Endovascular Skills: Guidewire and Catheter Skills for Endovascular Surgery, Fourth Edition

 

Description:

 

Since the first edition of this text was published, endovascular technique has become a mainstay of vascular care, treating disease that would have previously required open surgery. This book provides a step-by-step approach to endovascular intervention and aims to assist clinicians in the development and refinement of skills that are now essential

 

Table of Contents:

 

Part I Catheter and guidewire skills

1 Case preparation

Endovascular skills in practice

Reinvention of vascular care

Setting yourself up for success

Sizing up the case

Prior to the puncture

Working environment

Equipment

Facilities and room setup

How pretreatment history and physical examination help to plan therapy

Pretreatment imaging

2 Safe and strategic vascular access

Overview of percutaneous access

Choosing your approach

Femoral anatomy for arterial access

Puncture guidance with ultrasound

Micropuncture technique

Percutaneous retrograde puncture of the femoral artery

Percutaneous antegrade puncture of the femoral artery

Percutaneous puncture of a pulseless femoral artery

Proximal access

Percutaneous puncture of the brachial artery

Alternative access to the lower extremity: Superficial femoral, popliteal, tibial, and pedal arterie

Percutaneous puncture of bypass grafts

Puncture site complications

Summary of puncture site options and closure strategy

3 Sheath access

Introduction

Basic access site step-by-step

Initial maneuvers to secure the access

How do you place a sheath?

When is a dilator needed?

Basic sizing issues

When to use fluoroscopy

About access sheaths

How do you decide when to place a larger access sheath?

When to abandon an access

Access in a hostile groin

4 Guidewire skills

Introduction

Mastering guidewires

What makes guidewires different from each other

Guidewire types in practice

When to abandon the chosen guidewire

Useful guidewire techniques to start tackling chronic total occlusion

Organizing your guidewires

5 Small platform guidewires and monorail systems

Development of small platform guidewires and monorail systems

How do monorail systems differ from coaxial systems?

What are the advantages and disadvantages of monorail systems?

Principles for the use of rapid exchange systems

Which platform is best for each task?

Which platform should you start the case with, and when should you switch from one platform to anoth

Maneuvers you can undertake with 0.14-inch and0.18-inch guidewires

6 Handling catheters

Introduction to catheters: Exchange, flush, and selective catheters

Which angiographic catheter should you use?

Catheter head shape determines function

Describing catheter behavior

Handling catheters

7 Guidewire and catheter passage

The goal of the procedure determines the course of the guidewirecatheter apparatus

Guidewire and catheter combinations

Where does the guidewire naturally want to go?

Passing through diseased arteries

Negotiating tortuous arteries

Remote puncture site

How to change the plan if the catheter will not pass and you have tried everything

How do you decide if disease encountered on the pathway to treat the target lesion also needs to be

8 Imaging: The key to success

Imaging and best therapy are intricately linked

Image quality

Generating an X-ray image

Digital subtraction arteriography

Imaging technique for best resolution

Road mapping: How it works and when to use it

Automated power injector

Power injection versus contrast administration by hand

Contrast agents

How do you know where you are?

Radiation safety and occupational health issues

Radiographic equipment

Radiographic terms

Radiation exposure

9 Selective catheterization

Many catheter choices but few basic shapes

Selective catheterization of the brachiocephalic arteries

Selective catheterization of the visceral and renal arteries

Selective catheterization of the aortoiliac arteries

Selective catheterization of the infrainguinal arteries

Selective catheterization of prosthetic bypass grafts

Aberrant anatomy to consider

10 Principles of arteriography

Arteriography is strategic, not diagnostic

The future of arteriography

Supplies for arteriography

Planning for strategic arteriography

Questions to consider before arteriography

Evaluation before angiography

Deciding where to puncture

Catheter placement

Contrast administration and image acquisition

Arteriography sequences

11 Arteriography of the vascular beds

Arteriography of the brachiocephalic arteries

Thoracic aortography

Arteriography of the visceraland renal arteries

Arteriography of the infrarenal arteries

Lesion interrogation: Specialviews

Carbon dioxide arteriography

Pressure measurement

Arteriography of aneurysms

Intravascular ultrasound

Part II Endovascular therapy

12 Endovascular workshop

Where we work determines what we can do

Operating room versus special procedures suite versus catheterization laboratory

Stationary versus portable imaging systems

The ideal vascular workshop

13 Medications for endovascular therapy

Sedation and analgesia

Local anesthetic

Prophylaxis with antibiotics

Anticoagulation

Heparin alternatives: Direct thrombin inhibitors

Antiplatelet agents

Thrombolysis

Vasodilators

Contrast allergies

Practical advice for intraoperative problems

14 Access for endovascular therapy

Make access as simple as possible

Create a platform from which to work

Sizing considerations

What fits into what?

General principles of sheath placement during therapy

When to avoid using your initial access site for therapy

When do you use a guiding sheath versus a guiding catheter?

How do you know if the sheath is following the exchange wire?

Uses for upper extremity access

Sheath placement in remote branch arteries

15 Setting up the therapeutic maneuver: Crossing lesions

Introduction

Three types of lesions

Need for support and directionality

Crossing stenoses

16 Crossing challenging lesions

Arteriography of occluded arteries

Crossing occlusions

Tools for crossing occlusions

Subintimal angioplasty

Crossing occlusions in various vascular beds

When to approach from the other direction: Retrograde access

Crossing calcified lesions

Crossing really long lesions

What to do after the wire is across

Anatomic manipulations can assist in guidewire or device passage

17 Balloon angioplasty: Minimally invasive autologous revascularization

Balloon dilation causes dissection

About balloon catheters

The angioplasty procedure

Balloon selection

When to use a monorail system

Supplies for percutaneous balloon angioplasty

Sheath selection and placement

Balloon preparation and placement

Heparin administration during intervention

Balloon inflation

Balloon removal and completion arteriography

18 More about balloon angioplasty: Keeping out of trouble

Keeping out of trouble is simpler than getting out of trouble

What is the strategy for managing multiple lesions?

Which lesions should be predilated?

Which lesions are most likely to embolize?

What about postangioplasty dissection?

When to use kissing balloons

Pain during balloon angioplasty

What about spasm?

Preventing puncture site thrombosis

Balloon angioplasty troubleshooting

Technique: Solving angioplasty problems

Management of arterial rupture

Management of embolization

Management of acute occlusion

Technical aspects of balloon angioplasty in different vascular beds

Assessing the acute results of balloon angioplasty

19 Stents, covered stents, stentgrafts

Impact of stents

Stent choices

Covered stents

Indications for stents: Primary or selective stent placement

Which lesions should be stented?

Residual stenosis after angioplasty

Placement technique for balloon-expandable stents

Placement technique for self-expanding stents

Placement technique for covered stents

Which stent for which lesion?

How to select the best stent for the job

Tricks of the trade

Acute complications of stent placement

Chronic complications of stent placement

20 Other devices and how to use them

Microcatheters

Re-entry catheters

Chronic total occlusion catheters and crossing catheters

Atherectomy

Laser

Drug-coated balloons and drug-eluting stents

Cutting, scoring, and cryoplasty balloons

Peripheral stentgrafts

Thrombectomy and thrombolysis

Distal embolic filters

Part III Therapy in specific vascular beds

21 Brachiocephalic interventions

Introduction

Arch assessment

Innominate and common carotid artery

Assessment of arch branch lesions

Principal techniques

Transfemoral approach to the common carotid artery

Carotid bifurcation stent placement

Open cell, closed cell, and mesh covered carotid stents

Distal and proximal protection devices for transfemoral carotid stenting

Transcervical approach to carotid stenting

Retrograde approach to the common carotid artery

The subclavian and axillary arteries

22 Visceral and renal artery interventions

Approach to the visceral arteries

Celiac and superior mesenteric artery angioplasty and stenting

Renal angioplasty and stenting

23 The infrarenal aorta, aortic bifurcation, and iliac arteries: Advice about balloon angioplasty an

Introduction

Aorta

Aortic bifurcation

Iliac artery

Ipsilateral retrograde approach to the iliac artery

Contralateral approach to the iliac artery

Self-expanding versus balloon-expandable stents for the aortoiliac segment

Use of covered stents

Access related issues

24 The infrainguinal arteries: Advice about balloon angioplasty and stent placement

Introduction

Superficial femoral and popliteal arteries

Ipsilateral antegrade approach to the superficial femoral and popliteal arteries

Up-and-over approach to the superficial femoral and popliteal arteries

Access related issues: Difficult up-and-over approach to the superficial femoral and popliteal arter

Tibial artery occlusive disease: Angioplasty and stenting

25 Complex lower extremity revascularization

Aortoiliac occlusive disease

Femoralpopliteal occlusive disease

Tibial artery occlusive disease

Angiosomes of the lower leg and foot

26 Salvage of previous reconstructions

Introduction

Previous endovascular reconstruction

Managing occluded stents

Infrainguinal bypass graft

Extra-anatomic bypasses: Axillofemoral and femoralfemoral

Reconstructions for aortoiliac disease: Aortofemoral, iliofemoral, and aortoiliac bypasses

27 Hybrid procedures

Principles of hybrid procedures

Technical points for performing hybrid procedures

Iliac stent and femoral endarterectomy

Femoral endarterectomy plus distal intervention

28 Technical aspects of treating aortic aneurysms

Introduction

Imaging

Open access or percutaneous access of femoral arteries

Percutaneous large bore access using the pre-close technique

Closure of large bore access

Managing bad iliac arteries

Conduits

Endograft placement

Cannulation of the contralateral gate

Balloon angioplasty after endograft placement

Postplacement stenting of iliac arteries

Management of a difficult aortic neck

Endovascular graft treatment of a ruptured abdominal aortic aneurysm

Hybrid procedures associated with aortic disease: Arch debranching

Management of endoleaks after endovascular abdominal aortic aneurysm repair

29 Coiling of peripheral aneurysms

Coils

Vessel occluders

Endovascular management of a popliteal aneurysm

30 Puncture site management

Obtaining hemostasis

Holding pressure

Timing the sheath removal

Closure devices

Managing puncture site complications

Selected reading

Appendix: Trade/registered/generic names plus current manufacturers

Index

 

An aparitie	5 Sept. 2019
Autor	Peter A. Schneider
Dimensiuni	18.03 x 3.05 x 25.65 cm
Editura	CRC Press
Format	Hardcover
ISBN	9781482217377
Limba	Engleza
Nr pag	467