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.

This text evolved as a response to numerous requests to present a simplified approach to the diagnosis and management of most of the common aspects of both cosmetic and medical venous disorders. The authors, representing experienced plebologists from several different primary disciplines, have attempted to present simplistic paradigm-oriented approaches on how to thoughtfully evaluate and manage common vein issues with contemporary solutions. Several areas of phlebology were not addressed in this text. The management of vascular malformations are beyond the scope of this text and were not covered in detail. Although indications for the appropriate use of IVC filters are discussed, the details about the specific devices, their placement and removal are also beyond the scope of this text. Deep venous obstruction from prior thrombosis, venous compression by arteries such as the compression of the left common iliac vein by the right common iliac artery and pelvic venous insufficiency can now be managed with minimally invasive image guided treatments; the technical aspects of such treatments are complex and not discussed in detail in this handbook. This book will increase the therapeutic skill of the practicing phlebologist and thus increase the quality of care for patients faced with problems related to venous disorders.

A comprehensive, evidence-based introduction to the area of lymphology, the book is directed mainly to the US audience and will appeal to an interdisciplinary field of health professionals. It describes the unique anatomy and physiology of the lymphatic system and the intimate relationship it shares with the venous system. It explores the differential diagnosis of the "swollen leg/arm", which is often the presenting problem to the health care professional. The necessity of history taking, physical examination and laboratory studies are noted. Treatment methods are described as an introduction and psychosocial and quality of life issues are explored in depth.

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.

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.

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.

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$.

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.

In diesem Buch erfahren Betroffene alles Wissenswerte uber Krampfadern, Beinschwellung und Beinvenenthrombose: Ursachen der Erkrankung, Krankheitserscheinungen, Unterschiede zu anderen Erkrankungen der Beine, Diagnose- und Therapiemoeglichkeiten. Die Wahl des richtigen Arztes und die Vorbereitung auf das Gesprach mit dem Arzt werden detailliert beschrieben, ebenso die Untersuchungen, die der Arzt durchfuhrt. Ausfuhrlich und ausgewogen sind die zahlreichen Behandlungsmoeglichkeiten dargestellt und wird erlautert, welche der Verfahren in welcher Situation hilfreich sind; Medikamente und Kompressionsbehandlung sind ebenso berucksichtigt wie Venenveroedung, chirurgische Eingriffe und naturheilkundliche Verfahren. In einem eigenen Kapitel werden Tipps zum Leben mit Krampfadern und Empfehlungen zu Sport und Freizeitgestaltung gegeben.

G. Carstensen Die Chirurgie ist eine Wissenschaft, ihre Ausubl, mg ein Handwerk; sie verlangt eine UEbereinstimmung logischer, handwerklicher und intuitiver Vorgange, wobei der Kopf die Hand leitet. Wissenschaft ist nicht nur der jeweilige Stand unserer Er- kenntnisse, sondern auch unserer Irrtumer - allerdings mit der Einschrankung, dass der Irrtum von heute der Fortschritt von morgen sein kann und unsere Fahigkeiten, Entwicklungen vorauszusehen, nicht uberschatzt werden sollten. Eine Wissenschaft hutet als wertvollstes Gut, was sich nach Bewahrung durchge- setzt und als Bestand erwiesen hat. Diesem Ziel dienen unsere Tagungen, die auch Auskunft uber neue Entwicklungen oder sich abzeichnende Ergebnisse zu erteilen haben. Ausserdem verlangt die wissenschaftliche Halbwertszeit des Arztes nach standiger Erneuerung und Erganzung des Wissens. Chirurgischer Fortschritt grundet sich nicht zuletzt auf die Erkennung und Ver- meidung intra-und postoperativer Komplikationen, deren Eroerterung auf unseren Kongressen und im Schrifttum meist zu kurz gerat, weil verstandlicherweise lieber vom Erfolg geredet wird. Jedoch, das Kriterium und Gutezeichen chirurgischer Ar- beit ist die Sicherheit des Eingriffs, und zwar in der Indikation wie in der operativen Durchfuhrung. Diesem Buch und seiner Sammlung sei daher ein Wort von Rudolf Nissen vorangestellt: Es tut allen, den Jungen wie den Alten, gut, immer wieder daran erinnert zu werden, dass Unvollkommenheit der Leistung unser tagliches Schicksal und dass ih- re klare Erkenntnis der beste Weg ist, sie zu vermeiden.

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.

This book, from the faculty and residents of one of the world's most respected hospitals, provides a comprehensive and concise approach to vascular disease. Beginning with the foundations of vascular disease and diagnosis, this text moves on to cover critical disease processes. Each section of the book, dedicated to a unique pathology, explains salient pathophysiology, presentation, diagnosis, treatment options, and outcomes. A special emphasis is given to both open and endovascular techniques and their related pitfalls. Additionally, reflecting the growing importance of evidence-based medicine, readers are provided with references to critical publications that underpin diagnostic and therapeutic recommendations. Diagnosis, treatment, and more are provided succinctly, allowing this text to be broad in focus while remaining in a convenient portable format. As a brief review for practicing physicians or a primary educational text for fellows, residents, and medical students, Cleveland Clinic Manual of Vascular Surgery is a valuable addition to everyone's library.

Die Mikrogefasschirurgie spielt bei Gewebetransplantationen eine immer groessere Rolle. Dieses Buch ist ein "Gewusst-wie"-Text uber die mikrovaskulare Rekonstruktionschirurgie, das vorwiegend von einem einzelnen Chirurgen geschrieben wurde. Es richtet sich sowohl an den erfahrenen als auch an den noch in der Ausbildung befindlichen Chirurgen. Das Buch ist in zwei Abschnitte gegliedert. Der erste beschreibt die operative Anatomie und Technik, die mit der Hebung jedes freien Gewebetransfers verbunden ist. Der zweite Teil behandelt die Anwendung dieser Transplantate fur die Rekonstruktion in drei anatomischen Regionen, in denen die rekonstruktive Mikrochirurgie bedeutende Ergebnisse geliefert hat: Kopf, Hals sowie obere und untere Extremitat. Das Buch ist ein aktuelles Nachschlagewerk fur jeden auf diesem Gebiet arbeitenden Chirurgen, Orthopaden und Traumatologen.

Schritt fur Schritt fuhrt Sie das Buch durch alle Standards und Fallstricke der Methode. Jedem Textteil folgt der zugehoerige Atlasteil. Den Farbduplexbildern sind immer Arterio- bzw. Phlebogramme gegenubergestellt.

Die Gefasschirurgie wandelt sich. Neue Verfahren scheinen Altbewahrtes abzuloesen. Die medizinischen Strukturen erfahren entsprechende AEnderungen. Ist eine Kooperation zwischen der Gefasschirurgie und der Interventionellen Radiologie moeglich? Im Juni 1997 trafen sich namhafte Spezialisten auf dem Kongress fur Gefasschirurgie am AK Hamburg-Harburg. Neben einer Bestandsaufnahme der gegenwartigen Situation und ihren empirischen Wurzeln, wurden Perspektiven fur die Zukunft der Gefasschirurgie vorgestellt und diskutiert.

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.

von Methoden und Resultaten Zu 48 ausgewahlten Fragen um die extrakorporale Zirkulation wurde eine systematische Literatursuche in zwei Datenbanken (PubMed und MedLine), die die letzten zwanzig Jahre umfasste, vorgenommen. Die hierbei von dem jeweiligen Autor verwendeten Suchbegriffe wurden von je zwei unabhangi- gen weiteren Mitarbeitern der Arbeitsgruppe, die insgesamt 38 Autoren umfasst, uberpruft, um ein moeglichst komplettes Resultat zu erzielen. Nach Durchsicht der gefundenen Abstracta wurden alle fur die jeweilige Fragestellung wesentlich erscheinenden Publikationen nach einem zuvor fest- gelegten Schema, das eine UEbersicht uber Zielsetzung, Fragestellung, Metho- dik, Resultate, Schlussfolgerungen gibt, zusammengefasst. Die adaquate An- wendung statistischer Methoden in den einzelnen Originalquellen wurde kri- tisch uberpruft und mit beratenden Statistikern diskutiert. Abschliessend wur- de fur jede Arbeit eine Einschatzung der wissenschaftlichen Evidenz gemass eines modifizierten Klassifizierungsschemas der AHA/ ACC vorgenommen: Klasse 1 Untersuchungen mit einer klaren wissenschaftlichen Evidenz, dass ein Ver- fahren sinnvoll und effektiv ist (grosse randomisierte prospektive Studien mit niedrigem Falsch-Positiven (Alpha) und Falsch-Negativen (Beta) Fehler, Metaanalysen nach Evidence-based -medicine-Kriterien). Klasse 2 Untersuchungen, die keine klare wissenschaftliche Evidenz uber die Effekti- vitat eines Verfahrens zeigen, z. B. aufgrund einer geringen untersuchten Fallzahl oder eines nicht perfekten Studiendesigns. Klasse 3 Untersuchungen, die keine wissenschaftliche Evidenz uber die Effektivitat eines Verfahrens geben koennen (Untersuchungen mit niedrigem WIssen- schaftlichen Impact, Fallreportagen-Einzelbeobachtung). Klasse 4 In-vitro-Studien, tierexperimentelle Studien, Reviews, die nicht Evidence- based-medicine-Kriterien entsprechen.

"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.

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.

This book reviews the surgical management of patients with aortic disease, revealing many options open to cardiovascular specialists in this often controversial area of management. It reviews each controversy and provides clinical information for cardiac surgery, and discusses the spectrum of disorders and their management. With the knowledge base in this discipline changing rapidly, Controversies in Aortic Dissection and Aneurysmal Disease meets an important requirement to consolidate the wide-ranging information on which clinicians must base their practice. It is directed towards surgeons, physicians, and healthcare workers involved in the care of patients requiring cardiac, cardiothoracic and cardiovascular surgery. This book will be an essential resource for these professionals looking to accelerate the translation of basic research findings into clinical study and practice.

Among recent developments in vascular surgical techniques is the use of surgical strategies in which different techniques are combined. "Hybrid Vascular Procedures" discusses those procedures including endovascular and open surgery, endovascular and laparoscopic surgery, robotic and laparoscopic surgery, and video-assisted procedures.

The various chapters, written by international experts in the field, describe hybrid procedures in the supra-aortic trunks and cerebral arteries, in the thoracic aorta, the abdominal aorta, the lower limbs, and miscellaneous other procedures.

These new technologies and their application will determine the future of vascular surgery.

Das Anliegen dieses Buches ist, Problemfalle aus der gefasschirurgischen Praxis darzustellen und die Bewaltigung dieser Grenzsituationen aufzuzeigen. Schwerpunkte sind die Indikationen zum operativen Vorgehen bei Verschlussprozessen im Bereich der Karotisstrombahn, der Nieren- und Viszeralarterien und die praktisch inoperablen arteriellen Gefassverschlusse amputationsbedrohter Extremitaten. Die rechtliche Absicherung dieser in Grenzsituationen notwendigen und moglichen operativen Eingriffe behandelt das Buch im zweiten Themenkomplex, der folgerichtig die juristischen Aspekte fur den Chirurgen darstellt."

Das vorliegende Buch ist ein praktischer Leitfaden der interventionellen Techniken f}r die Gef{ intervention und richtet sich damit sowohl an rzte, die mit Gef{ intervention beginnen wollen, als auch an Kollegen, die bereits Erfahrungen gesammelt haben und sich in den modernen Techniken und Materialien fortbilden wollen. Angesprochen sind alle Praktiker in den Bereichen Radiologie, Chirurgie and Innere Medizin. Zur didaktischen Veranschaulichung sind die Kapitel des Buches einheitlich nach Pathophysiologie, Indikation, medikament-se Zusatztherapie, Beschreibung der Materialien, Methodik, Ergebnisse, Komplikation und Vorsichtsma nahmen gegliedert. Das Buch enth{lt viele wertvolle Anregungen zu allerneuesten Techniken und Materialien wie Stents, Mikroembolisationskatheter, Pulse-Spray u.v.a.m.