Visceral Vessels and Aortic Repair: Challenges and Difficult Cases

Description:

This book shows how new technologies and technical skills together with deeper understanding of pathophysiology of visceral and renal ischemia have contributed to significant improvements in the clinical outcomes in patients undergoing complex aortic repair involving splanchnic arteries. In recent years, aortic repair has expanded its borders, focusing more and more on the particularly challenging segments from which critical branches originate. Optimal results in this area are obtained through a multidisciplinary approach based on crucial elements such as sophisticated imaging techniques, advanced anesthesiological and pharmacological strategies, as well as updated surgical techniques and devices able to reduce ischemic injuries. The book presents problems tackled from different perspectives, by analyzing the main technical aspects of the surgical technique but also functional and metabolic issues. It also discusses concepts such as ischemic preconditioning and ischemia-reperfusion mechanisms, as well as innovative investigational approaches. In the “endovascular era”, it highlights the most recent updates in complex endovascular repair involving renal and visceral arteries, providing both practical tips and tricks and outcomes analyses. The volume also addresses specific, rarely reported problems in vascular surgery, including issues in renal transplant, oncologic surgery with involvement of splanchnic arteries and of the vena cava, and use of the deep veins in aortic surgery. This volume represents a powerful tool for both young and experienced operators who wish to approach the complex aortic pathology either by open surgery or through endovascular methods.”

Table of contents:

Part I. Introductory Remarks

1. Anatomical Overview and Imaging of the Aorta and Visceral Arteries

2. Ischaemic Preconditioning: The Rationale and Evidence-Based Outcomes

Part II. Abdominal Aorta

3. Open Repair of Pararenal Aneurysms: Renal Vessel Surgical Management

4. Aortic “Coral Reef” with Visceral Artery Involvement: Treatment Options

5. Renal Vascular Anatomic Abnormalities During Open Abdominal Aortic Repair

6. Endovascular Aortic Repair: The Renal Side of the Story

7. Device Evolution and New Concepts to Preserve Renal Artery Patency in Challenging Infrarenal Aortic Necks

8. Hypogastric Artery Management During Open and Endovascular Aortoiliac Repair

9. Operative Management of Type II Endoleaks After Aortic Endovascular Repair

10. Vascular Reconstructions in Kidney Transplantation

11. Renal Transplantation and Aortic Disease: Operative Management

12. Ex Vivo Open Reconstruction of Hilar Renal Artery Aneurysms: A Single-Center Experience

13. Pulsate Perfusion of Allografts

Part III. Thoracoabdominal Aorta

14. Physiopathology of Intraoperative Visceral Ischemia and Anesthesiological Management of Supravisceral Aortic Clamping

15. Tissue Ischemia During Aortic Repair: The Point of View of the Perfusionist

16. Perioperative Renal Pharmacological Protection During Cardiovascular Surgery

17. Renal Perfusion During Aortic Surgery: Looking for the Ideal Substrate

18. Thoracoabdominal Aortic Aneurysm Open Repair: Visceral Arteries Reattachment Strategies

19. Renal and Visceral Sutureless Anastomosis During Thoracoabdominal Aortic Repair

20. Long-Term Patency of Visceral Vessels After Thoracoabdominal Aortic Repair

21. Hybrid Repair of Thoracoabdominal Aortic Aneurysm with Rerouting of Visceral Arteries

22. Toward an Entirely Endovascular World for Thoracoabdominal Aortic Disease: Myth or Reality?

23. Total Endovascular Repair of Thoracoabdominal Aortic Aneurysm: Lessons Learned

24. Recurrent Thoracoabdominal Aortic Aneurysm with Visceral Artery Involvement: Treatment Options

25. Preoperative Assessment of the Spinal Cord Vasculature

26. Intercostal Artery Reattachment Guided by Intraoperative Neurophysiologic Monitoring During Open Thoracoabdominal Aortic Repair: Basic Principles and Clinical Experience

27. Spinal Cord Protection During Open and Endovascular Aortic Repair: State of the Art

28. Current Trends of Treatment Options for Complex Aortic Pathology with Visceral Artery Involvement in a Large Single-Center Experience

29. Visceral Ischemia During Type B Dissection: Incidence, Prognostic Value, Diagnosis, and Operative Management

30. Understanding Visceral Ischaemia in Acute Type B Dissection: State of the Art, Challenges and Future Perspectives

Part IV. Visceral Vessels Management in Oncologic, Infectious and Inflammatory Diseases

31. Vascular Reconstruction in Oncologic Patients with Aortic and Visceral Artery Involvement

32. Oncovascular Surgery; Surgery of the Vena Cava-Related Tumors

33. Aortic Infection with Visceral Artery Involvement in the Endovascular Era: Treatment Options

34. Management of Aortic Infections: Role of Open Surgery and the Value of Multidisciplinary Team Approach

35. Large-Vessel Vasculitides: Takayasu Arteritis and Giant Cell Arteritis

36. Visceral Artery Involvement in Takayasu Patients: Treatment Options