This is the second edition of a well-received book that has been recommended for inclusion in any vascular library or vascular radiology suite. The first edition has been fully revised so as to provide a comprehensive, up-to-date account of vascular ultrasound that reflects recent advances. The emphasis remains on the clinical aspects most relevant to angiologists and vascular surgeons. Ultrasound anatomy is discussed, examination procedures explained, normal and pathological findings described, and the clinical impact of ultrasound assessed. Atlas sections present pertinent case material to illustrate typical ultrasound findings for both the more common vascular diseases and rarer conditions. This book will serve not only as an invaluable guide for beginners, but also as an indispensable reference for experienced sonographers, who will benefit from the detailed evaluation of the role of ultrasound as compared with other modalities and the discussion of ultrasound findings in their clinical context.

Written by internationally acclaimed specialists, Cardio-Thoracic, Vascular, Renal and Transplant Surgery provides pertinent and concise procedure descriptions spanning benign and malignant problems and minimally invasive procedures. Complications are reviewed when appropriate for the organ system and problem, creating a book that is both comprehensive and accessible. Stages of operative approaches with relevant technical considerations are outlined in an easily understandable manner. Forming part of the series, Surgery: Complications, Risks and Consequences, this volume Cardio-Thoracic, Vascular, Renal and Transplant Surgery provides a valuable resource for all general surgeons and residents in training. Other healthcare providers will also find this a useful resource.

Vascular care has evolved from conservative therapy and open surgical therapy to a minimally invasive approach using endovascular techniques, laparoscopic or thoracoscopic techniques as well as hybrids of open and endovascular techniques. This volume provides up-to-the-minute information and details new developments and procedures.

Designed to provide a highly visual reference for surgeons and other members of the patient management team, Atlas of Intestinal Stomas is based on the 1967 gold standard text, Turnbull and Weakly's Atlas of Intestinal Stomas. Additions include chapters on anatomy and physiology, biliary stomas, pediatric ostomies, the continent ileostomy, urostomy, laparoscopic stoma construction, stomas in trauma surgery, stomas for antegrade continence enema, percutaneous ostomies, and quality of life. There are also sections on ileostomy, colostomy, enterostomal therapy and on the management of complications of stomas such as management of the high output ostomy, enterocutaneous fistula, parastomal hernia, prolapse, and skin conditions. The Cleveland Clinic pioneered the entire practice of ostomies, beginning in 1858 and continuing to this day as the world's leading academic and clinical center. The editors and contributors are all current or former Cleveland Clinic physicians and instructors. The fundamental focus of the book is not only how to install ostomies, but how to avoid complications and how to treat complications when they arise. Atlas of Intestinal Stomas will be of great value to colorectal and general surgeons, both in practice and in training.

When doctors first look at sutureless anastomosis devices created by new technologies, the most frequent comment is how amazingly easy it is to create a vascular anastomosis and, as a direct consequence, they believe anybody could play the role of the cardiovascular surgeon. Pessimistic c- diovascular surgeons, on their side, think that creating a machine capable of perfectly reproducing their core activity, which consists in making an- tomosis, will kill their profession. Actually, no medical specialty's demise has been more often predicted and, at the same time, more greatly ex- gerated than that of cardiovascular surgery. According to its detractors, - ginning in the late 1980s with the angioplasty boom, continuing in the mid-1990s with the introduction of bare metal stents, and then more - cently with the introduction of drug-eluting stents, cardiovascular surgery has been on life support for nearly 15 years. This specialty's claimed collapse has generally been attributed to recent advantages in percutaneous procedures and devices that give the oppor- nity to non-surgeon doctors to accomplish the surgeon's work. The reality is different. Data suggest that cardiac surgery continues to survive and has not suffered the precipitous decline that was predicted. From the economical standpoint, CABG is much more of a mature market and the size of the opportunity remains impressive and relatively stable, with around 1,500,000 procedures performed annually worldwide, at a total cost approaching 2. 5 billion US$.

Leading interventional cardiologists, including Patrick Serruys, provide the gold-standard reference on the treatment of restenosis for interventional cardiologists. Dr. Serruys, who pioneered the use of drug-eluting stents, and other pioneers in the field, cover everything from non-invasive imaging, to eluting stents, to brachytherapy through to the latest molecular biology-based treatments including antisense, stem cells and gene therapy.

Over the past three decades, carotid artery stenting has evolved to become a promising and viable alternative to carotid endarterectomy, especially for patients deemed to have high surgical risks. In Carotid Artery Stenting: The Basics, Jacqueline Saw and a panel of international experts on carotid artery stenting discuss in depth the details of all contemporary aspects of carotid stenting, while reviewing supporting studies, guidelines, technical perspectives, and peri-procedural management. This textbook serves as a learning resource on the multifaceted management of patients with carotid artery stenosis, with the key focus on extracranial carotid artery stenting. Additional sections detail the specifics of setting up and maintaining a laboratory and discuss the preparation of the carotid artery stenting procedure from both the patient and operator's perspective. Authoritative and highly practical, Carotid Artery Stenting: The Basics is an accessible guide and valuable resource for today's cardiologists, radiologists, and vascular surgeons.

The thoraco-abdominal aortic pathology is not uncommon and represents the ultimate challenge for vascular surgeons. The book deals with the newest endovascular and hybrid approaches, together with more traditional surgical strategies. Written by internationally renowned experts in vascular and cardiac surgery, anesthesiology and radiology, the volume provides a very practical approach to the main problems encountered from diagnosis to postoperative care: general principles of aortic diseases, imaging techniques, surgical and anesthesiologic strategies and techniques and other specific problems are some of the topic dealt with. Numerous pictures illustrate the most important diagnostic findings and depict key techniques and strategies. Vascular and cardiac surgeons, anesthesiologists, perfusionists and radiologists will find in this volume useful and updated information for the treatment of this very challenging condition.

Since the introduction of laser devices to the medical sciences this technology has created great interest. Specifically, the laser's unique physical properties and precise bio-tissue interactions render this versatile source of biologic energy an attractive tool for multiple therapeutic purposes in cardiovascular medicine. Over the course of the last 2 decades the utilization of laser technology has become an important component for the management of patients with complex cardiovascular diseases. During this time period, cutting edge laser technology including a variety of wave length generators, newly designed catheters, and a selection of advanced optic fibers have been introduced and applied in the cardiovascular circulation. Improved lasing techniques in the cardiac catheterization suites and operation rooms have been implemented for treatment of ischemic coronary syndromes, peripheral arterial occlusive disease and other atherosclerotic thrombotic conditions. Moreover, during this 20 year time frame, several multicenter and single center clinical studies have been published focusing on the role and utilization of lasers in coronary and peripheral revascularization. And within the rapidly expanding field of interventional cardiac electrophysiology, laser technology has recently revolutionized the management of fractured, abandoned and malfunctioning leads of cardiac pacemakers and automatic defibrillators. Consequently, replacing a notoriously cumbersome and high risk open heart surgery with safe and markedly efficient percutaneous laser based extraction. This textbook will provide the most authoritative, comprehensive and contemporary information covering technological progress, clinical experience and pertinent aspects of laser applications in cardiovascular medicine. It will be of interest to cardiologists, vascular surgeons and interventional radiologist as well as medical students, scientists, biomedical engineering students and graduates.

"Potential anatomical spaces" have attracted surgeons in the past and in recent years. Due to the development of modern imaging techniques and the advent of minimally invasive surgery, access to these spaces has become a real surgical option. The purpose of this book is to document the challenges related to "potential anatomical spaces", traditionally described as "hidden" spaces. The spread of video-assisted surgery and its application in the management of diseases involving organs or anatomical structures placed in the "potential spaces" (neck, mediastinum, pro-peritoneum and retro-peritoneum, subfacial space of the leg, and axilla), has rendered their surgical anatomy less abstract.

This updated and revised third edition of Vascular Surgery: Cases, Questions and Commentaries provides a unique collection of real-life case histories, written by experts, that highlights the diversity of problems encountered in vascular surgery. With an international panel of contributors, many of whom are also examiners on the UK, European or American Boards in Vascular Surgery, this book familiarizes the reader quickly with day-to-day clinical practice. Case studies are presented in question-and-answer format and have been widely referenced to reassure the reader that their contents are established best practice. Most cases are accompanied by multiple x-rays or color illustrations for visual clarity. This book serves as a teaching resource for vascular trainees or practitioners who are reviewing for the oral board exam or practitioners who wish to refresh their expertise with an interactive source of information. It also provides established practitioners the wherewithal to review the current standards of practice in vascular surgery.

Written by leaders in the field, the third edition of Common Surgical Diseases: An Algorithmic Approach to Problem Solving, provides surgical residents and medical students with a current, concise and algorithmic approach to frequently encountered clinical challenges. Each chapter details every common surgical disease in the form of a succinct text coupled with step-by-step algorithm. It also walks the reader through the evaluation, diagnosis, treatment and follow-up of the most common surgical problems. Thoroughly updated and revised, the third edition focuses on problems most frequently encountered by general surgeons and their residents and students. More factual information is included in the form of charts and tables for quick and easy reference. The section on critical care is updated and expanded. The section on pre-operative considerations has new chapters on how to best manage patient's medications before surgery (anticoagulants, anti-platelet drugs) and prophylaxis of deep venous thrombosis. Other new chapters include access for hemodialysis, adrenal incidentaloma, esophageal cancer, pancreatic cancer, management of abdominal wall defects, hyperglycemia, necrotizing soft tissue infections and SIRS/sepsis. Especially pertinent in todays' medical environment is an understanding of the genetic component of certain cancers and chapters are devoted to screening and treating patients with genetic predispositions to colorectal and breast cancer.

It is with great pleasure that we here present Artificial Heart 4 (proceedings of the 4th international symposium on artificial heart and assist devices). The symposium was held in Tokyo, Japan, on August 7 and 8, 1992 under the patronage of Mr. Hiromitsu Yoshioka, Chairman of the Board of Trustees, Tokyo Women's Medical College. Artificial heart 4 consists of the papers presented in nine sessions: Oral Presentations A to E, Forums 1 to 10, and nine lectures by invited guest speakers from the United States and Europe. In this volume, papers from two new sessions, sessions IV and VII, entitled New Approaches, were prepared for devices and systems developed according to new ideas. Twenty-one papers in these two sessions were presented in five Forums (3, 4, 7, 8, and 9). Session VI was provided to deal with heart transplantation, which is now closely related to both ventricular assist systems (VAS) and the total artificial heart (TAH). In this session, papers by two guest speakers from major heart transplantation centers in Europe were included.

Chronic venous insufficiency, manifesting as disabling open leg ulcers, lipodermatosclerosis and severe cutaneous hyperpigmentation is thought to affect five percent of the population over age 80 and a significant proportion, probably greater than one percent, of Western populations under age 65. To date little has been known about how to treat this condition cost-effectively beyond supportive and palliative care. Thus, the most important feature of Chronic Venous Insufficiency is that it describes the interventions which markedly ameliorate, and in some cases cure, the condition. The authoritative text has been skilfully illustrated to show how new methods of endovascular and endoscopic interventions can be integrated with radiologic techniques to correct totally the abnormalities which produce chronic venous insufficiency. Taken as a whole this volume will enable general surgeons, vascular surgeons, dermatologists and interventional radiologists to treat a condition that was, until recently, thought to be untreatable.

The 5th International Symposium on Artificial Heart and Assist Devices was held in Tokyo on January 26 - 27, 1995, bringing together leading researchers and specialists from all over the world. The proceedings of the symposium presents the newest ideas and approaches in the field, and will be of special interest and relevance to all who are concerned with artificial organs, cardiovascular surgery, organ transplantation, biomaterials, and related disciplines. Reflecting the content of the symposium, the major topics in this volume include biocompatible material development, clinical use of assist devices, completely implantable devices, and heart transplantation. These are presented in the two main divisions of the book: The first consists of eight lectures by leading researchers, world-renowned in the field of the artificial heart. The second comprises more than 50 papers on such subjects as biomaterials, research and development of ventricular assist systems and the total artificial heart, and their use as a bridge to heart transplantation. An additional, special feature of the book is the inclusion of descriptions of exhibitions at the symposium, with photographs of all artificial heart devices and systems displayed by major laboratories and companies from around the world.

Venous valves rank among the smallest and most delicate organs of the human and animal bodies - so why devote an entire book to them? We were induced to do so by several reasons. First of all we would point out the clinical significance of venous valves. In the pathogenesis of a number of widespread diseases, such as varicose veins or the post-thrombotic syndrome, venous valves are involved as the underlying cause or at least a factor contributory to the symptoms. According to Taheri et al. these venous diseases occur ten times more frequently than arterial obliterations. Incompetence of venous valves also plays a causal role in varicocele, the most frequent cause of male infertility. But not only pathogenetic reasons induced us to write this book. In more recent times there has been a growing tendency to reconstruct functional valve disorders therapeutically; several surgical methods have been developed, which are critically reviewed in this book. It was our aim to sum up existing knowledge with respect to structure and function of venous valves and to expand that knowl edge by findings of our own. Examinations of semi-thin sections and unilayered en-face preparations have hardly been published so far, and systematic studies of the ultrastructure by electron-microscopy were not to be found in the literature. We are very grateful, therefore, to Dr. Silvana Geleff for having undertaken such a study upon our suggestion."

Handbook of Endovascular Interventions presents a step-wise approach to the techniques of peripheral vascular interventions. Covering interventions in all major organ systems, this concise and comprehensive resource provides the rationale on why these approaches have been adopted by most practicing vascular interventionalists. This volume also presents key information on intervention techniques and pitfalls, complications and their management, surgical management options, as well as landmark papers on the topic. Unique to this book is the inclusion of sections building an endovascular suite, and coding as well as international training paradigms across the globe. Authored by international experts from around the globe, Handbook of Endovascular Interventions is a true how-to book for the busy interventionalist.

As societies have aged and aortic diseases have become more prevalent, advances in diagnostic imaging and surgical techniques have brought significantly improved results for patients. In cardiovascular surgery, important questions remain to be addressed, however. "Strategy for Cardio-aortic and Aortic Surgery" was the theme of the 7th Keio University International Symposium for Life Sciences and Medicine. Meeting in Tokyo, researchers and specialists in cardiac surgery from around the world discussed crucial issues in their field. Papers from the symposium, collected in this volume, cover a broad range of topics, including recent advances in diagnostic imaging, brain protection during aortic surgery, spinal protection during thoracoabdominal aneurysm repair, treatment of type A acute aortic dissection, and stent-grafts and less-invasive aortic surgery. This unique book provides valuable information especially for aortic, cardiovascular, and thoracic surgeons.

In this first volume of the series Update in Plastic Surgery, internationally acknowledged experts give an up-to-date view of the clinical possibilities in plastic surgery which result from video-assisted microsurgery with the endoscope. Advantages and disadvantages are discussed, and reasons are presented why it can be assumed that this technique will be the standard in plastic surgery within a few years.

The International Symposium on Artificial Heart and Assist Devices has been held three times, first in 1985, then in 1987 and 1990. It is my great pleasure to present Artificial Heart 3 (Proceedings of the 3rd International Symposium on Artificial Heart and Assist Devices). The third symposium was held in Tokyo on February 16 and 17, 1990. Our original intention was to invite all the principal investigators from the major artificial heart research laboratories in the world, in the first three symposia. The numbers of investigators in the fields of the artificial heart, ventricular assist systems, and biomaterials, invited for the symposia, totalled 7 in 1985, 8 in 1987, and 13 in 1990. The program of the third symposium consisted of 41 papers; 13 invited lectures, 8 papers contributed upon request, with 2 from the United States, and 20 regular selected papers including 2 from the United States, ana 1 each from Australia, Germany, and South Korea. During the last three years, the state of clinical application of artificial hearts and assist devices has changed. In the case of pneumatically driven blood pumps, we have now stepped into the age of practical use in patients. Accordingly, in this symposium we gave a special emphasis to topics of clinical application, particularly the use of an artificial heart as a bridge to heart transplantation. Sessions on implantable artificial hearts, biomaterials for the artificial heart, and heart transplantation were also included.

A definitive, comprehensive text on the technological developments and clinical applications of this critical subject matter. Written for the entire heart surgery team, this volume covers the physiology of cardiopulmonary bypass, mechanics and components of the heart-lung machine, the conduct of cardiopulmonary bypass in cardiac surgery, non-cardiac applications of cardiopulmonary bypass, and mechanical assistance of the failing heart and lung. The authors also give special consideration to such areas as blood conservation in cardiac surgery, religions objections to blood transfusions, medical-legal aspects and cardiopulmonary bypass, as well as warm blood cardioplegia and normothermic cardiopulmonary bypass.

Emergency General Surgery has become a cornerstone of Acute Care Surgery over the past decade. Once the scope of community general surgeons, the growing complexity of patients with acute surgical diseases has increasingly driven their care to tertiary referral centers. The aging population confounds this problem further as these patients present with more complex comorbidities, life-threatening physiology, and progressively severe anatomic disease severity. To ensure better outcomes, the practice has evolved to focus on evidence-based practice management guidelines in order to standardize care and optimize outcomes. The purpose of this text is to be a comprehensive volume for patients with acute surgical diseases. There will be three sections, each comprised of multiple chapters. The first section will be a comprehensive analysis of the background of Emergency General Surgery. The goal of this section will be to provide the reader background into the acute surgical practice and to introduce the reader to the important concepts discussed in the remainder of the textbook. The second section will be the largest and will discuss specific acute surgical diseases. Individual chapters will outline the diagnostic approach, current treatment standards, operative approaches, and expected outcomes with an emphasis on practice management guideline implementation into practice. As acute surgical diseases and surgical critical care are integral to each other, the last section will be Critical Care for the Acute Care Surgeon. These topics will focus on the critical care concepts essential to surgeons who care for acute diseases. This comprehensive text is targeted to any surgeon who takes emergency call for any of the listed diseases including community and referral general and vascular surgeons. In addition, this would be an excellent resource for all general surgery residents. Lastly, this would also serve as a resource to intensivists who care for acute surgical patients.

A comprehensive review the state-of-the-art in atherosclerosis of the arteries of the legs and feet. The authors discuss in detail the primary symptom-claudication-an intermittent pain in the leg or foot while walking, its predisposing factors, the current diagnostic methodologies, the impressive advances in the therapeutic armamentarium, and the need to screen for co-existing coronary artery disease. Additional chapters describe cutting-edge noninvasive angiography and vascular flow studies, specific drug therapy for claudication, regression of atherosclerosis therapy, gene therapy, and drug eluting stents for peripheral arterial disease. The authors also examine the epidemiology of LEAD, the effects of smoking and effective smoking cessation programs, its pathogenesis and its association with lipid abnormalities and hypertension, aggressive risk factor modification, and the need to measure the ankle brachial index of every patient over 45.

A comprehensive survey by leading basic and clinical researchers of the signal transduction mechanisms responsible for lung inflammation, including vascular hyperpermeability, white cell accumulation, and vascular remodeling. The authors cut across disciplines to bring together a broad-based presentation of inflammatory challenge, both in the initial phases of the inflammatory response, as well as in the more prolonged phase of genomic involvement. The book illuminates not only the processes of lung inflammation, but also the potential for developing new therapeutic strategies to combat inflammatory lung disease.

Stroke is the second leading cause of death and major cause of long-term disability, directly impacting the quality of life, worldwide. Strokes with more rare, and unknown causes unfortunately receive little to no attention due to the heterogeneity of disorders and a poor understanding of clinical features. There are considerable variations in the etiology of this rare sub-category of stroke; requiring heightened clinical awareness for recognition, evaluation and treatment. This book provides up-to-date guidance, through case reports concisely summarised by global leaders in the field describing the diagnosis and treatment of rare causes of stroke, from vasculitis, hypercoagulable states, hereditary and genetic factors, cardioembolism, vasculopathies, venous occlusive conditions to bone disorders. Offering practical advice and algorithms, this book aids the clinician in establishing an accurate diagnosis through detailed evaluation of such patients, leading to an early diagnosis improving risk assessment and family counselling.