When the Arizona Heart Institute’s endovascular program was initiated well over two decades ago, no one could have envisioned its current acceptance by all disciplines given its checkered beginning, with skepticism and resistance to move from traditional therapies. Today, radiologists, vascular surgeons, vascular medicine specialists, cardiologists, and more recently cardiovascular surgeons have all recognized the enormous benefits of the endovascular approach to cardiovascular disease. Interventional technology has been proven to shorten hospitalization, reduce morbidity and mortality, speed recovery, and hasten return to normal life. Clinical investigations have shown these procedures to be favorable over open surgical techniques in most situations.
Despite these findings and the worldwide movement toward less invasive techniques, our training and educational programs have lagged behind the technology explosion. The core curricula in our current training residencies and fellowships in the majority of cases were not designed to easily accommodate the rapid evolution in endovascular technology. Hence, the need to revamp and expand our educational process to assure that current and future endovascular interventionalists will have adequate fundamental knowledge and skill sets.
Didactic lectures, simulations, hands-on training, and observation of the experts are all essential in this training paradigm. Importantly, learning by case example has been a hallmark in cardiovascular surgery training for decades. To assure an optimum result, the pathophysiology and anatomy of the disease process must be appreciated. Modern diagnostic tools, particularly new imaging modalities, must be understood and applied appropriately. Interventionalists today must have not only an acquaintance with the growing variety of endovascular techniques, but also a working knowledge of their efficacy. In an effort to address these needs, the authors have called upon our vast endovascular experience to assemble this textbook of thoracic endovascular interventions. It is important to note that most cases in this textbook were performed under an investigational protocol with Institutional Board Review oversight. We earnestly believe that informed patients who adhere to a follow-up protocol will generate themuch-needed data that can help us address the pressing questions in this blossoming field.
Certain limitations exist currently regarding thoracic endografting techniques and their application to thoracic aortic pathologies. There is every indication, however, that most thoracic aortic pathologies will be treated with these less invasive procedures in the future, and so this textbook should prove useful as this segment of the field expands. Our particular institution has been fortunate enough to be at the forefront of this technological revolution.
With this in mind, the textbook has been organized to begin with the currently accepted procedures and progress to those techniques for which proof of principle exists. It then proceeds to evolving areas of treatment in which further understanding and investigation are needed. The final chapters address the challenges of the ascending aortic arch, with recommendations for future endovascular technology. There is no substitute for learning from experience. It is the authors hope that endovascular management of the thoracic aortawith its case study approach will provide a useful tool for practitioners as they plan and execute treatment of patients with these thoracic aortic pathologies.
- Introduction: Current status of thoracic endografting
- CASE 1 Endovascular repair of descending thoracic aortic aneurysms using the Gore TAG stent graft
- CASE 2 Endovascular management of thoracic aortic aneurysm using a Cook Zenith TX2 endograft
- CASE 3 Endovascular management of a thoracic aortic aneurysm using a Medtronic Talent thoracic graft (VALOR trial)
- CASE 4 Endovascular management of thoracic aortic aneurysms with coverage of the left subclavian artery
- CASE 5 Endovascular management of a thoracic aortic aneurysm with tortuous aorta and calcified iliac arteries using the brachiofemoral wire approach
- CASE 6 Endovascular management of a thoracic aortic aneurysm with small tortuous calcified iliac vessels (retroperitoneal conduit)
- CASE 7 Endovascular management of a ruptured thoracic aortic aneurysm
- CASE 8 Total percutaneous endovascular management of a thoracic aneurysm with severe iliofemoral occlusive disease: use of an endoconduit in a high-risk patient
- CASE 9 Complete endovascular management of a patient with multilevel aortic disease
- CASE 10 Endovascular repair of a descending thoracic aneurysm with previous open resection of abdominal aortic aneurysm
- CASE 11 Endovascular management of penetrating aortic ulcer
- CASE 12 Endovascular management of a penetrating aortic ulcer with rupture
- CASE 13 Endovascular management of thoracic aortic disruption
- CASE 14 Endovascular management of a traumatic pseudoaneurysm postcoarctation repair
- CASE 15 Endovascular management of a traumatic pseudoaneurysm of the thoracic aorta
- CASE 16 Endovascular management of acute Stanford type B dissection
- CASE 17 Endoluminal graft repair of chronic type B dissections
- CASE 18 Endovascular management of the aneurysmal false lumen distal to an interposition graft placed for ruptured Stanford type B dissection
- CASE 19 Hybrid management of type A dissection with malperfusion of the lower extremities
- CASE 20 Endovascular management of a type B dissection complicated by renovascular hypertension
- CASE 21 Endovascular management of a chronic type B dissection complicated with a new dissection and left renal artery compromise
- CASE 22 Hybrid management of a retrograde type B dissection after endoluminal stent grafting
- CASE 23 Endovascular management of thoracic aortic pseudoaneurysms
- CASE 24 Endovascular management of thoracic mycotic aneurysms
- CASE 25 Hybrid management of an arch aneurysm with a carotid–carotid bypass and deployment of an endoluminal graft
- CASE 26 Endovascular management of transverse arch aneurysms
- CASE 27 Hybrid endovascular management of an arch pseudoaneurysm using an antegrade deployment approach
- CASE 28 Hybrid management of a retrograde type B dissection
- CASE 29 Hybrid management of a chronic type B dissecting aneurysm with ascending aortic aneurysm
- CASE 30 Hybrid repair of Extent II thoracoabdominal aneurysms
- CASE 31 Hybrid repair of an extent V thoracoabdominal aneurysm
- CASE 32 Hybrid (combined open and endovascular) repair of thoracoabdominal aneurysms
- CASE 33 Endovascular management of adult primary coarctation of the aorta
- CASE 34 Endovascular management of the small thoracic aorta with postcoarctation pseudoaneurysm
- CASE 35 Recurrent coarctation of the thoracic aorta
- CASE 36 Endovascular management of aortobronchial fistulas
- CASE 37 Endovascular management of a type I endoleak
- CASE 38 Endovascular management of a type II endoleak
- CASE 39 Retrograde dissection following endovascular management of thoracic aortic aneurysm
- CASE 40 Endovascular management of an ascending aortic pseudoaneurysm
- CASE 41 Endovascular management of aneurysm of a right coronary vein graft using an ascending aorta endoluminal graft
- CASE 42 Hybrid approach to the management of a type C innominate artery aneurysm
- CASE 43 Remote wireless pressure sensing for postoperative surveillance of thoracic endoluminal grafts
- CASE 44 Zenith DissectionTM Case Study
Product Details
Hardcover: 320 pages
Publisher: Wiley-Blackwell; 1 edition (August 5, 2008)
Language: English
ISBN-10: 1405175354 / ISBN-13: 978-1405175357
List Price: $189.95