Emergency Vascular Surgery: A Practical Guide

Description:

 

This book provides clear, concise guidance on the surgical management of all kinds of emergent vascular problems and focuses in particular on open surgical strategies. The aim is to provide a combined text and hands-on guide that will permit rapid retrieval of information when treating vascular surgical patients in the emergency room. Emergency Vascular Surgery: A Practical Guide is organized into two sections, on specific body areas and general concepts. The first section covers the body from head to toe, with separate chapters for injuries and non-traumatic disease, while the second discusses general principles relating to emergent vascular surgical practice and provides broad vascular surgical guidelines for the inexperienced surgeon. Chapters in the first section are uniformly organized, addressing incidence, etiology, and pathophysiology; clinical presentation; suggestions for workup and diagnosis; and management and treatment. Initial management, selection of patients for emergent surgery, and the performance of common vascular surgical procedures are all carefully explained. The focus on a hands-on approach and practical tips will be invaluable in the clinical setting for both more experienced surgeons and newcomers to the field.

 

Table of Contents:

 

Part A: Specific Areas

1: Vascular Injuries to the Neck

1.1 Summary

1.2 Background

1.2.1 Causes and Mechanism

1.2.1.1 Penetrating Trauma

1.2.1.2 Blunt Trauma

1.3 Clinical Presentation

1.3.1 Medical History

1.3.2 Clinical Signs

1.4 Diagnostics

1.4.1 Penetrating Trauma

1.4.2 Blunt Trauma

1.5 Management and Treatment

1.5.1 Management Before Treatment

1.5.1.1 Treatment in the Emergency Department

1.5.1.2 Airway Obstruction

1.5.1.3 Immediate Operation or Further Diagnostic Work-Up?

1.5.1.4 Which Patients Can Be Safely Transported?

1.5.2 Operation

1.5.2.1 Preoperative Preparation and Proximal Control

1.5.2.2 Exposure and Repair

1.5.2.3 Exploration of Minor Injuries and Hematomas

1.5.2.4 Injuries to the Vertebral Artery

1.5.2.5 Venous Injury

1.5.2.6 Endovascular Treatment

1.5.3 Management After Treatment

1.5.4 Results and Outcome

Further Reading

2: Vascular Injuries to the Thoracic Outlet Area

2.1 Summary

2.2 Background

2.2.1 Magnitude of the Problem

2.2.2 Etiology and Pathophysiology

2.2.2.1 Penetrating Trauma

2.2.2.2 Blunt Trauma

2.3 Clinical Presentation

2.3.1 Medical History

2.3.2 Clinical Signs

2.3.2.1 Physical Examination

2.4 Diagnostics

2.5 Management and Treatment

2.5.1 Management Before Treatment

2.5.1.1 Management in the Emergency Department

2.5.1.2 Patients in Extreme Shock

2.5.1.3 Unstable Patients

2.5.1.4 Control of Bleeding

2.5.1.5 Stable Patients

2.5.1.6 Nonsurgical Management

2.5.2 Operation

2.5.2.1 Preoperative Preparation and Control of Bleeding

2.5.2.2 Exposure and Repair

2.5.2.3 Venous Injuries

2.5.2.4 Endovascular Repair and Control

2.5.3 Management After Initial Treatment

2.6 Results

Further Reading

3: Vascular Injuries in the Upper Extremity

3.1 Summary

3.2 Background

3.2.1 Background

3.2.2 Etiology and Pathophysiology

3.3 Clinical Presentation

3.3.1 Medical History

3.3.2 Clinical Signs and Symptoms

3.4 Diagnostics

3.5 Management and Treatment

3.5.1 Initial Management

3.5.1.1 Severely Injured and Unstable Patients

3.5.1.2 Less Severe Injuries

3.5.1.3 Amputation

3.5.2 Operation

3.5.2.1 Preoperative Preparation

3.5.2.2 Proximal Control

3.5.2.3 Exploration and Repair

3.5.2.4 Finishing the Operation

3.5.2.5 Endovascular Treatment

3.5.3 Management After Treatment

3.6 Results and Outcome

3.7 Latrogenic Vascular Injuries

3.8 Miscellaneous Vascular Injuries

Further Reading

4: Acute Upper Extremity Ischemia

4.1 Summary

4.2 Background and Pathogenesis

4.3 Clinical Presentation

4.4 Diagnostics

4.5 Management and Treatment

4.5.1 Initial Management

4.5.2 Operation

4.5.2.1 Embolectomy

4.5.2.2 Endovascular Treatment

4.5.3 Management After Treatment

4.6 Results and Outcome

Further Reading

5: Abdominal Vascular Injuries

5.1 Summary

5.2 Background

5.2.1 Background

5.2.2 Magnitude of the Problem

5.2.3 Etiology and Pathophysiology

5.2.3.1 Penetrating Injury

5.2.3.2 Blunt Injury

5.2.3.3 Pathophysiology

5.2.3.4 Associated Injuries

5.3 Clinical Presentation

5.3.1 Medical History

5.3.2 Clinical Signs and Symptoms

5.4 Diagnostics

5.5 Management and Treatment

5.5.1 Management Before Treatment

5.5.1.1 Treatment and Management in the Emergency Department

5.5.1.2 Unstable Patients

Emergency Thoracotomy

5.5.1.3 Stable Patients

5.5.1.4 Laparotomy or Not?

5.5.1.5 Renal Artery Injuries

5.5.2 Operation

5.5.2.1 Preoperative Preparation

5.5.2.2 Exploration

5.5.2.3 Exposure and Control

5.5.2.4 Retrohepatic Injuries

5.5.2.5 Superior Mesenteric Artery Injuries

5.5.2.6 Retroperitoneal Hematomas

5.5.2.7 Management of Renal Injuries

5.5.2.8 Vessel Repair

Arterial Injuries

Venous Injuries

Final Vascular Repair Following “Damage Control”

5.5.2.9 Finishing the Operation

5.5.2.10 Endovascular Treatment

5.5.3 Management After Treatment

5.6 Results and Outcome

5.7 Iatrogenic Vascular Injuries in the Abdomen

5.7.1 Laparoscopic Injuries

5.7.2 Iliac Arteries and Veins During Surgery for Malignancies in the Pelvis

5.7.3 Iliac Artery Injuries During Endovascular Procedures

5.7.4 Iatrogenic Injuries During Orthopedic Procedures

Further Reading

6: Acute Intestinal Ischemia

6.1 Summary

6.2 Background

6.2.1 Background

6.2.2 Magnitude of the Problem and Patient Characteristics

6.3 Pathophysiology

6.4 Clinical Presentation

6.4.1 Medical History

6.4.1.1 Embolism

6.4.1.2 Thrombosis

6.4.2 Physical Examination

6.5 Diagnostics

6.5.1 Laboratory Tests

6.5.2 Angiography

6.5.3 Diagnostic Pitfalls

6.6 Management and Treatment

6.6.1 Management Before Treatment

6.6.1.1 In the Emergency Department

6.6.2 Operation

6.6.2.1 Laparotomy

Embolic Occlusion

Arterial Thrombosis

Venous Thrombosis and NOMI

6.6.2.2 Endovascular Treatment

6.6.3 Management After Treatment

6.6.3.1 In the ICU

Mesenterial Vein Thrombosis

6.6.3.2 Second-Look Operation

6.7 Results and Outcome

Further Reading

7: Abdominal Aortic Aneurysms

7.1 Summary

7.2 Background

7.2.1 Magnitude of the Problem

7.2.2 Pathogenesis

7.3 Clinical Presentation

7.3.1 Medical History

7.3.2 Examination

7.3.3 Differential Diagnosis

7.3.4 Clinical Diagnosis

7.4 Diagnostics

7.5 Management and Treatment

7.5.1 Management Before Surgery

7.5.1.1 Ruptured AAA

7.5.1.2 Suspected/Possible Rupture

7.5.1.3 Rupture Unlikely

7.5.2 Open Operation

7.5.2.1 Starting the Operation

7.5.2.2 Exposure and Proximal Control

7.5.2.3 Other Options for Proximal Control

7.5.2.4 Continuing the Operation

7.5.2.5 What to Do While Waiting for Help

7.5.2.6 Endovascular Treatment

7.5.3 Management After Treatment

7.6 Results and Outcome

7.7 Unusual Types of Aortic Aneurysms

7.7.1 Inflammatory Aneurysm

7.7.2 Aortocaval Fistula

7.7.3 Thoracoabdominal Aneurysm

7.7.4 Mycotic Aneurysm

7.8 Ethical Considerations

Further Reading

8: Acute Aortic Dissection

8.1 Summary

8.2 Background

8.2.1 Magnitude of the Problem

8.2.1.1 Definition and Classification

8.2.2 Etiology

8.2.3 Pathophysiology

8.3 Clinical Presentation

8.3.1 Medical History

8.3.2 Physical Examination

8.4 Diagnostics

8.5 Management

8.5.1 Initial Treatment

8.5.2 Surgical Treatment

8.5.3 Type B Dissection

8.5.4 Endovascular Treatment

8.6 Results and Outcome

Further Reading

9: Vascular Injuries in the Legs

9.1 Summary

9.2 Background

9.2.1 Background

9.2.2 Magnitude of the Problem

9.2.3 Etiology and Pathophysiology

9.2.3.1 Penetrating Injury

9.2.3.2 Blunt Injury

9.2.3.3 Pathophysiology

9.3 Clinical Presentation

9.3.1 Medical History

9.3.2 Clinical Signs and Symptoms

9.4 Diagnostics

9.4.1 Angiography

9.4.2 CT Angiography

9.4.3 Duplex Ultrasound

9.5 Management and Treatment

9.5.1 Management Before Treatment

9.5.1.1 Severe Vessel Injury

9.5.1.2 Less Severe Injuries

9.5.1.3 Angiography Findings

9.5.1.4 Primary Amputation

9.5.2 Operation

9.5.2.1 Preoperative Preparation

9.5.2.2 Proximal Control

9.5.2.3 Distal Control and Exploration

9.5.2.4 Shunting

9.5.2.5 Vessel Repair

Arterial Injuries

Venous Injuries

9.5.2.6 Finishing the Operation

9.5.3 Endovascular Treatment

9.5.4 Management After Treatment

9.6 Results and Outcome

9.7 Fasciotomy

9.8 Iatrogenic Vascular Injuries to the Legs

Further Reading

10: Acute Leg Ischemia

10.1 Summary

10.2 Background

10.2.1 Background

10.2.2 Magnitude of the Problem

10.2.3 Pathogenesis and Etiology

10.2.3.1 Pathogenesis

10.2.3.2 Embolus and Thrombosis

10.3 Clinical Presentation

10.3.1 Medical History

10.3.2 Clinical Signs and Symptoms

10.3.3 Evaluation of Severity of Ischemia

10.3.3.1 Classification

10.3.3.2 Viable Leg

10.3.3.3 Threatened Leg

10.3.3.4 Management Strategy

10.4 Management and Treatment

10.4.1 Management Before Treatment

10.4.1.1 Viable Leg

10.4.1.2 Threatened Leg

10.4.2 Operation

10.4.2.1 Embolectomy

10.4.2.2 Thrombosis

10.4.3 Thrombolysis

10.4.4 Management After Treatment

10.4.4.1 Anticoagulation

10.4.4.2 Reperfusion Syndrome

10.4.4.3 Compartment Syndrome

10.5 Results and Outcome

10.6 Conditions Associated with Acute Leg Ischemia

10.6.1 Chronic Ischemia of the Lower Extremity

10.6.2 Acute Ischemia After Previous Vascular Reconstruction

10.6.3 Blue Toe Syndrome

10.6.4 Popliteal Aneurysms

Further Reading

Part B: General Concepts

11: Acute Complications Following Vascular Interventions

11.1 Summary

11.2 Background

11.2.1 Magnitude of the Problem

11.3 Ischemic Complications

11.3.1 Pathophysiology

11.3.2 Clinical Presentation

11.3.2.1 Graft Occlusion in the Leg

11.3.2.2 Postoperative Ischemia After Carotid Interventions

11.3.2.3 Ischemia After Aneurysm Operations and Endovascular Procedures

11.3.3 Diagnostics

11.3.3.1 Leg Ischemia

11.3.3.2 Visceral Ischemia

11.3.4 Management and Treatment

11.3.4.1 Management in the Emergency Department, the ICU, and the Ward

Leg Ischemia

Cerebral Ischemia

Ischemia After Aneurysm Surgery and Endovascular Procedures

11.3.4.2 Operation

11.3.5 Results and Outcome

11.3.5.1 Graft Occlusion

Thrombolysis Versus Thrombectomy

11.3.5.2 Ischemia After Carotid and Aortic Interventions

11.4 Bleeding Complications

11.4.1 Causes

11.4.2 Clinical Presentation

11.4.2.1 Medical History

11.4.2.2 Physical Examination

11.4.3 Diagnostics

11.4.4 Management and Treatment

11.4.4.1 In the Emergency Department, ICU, or Surgical Ward

Emergency Measures

Which Patients Should Be Reoperated?

Bleeding After Aortic Surgery

Bleeding After Carotid Surgery

Bleeding During Thrombolysis

Medical Treatment and Monitoring

11.4.4.2 Operation

Control of Bleeding

Repair of Bleeding Sites

11.4.4.3 Management After Treatment

11.5 Infections

11.5.1 Pathophysiology

11.5.1.1 Types of Infection

11.5.1.2 Microbiology

11.5.1.3 Pathophysiology

11.5.2 Clinical Presentation

11.5.2.1 Medical History

11.5.2.2 Physical Examination

11.5.3 Diagnostics

11.5.3.1 Laboratory Tests

11.5.3.2 Imaging

11.5.4 Management and Treatment

11.5.4.1 In the Emergency Department

Wound and Subcutaneous Graft Infections

Infection Following Carotid Endarterectomy

Suspected Aortoduodenal Fistula

Other Aortic Graft Infections

11.5.4.2 Operation

Control

Continued Operation

11.5.4.3 Management After Treatment

11.5.5 Results and Outcome

11.6 Local Complications

11.6.1 Lymphocele and Seroma

11.6.1.1 Background and Causes

11.6.1.2 Clinical Presentation

11.6.1.3 Management and Treatment

11.6.2 Postoperative Leg Swelling

11.6.2.1 Background and Causes

11.6.2.2 Clinical Presentation

11.6.2.3 Management and Treatment

11.6.3 Wound Edge Necrosis

11.6.3.1 Background and Causes

11.6.3.2 Clinical Presentation

11.6.3.3 Management and Treatment

11.6.4 Local Nerve Injuries

11.6.4.1 Background and Causes

11.6.4.2 Clinical Presentation

11.6.4.3 Management and Treatment

Further Reading

12: Acute Venous Problems

12.1 Summary

12.2 Background and Pathogenesis

12.2.1 Background

12.2.2 Pathogenesis

12.3 Clinical Presentation

12.4 Diagnostics

12.4.1 Duplex, CT, and Phlebography

12.4.2 Pretest Clinical Probability and Scoring Systems

12.4.3 Blood Tests

12.4.4 In the Emergency Department

12.4.5 Endovascular Treatment

12.4.5.1 When Is Thrombolysis Indicated?

12.4.5.2 Techniques for Performing Thrombolysis

12.4.6 Operation

12.4.7 Phlegmasia Cerulea Dolens

12.4.8 Vena Cava Filter Placement

12.4.9 Postoperative Treatment

12.5 Results and Outcome

12.6 Miscellaneous

12.6.1 Thrombophlebitis

Further Reading

13: Acute Problems with Vascular Dialysis Access

13.1 Summary

13.2 Background

13.3 Pathophysiology

13.3.1 Occlusion and Thrombosis

13.3.2 Infection

13.3.3 Bleeding

13.3.4 Aneurysms and Hematomas

13.3.5 Steal and Arterial Insufficiency

13.4 Clinical Presentation

13.4.1 Occlusions and Thrombosis

13.4.2 Infection

13.4.3 Bleeding, Aneurysms, and Hematomas

13.4.4 Steal and Arterial Insufficiency

13.5 Diagnostics

13.6 Management and Treatment

13.6.1 In the Emergency Department

13.6.1.1 Occlusion and Thrombosis

13.6.1.2 Infection

13.6.1.3 Bleeding

13.6.1.4 Aneurysms and Hematomas

13.6.1.5 Arterial Insufficiency and Steal

13.6.2 Operation and Other Interventions

13.6.2.1 Occlusion and Thrombosis

Thrombolysis

AV Grafts

Revision

13.6.2.2 Infection

13.6.2.3 Bleeding

13.6.2.4 Aneurysms and Hematomas

13.6.2.5 Arterial Insufficiency and Steal

13.6.3 Management After Treatment

13.6.4 When Can Dialysis be Started Using the Access?

13.7 Results and Outcome

Further Reading

14: General Principles of Vascular Surgical Technique

14.1 Summary

14.2 Background

14.3 Access to the Vascular System

14.3.1 Vascular Access in Trauma

14.3.1.1 Need for Vascular Access

14.3.1.2 Management Guidelines

14.3.1.3 Which Route Is Recommended for Acute Vascular Access?

14.3.1.4 Technique for Achieving Alternative Acute Vascular Access in Trauma

14.3.2 Endovascular Vascular Access

14.3.2.1 Endovascular Access via the Common Femoral Artery

14.3.2.2 Endovascular Access via the Brachial Artery

14.3.2.3 Post-Procedure Measures Following Endovascular Access

14.4 Vessel Exposure

14.5 Control of Bleeding and Clamping

14.5.1 Proximal Endovascular Aortic Control

14.6 Vascular Suture

14.6.1 Choice of Suture Material

14.7 Arteriotomy

14.8 Closure with Patch (Patch Angioplasty)

14.9 Interposition Grafts

14.9.1 Autologous Vein as Graft Material

14.9.2 Synthetic Vascular Prosthesis

14.10 Vein Operations

14.11 Miscellaneous

14.11.1 Drains

14.11.2 Infection Prophylaxis

Index

 

Springer

An aparitie	30 Dec 2017
Autor	Eric Wahlberg,‎ Jerry Goldstone
Dimensiuni	17.8 x 25.4 cm
Editura	Springer
Format	Hardback
ISBN	9783662540176
Limba	Engleza
Nr pag	215