosis of, 33 symptoms of, 33 therapeutic approach to, 33 Von Willebrand factor (VWF) deficiency of, 32–33 factor VIII and, 32–33 platelet activation and, 22 elevated, 252 Voorhees, Arthur, VR See Volume Rendering (VR) VTE See Venous thromboembolism (VTE) VWD See Von Willebrand disease (VWD) VWF See Von Willebrand factor Westermark’s sign, 823, 823f Whiplash and neurogenic TOS, 322 Whisnant, Jack, White blood cell scan, 694, 694t White cell trapping hypothesis, 740–741 Whole-blood agglutination testing (SimpliRED) , 816 Whole-body CE-MRA, 89 Wick catheter and intracompartmental p ­ ressures, 282, 282f Windsock effect of endograft, 564 WIQ See Walking Impairment Questionnaire Wire infrainguinal arterial disease and, 155 traversal technique and hydrophilic, 157–158f, 160f, 161 Wiskott-Aldrich syndrome, 34 WL Gore phase II (PIVOTAL) trial, 564–565 Women’s Health Study, 57 Work defined, 40 World War I and military vascular surgery, World War II and military vascular surgery, Woven Dacron vascular graft, 666, 666f Wrist access autogenous radial–cephalic direct vascular technique, 435–436, 436f autogenous radial–cephalic direct, 433t, 434–435 Wuchereria bancrofti, 864 Wylie, Edwin, 8–9 W X Walking and varicose veins, 749 Walking as exercise, 128 Walking Impairment Questionnaire, 61 Wall shear stress and neointimal fibrous h ­ yperplasia, 677 Wall stress biomechanical, 469–470 in blood vessels aneurysm morphology and, 45, 45f aneurysm sac and, 45 formula for, 45 Wallgraft stent graft, 678–679 Wallstent formulation of, 632–633, 632–633f iliac vein occlusion and, 799 replacement of, 167 stent fracture and, 166, 167f Water molecule, rigid elastic modulus of, 41 Watson-Cheyne dissector, 615, 616f Waves, electromagnetic, 110, 111f Weight gain after treatment for CMI and, 348 Weight loss and CMI, 342 Wells criteria, 818–819, 818t, 826–827, 828t Xa inhibitors oral, 35 selective, 34 Xenograft, 681–682 Ximelagatran, 35 Xiphoid-to-pubis incision, 414, 415f X-ray matter and, 110 radiation safety and, 110 Y Yellow nail syndrome, 863 Yield strength defined, 43–44, 44f Z Zilver PTX Stent Platform, 168 ... Cataloging-in-Publication Data Comprehensive vascular and endovascular surgery/ [edited by] John W Hallett … [et al.] 2nd ed p ; cm Includes bibliographical references and index ISBN 97 8-0 -3 2 3-0 572 6-4 ... of Vascular Surgery Department of Vascular and Endovascular Surgery Southern Arizona Veterans Affairs Health Care System Associate Professor of Surgery Department of Vascular and Endovascular Surgery. .. readers As we planned this new edition of Comprehensive Vascular and Endovascular Surgery, the original four editors and our editorial staff discussed that “something” in great detail What have