Current Therapy in Vascular and Endovascular Surgery

Front Matter
Copyright
Contributors
Preface
Cerebrovascular Disease
	1 Cerebrovascular Disease
		Pathology of Carotid
Artery Atherosclerosis
		Geometry of
The Carotidbifurcation
		Hemodynamic Conditions At Thecarotid Bifurcation
		Carotid Bifurcation Atherosclerosis
	2
Carotid and Vertebral Artery Fibrodysplasia
		Carotid Artery Fibrodysplasia
		Vertebral Artery Fibrodysplasia
	3
Carotid Artery Dissections
		Clinical Pathophysiology
		Diagnosis
		Treatment
		Outcomes
	4
Carotid Artery Kinks and Coils
		ETIOLOGY
		EPIDEMIOLOGY
		IMAGING AND DIAGNOSIS
		MANAGEMENT AND TREATMENT
	5
Giant Cell Arteritis
		PATHOPHYSIOLOGY
		CLINICAL FEATURES
		DIAGNOSIS
		MEDICAL TREATMENT
		SURGICAL TREATMENT
		PROGNOSIS
	6
Arteriographic Evaluation of Cerebrovascular Disease
		INDICATIONS FOR CATHETER-BASED ANGIOGRAPHY
			Diagnostic Indications
			Intraoperative Indications
			Surveillance
		ANGIOGRAPHIC PROCEDURES
			Access to the Arterial System
			Sheath and Catheter Principles
			Contrast Agents
			Vessel Selection
			Catheter Positioning
			Angiographic Images
			Angiographic Anatomy
			Embolic Precautions
			Injection Rates
			Sedation and Anesthesia Requirements
			Postangiography Orders
		COMPLICATIONS OF CEREBRAL ANGIOGRAPHY
		Neurologic Complications
		Nonneurologic Complications
	7
Computed Tomography in Cerebrovascular Disease
	8
Magnetic Resonance Imaging and Positron Emission Tomography in the Evaluation of Cerebrovascular Disease
		MAGNETIC RESONANCE IMAGING
		POSITRON EMISSION TOMOGRAPHY
		CONCLUSION
	9
Duplex Scanning and Spectral Analysis of Carotid Bifurcation Atherosclerotic Disease
		IMPORTANT CONCEPTS
		GRADING OF STENOSIS
			Use of Velocity Criteria
			Limitations of Duplex Velocity Criteria
			Other Methods of Grading ICA Stenosiswith Ultrasound
		DUPLEX SCANNING AND STROKE RISK STRATIFICATION: FUTURE PERSPECTIVES
	10
Transcranial Doppler in the Evaluation of Cerebrovascular Disease
		TECHNIQUE
		CLINICAL INDICATIONS
			Cerebral Ischemia
			Vasomotor Reactivity
			Cerebral Embolization
			Subarachnoid Hemorrhage
			Sickle Cell Disease
			Cerebral Circulatory Arrest
		FUNCTIONAL TRANSCRANIAL DOPPLER
		THERAPEUTIC TRANSCRANIAL DOPPLER
		SUMMARY
	11
Medical Treatment to Prevent Transient Ischemic Attacks and Ischemic Stroke
		MODIFICATION OF RISK FACTORS
			Hypertension
			Tobacco Abuse
			Diabetes Mellitus
			Hyperlipidemia
			Antiplatelet Medication
			Lifestyle Interventions to Prevent Stroke
		CARDIOEMBOLIC STROKE PREVENTION
			Atrial Fibrillation
			Carotid Artery Stenosis
		STROKE PREVENTION IN SPECIAL PATIENT POPULATION
		SECONDARY PREVENTION OF TRANSIENT ISCHEMIC ATTACKAND STROKE
		SECONDARY PREVENTION OF CARDIOEMBOLIC STROKE
			Antiplatelet Agents for Secondary Preventionof Stroke or Transient Ischemic Attack
		CONCLUSION
	12
Medical Therapy Including Fibrinolytic Therapy of Acute Ischemic Stroke
		DIAGNOSIS
		TREATMENT
		PREVENTING FUTURE STROKES
			Strokes of Unknown Onset and Wake-up Strokes
		INTRAARTERIAL THROMBOLYSIS
	13
Diabetes as a Risk Factor in Atherosclerotic Cerebrovascular Disease
		DIABETES AND CEREBROVASCULAR DISEASE
			Stroke Characteristics in Diabetes
			Pathophysiology of Stroke in Diabetes and Hyperglycemia
		PREVENTION OF STROKE IN PATIENTS WITH DIABETES
			Glycemic Control
			Antihypertensive Therapy
			Lipid-Lowering Therapy
			Antiplatelet and Anticoagulation Therapy
		DIABETES AND SURGICAL INTERVENTION FOR CEREBROVASCULAR DISEASES
		GLYCEMIC CONTROL IN THE SETTING OF ACUTE ISCHEMIC STROKE
		CONCLUSION
	14
Selection of Patients for Carotid Endarterectomy versus Carotid Artery Stenting
		CAROTID STENTING VERSUS ENDARTERECTOMY: MAJORTRIAL DATA
		TREATMENT OF ASYMPTOMATIC CAROTID ARTERY STENOSIS
		TREATMENT OF SYMPTOMATIC CAROTID ARTERY STENOSIS
		LIMITATIONS OF TRANSFEMORAL CAROTID ARTERY STENTING WITH DISTAL FILTER PROTECTION
	15
Technical Aspects of Percutaneous Carotid Angioplasty and Stenting for Arteriosclerotic Disease
		PREPROCEDURAL EVALUATION
		ARTERIAL ACCESS
		CAROTID IMAGING AND SHEATH ACCESS
			Aortic Arch Angiogram
			Selective Common Carotid Catheterization
			Carotid Sheath Access
		CEREBRAL PROTECTION
			Technique for Using Distal Filters
			Proximal Occlusion and Flow-Reversal Devices
		ANGIOPLASTY AND STENTING
		COMPLETION ANGIOGRAM
		MANAGEMENT OF THE ACCESS SITE
		POSTOPERATIVE CARE ANDFOLLOW-UP
	16
Reversal of Cerebral Blood Flow to Prevent Stroke during Percutaneous Carotid Artery Angioplasty and Stenting
		IMPACT OF EMBOLIZATION
		PRINCIPLES OF FLOW REVERSAL
		CLINICAL RESULTS WITH THEFIRST-GENERATION FLOW-REVERSAL SYSTEM
		SECOND-GENERATION FLOW-REVERSAL SYSTEM AND EMPIRE TRIAL
	17
Embolic Protection Devices to Prevent Stroke during Percutaneous Angioplasty and Stenting
		DEVICE CHARACTERISTICS
		SELECTION OF DEVICES
		TECHNIQUE
		CLINICAL TRIAL RESULTS
		CONCLUSIONS
	18
Blood Pressure Instability after Percutaneous Carotid Angioplasty and Stenting
		PATHOPHYSIOLOGY OF HEMODYNAMIC INSTABILITY ASSOCIATED WITH CAROTID INTERVENTIONS
		HEMODYNAMIC INSTABILITY TRIGGERED BY CAROTID ARTERY INTERVENTIONS
		FACTORS PREDICTING HEMODYNAMIC INSTABILITY DURING CAROTID INTERVENTIONS
		MANAGEMENT OF HEMODYNAMIC INSTABILITY INDUCED BY CAROTID ANGIOPLASTY AND STENTING
	19
Cerebral Hyperperfusion Syndrome After Carotid Endarterectomy and Carotid Stenting
		PATHOPHYSIOLOGY
		INCIDENCE
		RISK FACTORS
		CLINICAL MANIFESTATIONS
		DIAGNOSIS
		TREATMENT
	20
Treatment of Recurrent Carotid Artery Stenosis After Percutaneous Angioplasty and Stenting
		INCIDENCE
		DIAGNOSIS
		NATURAL HISTORY
		CLINICAL SIGNIFICANCE
		TREATMENT
		CONCLUSION
	21
Technical Aspects of Conventional Carotid Endarterectomy for Atherosclerotic Disease
		SURGICAL TECHNIQUE
		POSTOPERATIVE CARE
		POSTOPERATIVE RESULTS
	22
Technical Aspects of Eversion Carotid Endarterectomy for Atherosclerotic Disease
		METHODS
		SHUNTING AND EVERSION ENDARTERECTOMY
		UNUSUAL PROBLEMS AND TROUBLESHOOTING
	23
Patch Graft Closure with Carotid Endarterectomy
		PATCH CLOSURE VERSUS PRIMARY CLOSURE
		ROLE OF SELECTIVE PATCHING
		CHOICE OF PATCH MATERIAL
		CONCLUSIONS
	24
Management of the Infected Carotid Artery Patch
		INFECTING MICROORGANISMS
		CLINICAL PRESENTATION
		RELATIONSHIP WITH PERIOPERATIVE INFECTION
		INVESTIGATION OF PROSTHETIC PATCH INFECTION
		MANAGEMENT OF PROSTHETIC PATCH INFECTION
		CONCLUSION
	25
Role of Shunting During Carotid Endarterectomy
		SELECTIVE SHUNTING
			Awake Carotid Endarterectomy
			Carotid Back Pressure Measurement
			Electroencephalographic Monitoring
			Transcranial Doppler
			Cerebral Oximetry
		ROUTINE SHUNTING
		CONCLUSIONS
	26
Intraoperative Assessment of the Technical Adequacy of Carotid Endarterectomy
		ANGIOGRAPHY
		DOPPLER STUDIES
		DUPLEX SCANNING
		FOLLOW-UP STUDIES
		CURRENT RECOMMENDATIONS
	27
Intraoperative Recognition and Treatment of Cerebral Ischemia During Carotid Endarterectomy
		REGIONAL ANESTHESIA
		GENERAL ANESTHESIA
		INTRAOPERATIVE TREATMENT
			Hypoperfusion
			Embolization
			Fronds
			Dissection
			Thrombosis
	28
Early Postoperative Recognition and Management of Acute Stroke After Carotid Endarterectomy
		EVALUATION
			Portable Duplex Sonography
			Magnetic Resonance Imaging andComputed Tomography
			Angiography
		SURGICAL REEXPLORATION
		ENDOVASCULAR NEURORESCUE
		MEDICAL MANAGEMENT
		CEREBRAL HYPERPERFUSION VERSUS MICROEMBOLIC SHOWERS
	29
Regional and Local Anesthesia for Carotid Endarterectomy
	30 Carotid Endarterectomy or Stenting for Evolving Stroke Secondary
to Carotid Artery Atherosclerosis
		THROMBOLYSIS AND CAROTID ENDARTERECTOMY IN ACUTE CERVICAL CAROTID OCCLUSION
		CAROTID ARTERY STENTING IN ACUTE CERVICAL CAROTID OCCLUSION
		CAROTID ARTERY STENTING FOR EMERGENT REVASCULARIZATION FOR ACUTE ISCHEMIC STROKE
		CONCLUSION
	31
Timing of Carotid Endarterectomy After Fixed Stroke Secondary to Carotid Artery Atherosclerosis
	32
Carotid Occlusion and Near-Carotid Occlusion of the Extracranial Internal Carotid Artery
		INTERNAL CAROTID ARTERY OCCLUSION
			Acute Occlusion, Asymptomatic
			Acute Occlusion, Symptomatic
			Chronic Occlusion, Asymptomatic
			Chronic Occlusion, Symptomatic
		CAROTID STRING SIGN
		SUMMARY
	33
Blood Pressure Instability After Carotid Endarterectomy
		INCIDENCE
		ETIOLOGY
		TREATMENT
	34
Relevance of External Carotid Artery Disease in Internal Carotid Artery Occlusion
		ANATOMY OF CEREBRAL COLLATERAL CIRCULATION
		EVALUATION OF THE PATIENT WITH SYMPTOMATIC OCCLUSION OF THE INTERNAL CAROTID ARTERY
		CURRENT INDICATIONS AND RESULTS OF SURGICAL TREATMENT
		TECHNIQUE OF EXTERNAL CAROTID ENDARTERECTOMY
		RECOMMENDATIONS
	35
Intracranial Occlusive Disease and Aneurysms: Influence on Carotid Revascularization Outcomes
		INTRACRANIAL OCCLUSIVE DISEASE
		INTRACRANIAL ANEURYSMS
	36
Pathology of Carotid Artery Restenosis
		DESCRIPTIVE PATHOLOGY
		PATHOGENESIS
			Cell Proliferation
			Extracellular Matrix Synthesis
			Thrombus Organization
			Artery Wall Remodeling
			Predictors of Carotid Restenosis after Endarterectomy
	37
Treatment of Recurrent Stenosis After Previous Carotid Endarterectomy
		OPTIMAL IMAGING FOR ASSESSMENT OF CAROTID RESTENOSIS
		TREATMENT OPTIONS FOR RECURRENT CAROTID ARTERY STENOSIS
			Repeat CEA for Recurrent Carotid Stenosis
			Other Surgical Options for RecurrentCarotid Stenosis
			Endovascular Procedures
			Carotid Endarterectomy versus Carotid Artery Stenting
	38
Management of Concomitant Carotid and Coronary Arterial Disease
		CARDIAC RISK STRATIFICATION PRIOR TO CAROTID ENDARTERECTOMY
		CAUSES OF STROKE FOLLOWING CORONARY REVASCULARIZATION
		RELATIONSHIP OF CAROTID STENOSIS TO PERIOPERATIVE STROKE
		TIMING OF CAROTID AND CORONARY OPERATIONS
		CONCOMITANT CAROTID AND CORONARY ARTERY OPERATIONS
		STAGED VERSUS COMBINED CAROTID AND CORONARY ARTERY OPERATIONS
		CONCLUSION
	39
The Role of Extracranial–Intracranial Bypass in Current Practice
		HISTORICAL PERSPECTIVE
		PROCEDURAL CHARACTERISTICS
			Preoperative Evaluation
			Procedural Considerations
			Postprocedural Follow-up and Management
		CURRENT DATA
		CONCLUSIONS
	40
Open Surgical Treatment of Fibromuscular Dysplasia of the Carotid Artery
		OPERATIVE TECHNIQUES
			Open Dilation
			Resection and Interposition Graft Reconstruction
		SURGICAL RESULTS
	41
Endovascular Treatment of Fibromuscular Dysplasia of the Carotid Artery
		INDICATIONS
		TECHNIQUE
		RESULTS
		SUMMARY
	42
Vertebral Artery Reconstruction for Vertebrobasilar Ischemia
		PATIENT EVALUATION
		INDICATIONS FOR OPERATION
		SURGICAL REPAIR
			Transposition of the Proximal VA to the Common
Carotid Artery
			Proximal Subclavian–Vertebral Bypass
			Distal VA Reconstruction (Bypass)
			Reconstruction and Decompressionof the VA of the C0–C1 Level
	43
Endovascular Angioplasty and Stenting for Proximal Subclavian Artery Stenosis
		CLINICAL EVALUATION AND DIAGNOSIS
		INDICATIONS FOR TREATMENT
		TECHNICAL PRINCIPLES OF ENDOVASCULAR THERAPY
		RESULTS OF SUBCLAVIAN ARTERY ANGIOPLASTY AND STENTING
		ENDOVASCULAR VERSUS SURGICAL INTERVENTION
		CONCLUSION
	44
Subclavian to Carotid Arterial Transposition
	45
Carotid–Subclavian Bypass and Other Nonanatomic Revascularizations for Proximal Subclavian Artery Stenosis
		ANATOMY
		CAROTID–SUBCLAVIAN BYPASS
		OTHER NONANATOMIC SUBCLAVIAN ARTERY RECONSTRUCTIONS
	46
Conventional Surgical and Endovascular Treatment of Innominate Artery Atherosclerosis
		CLINICAL PRESENTATION
		DIAGNOSIS
		TREATMENT
			Surgical Techniques
			Endovascular Techniques
		CONCLUSIONS
	47
Extracranial Carotid Artery Aneurysms
		TRUE CAROTID ARTERY ANEURYSMS
			Incidence
			Manifestations
			Treatment
		TRAUMATIC FALSE ANEURYSMS OF THE CAROTID ARTERY
			Incidence
			Treatment
		FALSE ANEURYSMS FOLLOWING CAROTID ARTERY ENDARTERECTOMY
			Incidence
			Treatment
	48
Carotid Body Tumors
		CLINICAL PRESENTATION
		DIAGNOSIS
		PREOPERATIVE EMBOLIZATION
		SURGICAL INDICATIONS
		SURGICAL APPROACH
		SURGICAL RESULTS
	49
Radiation-Induced Arteritis
		COMPARISON WITH ARTERIOSCLEROSIS
		PATHOPHYSIOLOGY
		CLINICAL MANIFESTATIONS
			Subclavian–Axillary Lesions
			Extracranial Cervical Lesions
			Abdominal Aorta and Its Branches
		MANAGEMENT
			Carotid Lesions
			Subclavian–Axillary Lesions
			Lesions of the Abdominal Aorta and Its Branches
		SURVEILLANCE AND PREVENTION
	50
Surgical Treatment of Takayasu Arteritis
		CLINICAL FEATURES
		MEDICAL TREATMENT
		SURGICAL TREATMENT
			Transluminal Angioplasty
			Arterial Reconstruction
			Surgical Results
Upper Extremity
Arterial Disease
	51
Pathology of Upper Extremity Arterial Disease
		VASOSPASM
		INTRINSIC ARTERIAL DISEASE
			Atherosclerosis
			Inflammatory Diseases
			Connective Tissue Disorders
			Aneurysms
		EMBOLISM
		TRAUMA
			Iatrogenic Injuries
			Occupational Trauma
			Athletic Injuries
		MEDICAL CONDITIONS
	52
Upper Extremity Revascularization
		DIAGNOSTIC EVALUATION
		ENDOVASCULAR TREATMENT
		SURGICAL TREATMENT
		COMMON APPROACHES TO THE UPPER EXTREMITY VESSELS
			Subclavian Artery and Proximal Axillary Artery
			Distal Axillary Artery
			Brachial, Proximal Radial, and Ulnar Arteries
			Distal Arteries
		SURGICAL RESULTS
	53
Diagnosis and Treatment of Upper Extremity Vasospastic Disease
		RAYNAUD’S SYNDROME
			Primary Raynaud’s Syndrome
			Secondary Raynaud’s Syndrome
			Disorders That Mimic Raynaud’s Syndrome
		TREATMENT
			Conservative Therapy
			Pharmacologic Therapy
			Lumbar Sympathectomy
	54
Extremity Causalgia: Reflex Sympathetic Dystrophy
		DIFFERENTIAL DIAGNOSIS
		MEDICAL THERAPY
		SUMMARY
	55
Thoracic Sympathectomy
		ANATOMY OF THE CERVICAL AND THORACIC SYMPATHETIC GANGLIA
		PHYSIOLOGY OF SYMPATHETIC NERVOUS SYSTEM
			Indications for Cervicodorsal Sympathectomy
		THERAPEUTIC OPTIONS
			Medical Therapy
			Surgical Therapy
			Conclusion
	56
Etiology and Anatomic Pathology of Thoracic Outlet Syndrome
		ANATOMY
		PATHOPHYSIOLOGY
			Neurogenic Thoracic Outlet Syndrome
			Venous Thoracic Outlet Syndrome
			Arterial Thoracic Outlet Syndrome
		SUMMARY
	57
Diagnosis of Thoracic Outlet Syndrome
		NEUROGENIC THORACIC OUTLET SYNDROME
			Clinical Presentation
			Physical Examination
		VENOUS THORACIC OUTLET SYNDROME
			Clinical Presentation
		ARTERIAL THORACIC OUTLET SYNDROME
			Clinical Presentation
			Management and Indications for Surgery
	58
Conservative Treatment for Thoracic Outlet Syndrome
		ASSESSMENT FOR PHYSICAL THERAPY
		COMMENT
	59
Transaxillary Operative Management of Thoracic Outlet Syndrome
		OPERATIVE TECHNIQUE
	60
Supraclavicular Operative Approach for Thoracic Outlet Syndrome
		MANAGEMENT OF NEUROGENIC THORACIC OUTLET SYNDROME
			Positioning and Initial Exposure
			Mobilization of the Scalene Fat Pad
			Anterior Scalenectomy
			Brachial Plexus Mobilization
			Middle Scalenectomy
			Division of the Posterior First Rib
			Division of the Anterior First Rib
			Cervical Rib Resection
			Pectoralis Minor Tenotomy
		MANAGEMENT OF VENOUS THORACIC OUTLET SYNDROME
		MANAGEMENT OF ARTERIAL THORACIC OUTLET SYNDROME
		CLOSURE, POSTOPERATIVE CARE, AND RECOVERY
	61
Treatment of Arterial Complications in Thoracic Outlet Syndrome
		ANATOMIC FEATURES
		CLINICAL PRESENTATION
		DIAGNOSIS
		TREATMENT
	62
Subclavian and Axillary Artery Aneurysms
		SUBCLAVIAN ARTERY ANEURYSMS
		ABCDABERRANT SUBCLAVIAN ARTERY ANEURYSMS
		AXILLARY ARTERY ANEURYSMS
		DIAGNOSIS AND EVALUATION
		OPERATIVE TREATMENT
		ENDOVASCULAR REPAIR
		RESULTS
	63
Buerger’s Disease
		DIAGNOSIS
		NONOPERATIVE MANAGEMENT
			Patient Education
			Smoking Cessation
			Pharmacologic Therapy
			Pain Control
			Local Wound Care
		OPERATIVE MANAGEMENT
			Arterial Reconstruction
			Sympathectomy
			Amputation
	64
Ergotism
		PHARMACOLOGY
		CLINICAL PRESENTATION OF ERGOTISM
		ERGOT ALKALOIDS AND DRUG INTERACTIONS
		TREATMENT
	65
Hypothenar Hammer Syndrome
		PREVALENCE OF DISEASE
		ANATOMY AND PATHOPHYSIOLOGY
		DIAGNOSTIC EVALUATION
		MANAGEMENT
Aortic Aneurysm
	66
Pathogenesis of Abdominal Aortic Aneurysms
		BIOMECHANICAL WALL STRESS ANDSTRUCTURAL PATHOLOGY
		INTRALUMINAL THROMBUS
		MATRIX METALLOPROTEINASES AND ENDOGENOUS PROTEASES
		AORTIC MEDIAL DECOMPENSATION
		INFLAMMATION AND AUTOIMMUNITY
		PATHOGEN INVOLVEMENTAND AUTOIMMUNITY
		OXIDATIVE STRESS
		ADVENTITIAL MODIFICATION
		MODELS OF ABDOMINAL AORTIC ANEURYSM AND FUTURE RESEARCH
		SUMMARY
	67
Genetics of Abdominal Aortic Aneurysms
		THE HERITABILITY OF ABDOMINAL AORTIC ANEURYSMS VERSUS THORACIC AORTIC ANEURYSMS
		INHERITANCE OF ABDOMINAL AORTIC ANEURYSM
		IDENTIFYING GENES ASSOCIATED WITH ABDOMINAL AORTIC ANEURYSMS
		LINKAGE STUDIES
		GENOME-WIDE ASSOCIATION STUDIES
		FUTURE RESEARCH
		CONCLUSION
	68
Pathogenesis of Inflammatory Aortic Aneurysms
		PATHOLOGY
		ETIOLOGY
			A Severe Variant of Aortic Aneurysm
			A Generalized Autoimmune Process
			An Immunoglobulin G4–Related Systemic Disease
		CONCLUSION
	69
Pathophysiology of Aortic Dissection
		EARLY ANATOMIC CHANGESIN AORTIC DISSECTION
		ISCHEMIC COMPLICATIONSOF AORTIC DISSECTION
		FALSE LUMEN EXPANSION
	70
Arteriomegaly and Aneurysmosis
		ETIOLOGY
		CLASSIFICATION
		SURGICAL MANAGEMENT
		CONCLUSION
	71
Vascular Complications of Marfan Syndrome, Ehlers–Danlos Syndrome, and Loeys–Dietz Syndrome
		MARFAN SYNDROME
			Affected Organ Systems
			Treatment
		EHLERS–DANLOS SYNDROME
			Affected Organ Systems
			Treatment
			Prognosis
		LOEYS–DIETZ SYNDROME
			Affected Organ Systems
			Treatment
	72
Ultrasonography in the Evaluation of Abdominal Aortic Aneurysms
		SCREENING FOR ABDOMINAL AORTIC ANEURYSM
		ULTRASONOGRAPHIC FOLLOW-UP OF ABDOMINAL AORTIC ANEURYSM
			Abdominal Aortic and Iliac Artery Aneurysms
			Follow-up after Endovascular Aneurysm Repair
	73
Angiography in the Evaluation of Abdominal Aortic Aneurysm
		INDICATIONS FOR CATHETER-BASED ARTERIOGRAPHY
		PLANNING ABDOMINAL AORTIC ANEURYSM REPAIR
	74
Magnetic Resonance Imaging in the Evaluation of Abdominal Aortic Aneurysm
	75
Computed Tomography and Computed Tomographic Arteriography in the Evaluation of Abdominal Aortic Aneurysms
		DATA SETS
		SCAN PARAMETERS
		RECONSTRUCTION
		INITIAL AORTIC ASSESSMENT
		ANALYSIS OF DISEASE EXTENT
		ANEURYSM SIZE
		ASSESSMENT OF THE PROXIMAL AND DISTAL NECKS
		TORTUOSITY
		AORTIC BRANCH ASSESSMENT
		RELATIONAL BRANCH VESSEL GEOMETRY
		AORTIC COMPUTED TOMOGRAPHY AFTER OPEN OR ENDOVASCULAR TREATMENT
	76
Selection of Patients with Aortic Aneurysms for Open Surgical or Endovascular Repair
		OPEN REPAIR OF ABDOMINAL AORTIC ANEURYSM
		ENDOVASCULAR ANEURYSM REPAIR
		OPEN VERSUS ENDOVASCULAR ANEURYSM REPAIR: THE DATA
			Endovascular versus Open Repair of Abdominal Aortic Aneurysm Trial
			Dutch Randomized Endovascular Aneurysm Management Trial
			Open Versus Endovascular Repair Trial
			The Medicare Population
		INTEGRATION OF TRIAL DATA INTO CLINICAL DECISION MAKING
			Mortality
			Rates of Reintervention
			Cost
			Quality of Life
		EVAR VERSUS MEDICAL MANAGEMENT IN PATIENTSAT TOO-HIGH RISK FOR OPEN REPAIR
		SUMMARY
	77
Management of Small Abdominal Aortic Aneurysms
		RUPTURE RISK
		LIFE EXPECTANCY
		OPERATIVE RISK
		OPERATIVE DECISION MAKING
		GROWTH AND MEDICAL MANAGEMENT
		SURVEILLANCE RECOMMENDATIONS
	78
Endovascular Treatment of Nonruptured Infrarenal Aortic and Aortoiliac Aneurysms
		PROCEDURAL PLANNING AND ANATOMIC MEASUREMENTS
		DEVICE OVERSIZING
		ENDOVASCULAR STENT DEPLOYMENT TECHNIQUES
			Imaging
			Access
			Anatomic Aims
			Aortic Neck
			Contralateral Limb Cannulation
			Iliac Anatomy
		LONG-TERM DATA AND FUTURE DIRECTIONS
	79
Endovascular Treatment of Pararenal and Suprarenal Abdominal Aortic Aneurysms
		TECHNIQUE
		LIMITATIONS
		PUBLISHED RESULTS
		EVOLUTION
	80
Endovascular Treatment of Inflammatory Abdominal Aortic Aneurysms
		CLINICAL FEATURES
		ENDOVASCULAR MANAGEMENT
		RUPTURED INFLAMMATORY ABDOMINAL AORTIC ANEURYSMS
		SUMMARY
	81
Endovascular Treatment of Ruptured Infrarenal Aortic Aneurysms
		THEORETICAL CONSIDERATIONS
		A SINGLE CENTER EXPERIENCE
		COLLECTED WORLD EXPERIENCE
		WHY ARE RESULTS VARIABLE?
			Standard Approach or Protocol
			Fluid Restriction (Hypotensive Hemostasis)
			Treatment Site
			Anesthesia and Catheter-Guidewire Placement
			Supraceliac Aortic Sheath Placementand Balloon Control
			Endograft Type and Configuration
			Abdominal Compartment Syndrome
			Endovascular Aneurysm Repair for Highest-Risk Patients
		IS A RANDOMIZED, CONTROLLED COMPARISON OF ENDOVASCULAR AND OPEN REPAIR NEEDED
	82
Management of Coexistent Splanchnic and Renal Artery Occlusive Disease
		SPLANCHNIC OCCLUSIVE DISEASE AND ENDOVASCULAR ANEURYSM REPAIR
		RENAL ARTERY OCCLUSIVE DISEASE AND ENDOVASCULAR ANEURYSM REPAIR
	83
Internal Iliac Artery Embolization as an Adjunct to Endovascular Aneurysm Repair
		RELEVANT ANATOMY
		EMBOLIZATION TOOLS
			Pushable Coils
			Detachable Coils
			Vascular Occlusion Plug
		TECHNIQUE
			Embolization of Internal Iliac Arteries
		COMPLICATIONS
	84
Endovascular Iliac Branch Devices for Iliac Aneurysms
		RATIONALE
		DEVICE DESIGN
		DEVICE DEPLOYMENT
		RESULTS
		DISCUSSION
	85
Iliac Artery Conduits for Endovascular Access
		ILIAC ARTERY ACCESS
		REMOTE FEMORAL ARTERY ACCESS
	86
Conversion to Open Surgical Treatment After Failed Endovascular Aortic Aneurysm Repair
		INDICATIONS
		PREOPERATIVE CONSIDERATIONS
		OPERATIVE TECHNIQUES
		POSTOPERATIVE CONSIDERATIONS
	87 Treatment of Endovascular Leaks After Aortic Endografting
		TYPE I ENDOLEAK
		TYPE II ENDOLEAK
		TYPE III ENDOLEAK
		TYPE IV ENDOLEAK
		TYPE V ENDOLEAK
		CONCLUSIONS
	88
Management of Acute Limb Ischemia Complicating Aortic Reconstruction
		SCOPE OF THE PROBLEM
		ETIOLOGY
		PREVENTION
		DIAGNOSIS
		MANAGEMENT
			Medical
			Interventional
			Open Surgical
	89
Intestinal and Renal Ischemia Complicating Open and Endovascular Abdominal Aortic Reconstructions
		RENAL COMPLICATIONS
			Open Repair
			Endovascular Repair
		INTESTINAL COMPLICATIONS
			Open Repair
			Endovascular Repair
	90
Neurologic Complications after Open and Endovascular Aortic Surgery
		SPINAL CORD INJURY
		STROKE
		DIRECT NERVE INJURY
			Retrograde Ejaculation
			Peripheral Neuropathy
	91
Postoperative Surveillance of Thoracic and Abdominal Aortic Endografts
		RATIONALE FOR POSTOPERATIVE SURVEILLANCE
		ELEMENTS OF COMPLETE SURVEILLANCE
			Computed Tomography Angiography
			Magnetic Resonance Angiography
			Multiview Radiographs
			Duplex Ultrasound with or without Contrast
			Intravascular Pressure Sensor
		FOLLOW-UP SCHEDULE
	92
Treatment of Aortic Endograft Migration
		DEFINITION
		INCIDENCE
		RISK FACTORS FOR MIGRATION
		TREATMENT
			Endovascular Treatment
			Hybrid Treatment
			Open Treatment
	93
Open Transperitoneal Surgical Treatment of Nonruptured Infrarenal Aortic Aneurysms
		ANATOMIC PREOPERATIVE PLANNING
		TECHNIQUE
			Exposure
			Clamping
			Aneurysmorrhaphy
			Unclamping
			Closure
		POSTOPERATIVE CARE
			Myocardial Infarction
			Bleeding
			Acute Pulmonary Decompensation Resulting in Reintubation
			Deep Vein Thrombosis
			Kidney Dysfunction
			Ischemic Colitis
			Lower Extremity Ischemia
		EARLY SURVIVAL
	94
Open Surgical Treatment of Ruptured Infrarenal Aortic Aneurysms
		DIAGNOSIS
		PROCEDURE
		OUTCOMES
	95
Surgical Treatment of Infected Abdominal Aortic Aneurysms
		DIAGNOSIS
		MANAGEMENT
		OUTCOMES
	96
Surgical Treatment of Inflammatory Abdominal Aortic Aneurysms
		CLINICAL PRESENTATION
		OPERATIVE MANAGEMENT
	97
Open Surgical Treatment of Pararenal and Suprarenal Abdominal Aortic Aneurysms
		PRESENTATION AND DIAGNOSIS
		OPERATIVE CONSIDERATIONS
		OUTCOMES
	98
Retroperitoneal Approach for Elective Abdominal Aortic Aneurysmectomy
		INDICATIONS AND CONTRAINDICATIONS
		SURGICAL TECHNIQUES
			Left Posterolateral Retroperitoneal Approach
			Right Retroperitoneal Approach
			Retroperitoneal Exposure for Failed Endovascular Aneurysm Repair
		OUTCOMES
	99
Autotransfusion in Aortic Reconstruction
		AUTOLOGOUS PREOPERATIVE DEPOSIT
		INTRAOPERATIVE AUTOTRANSFUSION IN ELECTIVE AND EMERGENCY AORTIC PROCEDURES
		INDICATIONS FOR TRANSFUSION
	100
Surgical Treatment of Abdominal Aortic Aneurysm–Inferior Vena Cava Fistula
		CLINICAL PRESENTATION
		SURGICAL TREATMENT
	101
Management of Primary Aortoenteric Fistulas
		ETIOLOGY
		DIAGNOSIS
		TREATMENT
	102
Renal Ectopia and Renal Fusion in Patients Requiring Abdominal Aortic Operations
		EMBRYOLOGY
		ANATOMIC SUBGROUPS OF RENAL ECTOPIA
			Ipsilateral Renal Ectopia
			Horseshoe Kidney
			Crossed Renal Ectopia
		PREOPERATIVE IMAGING
		THERAPEUTIC ALTERNATIVES
			Open Surgical Approach
			Open Surgical Technique
			Endovascular Approaches
		COMPLICATIONS AND RESULTS
	103
Venous Anomalies Encountered During Aortic Reconstruction
		RETROAORTIC OR CIRCUMAORTIC LEFT RENAL VEIN
		TRANSPOSED OR DUPLICATE INFERIOR VENA CAVA
	104
Open and Endovascular Repair of Abdominal Aortic Aneurysms in Kidney Transplant Patients
		INDICATIONS
		RENAL PROTECTION
			Preoperative Measures
			Intraoperative Techniques
		OPEN AORTIC RECONSTRUCTION
			Technique
			Complications
			Follow-up
		ENDOVASCULAR AORTIC RECONSTRUCTION
			Technique
			Complications
			Follow-up
		RUPTURED ABDOMINAL AORTIC ANEURYSM IN KIDNEY TRANSPLANT PATIENTS
	105
Open Abdominal Aortic Aneurysm Repair and Concurrent Nonvascular Disease
		SYNCHRONOUS DISEASE
		GALLBLADDER AND HEPATOBILIARY DISEASE
		PANCREATIC DISEASE
		UPPER GASTROINTESTINAL TRACT
		LOWER GASTROINTESTINAL TRACT
		GENITOURINARY TRACT
		GYNECOLOGIC DISEASE
		RARE TUMORS AND SPINE DISORDERS
		ABDOMINAL WALL
	106
Recognition and Treatment of Abdominal Compartment Syndrome Following Ruptured Abdominal Aortic Aneurysm Repair
		DETECTION
		PATHOPHYSIOLOGY
			Cardiovascular Derangements
			Pulmonary Derangements
			Renal Derangements
			Gastrointestinal Derangements
			Hepatic Derangements
			Central Nervous System Derangements
			Abdominal Wall Derangements
		RISK FACTORS
		CLINICAL PRESENTATION
		CURRENT MANAGEMENT
			Nonsurgical Management
			Surgical Management
			Outcome after Surgical Management
	107
Endovascular Treatment of Thoracic Aortic Aneurysms
		STENT GRAFTS
		INDICATIONS
		TECHNIQUE
		RESULTS
	108
Endovascular Graft Completion of Elephant Trunk Thoracic Aneurysm Repair
		SECOND-STAGE ENDOVASCULAR PROCEDURE
		RESULTS
	109
Thoracic and Abdominal Aortic Debranching in the Endovascular Treatment of Thoracoabdominal Aortic Aneurysms
		AORTIC ARCH AND PROXIMAL DESCENDING AORTIC ANEURYSM DEBRANCHING
		ASCENDING, ARCH, AND MORE EXTENSIVE ANEURYSMS
		DEBRANCHING OF THORACOABDOMINAL ANEURYSMS
			Thoracoceliac with Thoracomesenteric–Left Renal Bypass (Antegrade Bypass)
			Iliomesenteric Reconstructions (Retrograde Bypass)
			Complete Visceral Revascularization (Retrograde)
		POSTOPERATIVE CONSIDERATIONS
	110
Endograft (VORTEC) Reconstruction of Aortic Branches Allowing Endovascular Treatment of Aortic Aneurysms
		ORIGINAL TECHNIQUE
		INCISION AND TRANSECTION TECHNIQUES
		RESULTS
		DISCUSSION
	111
Multibranched Endovascular Repair of Thoracoabdominal Aortic Aneurysm
		MULTIBRANCHED THORACOABDOMINAL STENT GRAFTS
		STANDARDIZATION
		STANDARD STENT GRAFT
		PLANNING THE REPAIR
		ADJUNCTIVE PROCEDURES
		STENT GRAFT IMPLANTATION
		RADIATION SAFETY
		RESULTS
	112
Open Surgical Treatment of Thoracic Aortic Aneurysms
		INDICATIONS FOR REPAIR
		OPERATIVE PLANNING
			Comorbidity Assessment
		MEASURES FOR END-ORGAN PROTECTION
			Extracorporeal Circulation by Atriofemoral Perfusion
			Hypothermic Arrest
			Alternative Perfusion Techniques
			Spinal cord protection
		SURGICAL TECHNIQUE
		POSTOPERATIVE MANAGEMENT
		SURGICAL RESULTS
	113
Open Surgical Treatment of Thoracoabdominal Aortic Aneurysms
		CLASSIFICATION OF THORACOABDOMINAL AORTIC ANEURYSMS
		CLINICAL MANIFESTATIONS
		OPEN SURGICAL TECHNIQUE
		RISK OF IMMEDIATE NEUROLOGIC DEFICIT
		RISK OF DELAYED NEUROLOGIC DEFICIT
		RISK OF KIDNEY DYSFUNCTION
		POSTOPERATIVE GASTROINTESTINAL COMPLICATIONS
		SURVIVAL AND LONG-TERM OUTCOMES
	114
Paraplegia Prevention in Thoracic and Thoracoabdominal Aortic Aneurysm Repair
		ASSISTED CIRCULATION
		INTERCOSTAL REIMPLANTATION
		MOTOR EVOKED POTENTIALS
		HYPOTHERMIA
		CEREBROSPINAL FLUID DRAINAGE
		ENDOGRAFT THORACIC AND THORACOABDOMINAL AORTIC ANEURYSM REPAIR
	115
Nonoperative Medical Management of Acute Aortic Dissection
		EPIDEMIOLOGY
		CLINICAL SIGNS AND SYMPTOMS
		INITIAL MEDICAL THERAPY
		ASCENDING AORTA
		DESCENDING AORTA
		LONG-TERM FOLLOW-UP
	116 Endovascular Treatment of Aortic Dissection
		ROLE OF IMAGING
		VASCULAR ACCESS
		EXCLUDING THE FALSE LUMEN
		MALPERFUSION
		CHRONIC AORTIC DISSECTION
	117
Open Surgical Treatment of Aortic Dissection
		CLASSIFICATION
		OPERATIVE TREATMENT
			Surgery for Acute Proximal Aortic Dissection
			Surgery for Chronic Proximal Aortic Dissection
			Surgery for Acute Distal Aortic Dissection
			Surgery for Chronic Distal Aortic Dissection
		POSTOPERATIVE CARE
	118
Natural History and Open Treatment of Isolated Iliac Artery Aneurysms
		EPIDEMIOLOGY
		CLINICAL FINDINGS
		DIAGNOSIS
		NATURAL HISTORY
		INDICATIONS FOR TREATMENT
		TREATMENT
		POSTOPERATIVE CARE
	119
Endovascular Management of Isolated Iliac Artery Aneurysms
		PREOPERATIVE PLANNING AND IMAGING
		OPERATIVE TECHNIQUE
		RESULTS
		ISOLATED INTERNAL ILIAC ARTERY ANEURYSMS
		FUTURE THERAPY
	120
Long-Term Alterations in Large-Caliber Arterial Prostheses Used for Aortic Repair
		EARLY HOST RESPONSES TO IMPLANTED MATERIALS
			Protein Deposition
			Platelet Deposition and Coagulation
			Inflammation
			Mesenchymal Cell Infiltration
		MID- TO LONG-TERM PROSTHETIC HEALING
		LONG-TERM PHYSICAL ALTERATIONS
			Dilatation
			Other Changes
	121 Surgical Treatment
of Pediatric Abdominal Aortic Aneurysms
		ETIOLOGIES
			SURGICAL OPTIONS
Lower Extremity
Aneurysm
	122 Arteriosclerotic
Femoral Artery Aneurysms
		PATHOGENESIS
		PATTERN OF DISEASE
		NATURAL HISTORY
		CLINICAL PRESENTATION
		DIAGNOSIS
		MANAGEMENT
		RESULTS
	123
Infected Femoral Artery False Aneurysms
		ETIOLOGY
		PRESENTATION AND DIAGNOSIS
		TREATMENT
			Ligation
			Reconstruction
	124
Obturator Foramen Bypass Grafts in Groin Sepsis
		PATIENT SELECTION
		OPERATIVE PROCEDURE: ANATOMIC CONSIDERATIONS
		RESULTS
	125
Open Surgical Treatment of Popliteal Artery Aneurysms
		CLINICAL PRESENTATION
		DIAGNOSIS AND IMAGING
		SURGICAL MANAGEMENT
		SURVEILLANCE
	126
Endovascular Treatment of Popliteal Artery Aneurysms
		PREOPERATIVE EVALUATION
		CONTRAINDICATIONS FOR ENDOVASCULAR REPAIR
		STENT GRAFTS
		ENDOVASCULAR PROCEDURE AND FOLLOW-UP
		RESULTS OF ENDOVASCULAR REPAIR
Aortoiliac
Occlusive Disease
	127 Conventional Arteriography, Magnetic Resonance Angiography, and Computed Tomographic Arteriography of
Aortoiliac Occlusive Disease
		DIGITAL SUBTRACTIONARTERIOGRAPHY
		COMPUTED TOMOGRAPHY ANGIOGRAPHY
		MAGNETIC RESONANCE ANGIOGRAPHY
		CONCLUSION
	128
Physiologic and Noninvasive Studies to Document Severity and Extent of Aortoiliac Occlusive Disease
		SYMPTOMS AND SIGNS
		EXTREMITY PRESSURE MEASUREMENTS AND DOPPLER ANALYSIS
		DUPLEX ULTRASONOGRAPHY
	129
Selecting Treatment for Patients with Aortoiliac Occlusive Disease
		CONSERVATIVE MEDICAL TREATMENT
		CRITERIA INFLUENCING CHOICE OF REVASCULARIZATION TECHNIQUES
			Patient Factors
			Operator and Resource Factors
			Anatomic and Technical Factors
		CONCLUSIONS
	130
Percutaneous Arterial Angioplasty with and without Stenting for Atherosclerotic Aortic and Iliac Artery Occlusive Disease
		INDICATIONS
		TECHNIQUE
		RESULTS
	131
Aortofemoral Bypass for Atherosclerotic Aortoiliac Occlusive Disease
		PROCEDURE SELECTION
		OPERATIVE MANAGEMENT
			Operative Approach
			Tunnel Construction
			Proximal Graft Anastomosis
			Femoral Anastomosis
		RESULTS OF AORTOFEMORAL BYPASS GRAFTS
	132
Endarterectomy for Atherosclerotic Aortoiliac Occlusive Disease
		OPERATIVE TECHNIQUE
		RESULTS
	133
Management of Juxtarenal Aortic Occlusive Disease by Retroperitoneal and Transperitoneal Exposure of the Pararenal and Suprarenal Aorta
		TRANSPERITONEAL EXPOSURE OF THE SUPRACELIAC AORTA AND CELIAC ARTERY
		TRANSPERITONEAL APPROACH TO SUPERIOR MESENTERIC ARTERY AND PARARENAL AORTA
		LEFT RETROPERITONEAL APPROACH TO THE ABDOMINAL AORTA
		TRANSPERITONEAL APPROACH TO THE COMPLETE ABDOMINAL AORTA WITH LEFT MEDIAL VISCERAL ROTATION
		DISCUSSION
	134
Acute Aortic Occlusion
		ETIOLOGY
		CLINICAL PRESENTATION AND DIAGNOSIS
		PRINCIPLES OF MANAGEMENT
		PREOPERATIVE EVALUATION
		OPERATIVE PLANNING
		THROMBOEMBOLECTOMY
		AXILLOBIFEMORAL AND AORTOBIFEMORAL BYPASS
		PERCUTANEOUS ENDOVASCULAR TREATMENT
		ADEQUACY OF REVASCULARIZATION AND ADJUNCTIVE PROCEDURES
		ISCHEMIA AND REPERFUSION INJURY
		OUTCOME
	135
Aortic Graft Limb Occlusion
		ETIOLOGY
		CLINICAL PRESENTATION
		MANAGEMENT
			Open Surgical Treatment
			Surgical Technique
			Interventional Management
		RESULTS
	136
Open and Endovascular Treatment of Anastomotic Aneurysms after Aortoaortic, Aortoiliac, and Aortofemoral Bypass
		INCIDENCE
		PATHOPHYSIOLOGY
		PRESENTATION
		EVALUATION AND DIAGNOSIS
		OPEN SURGICAL TREATMENT
		ENDOVASCULAR TREATMENT
		RESULTS
	137
Combined Laparoscopic and Endovascular Treatment of Aortic Diseases
		OPERATIVE TECHNIQUE
		LAPAROSCOPIC REMODELLING OF THE AORTA AFTER ENDOVASCULAR ANEURYSM REPAIR
		EXCLUSION CRITERIA FOR LAPAROSCOPIC REMODELING AFTER ENDOVASCULAR ANEURYSM REPAIR
		LAPAROSCOPY-ASSISTED THORACIC ENDOVASCULAR ANEURYSM REPAIR
		RESULTS OF HYBRID PROCEDURES AND LAPAROSCOPIC TECHNIQUES AFTER ENDOVASCULAR ANEURYSM REPAIR
		DISCUSSION
		THE ROLE OF LAPAROSCOPIC AORTIC SURGERY
	138
Abdominal Aortic Coarctation and Hypoplasia
		ETIOLOGY
		CLINICAL MANIFESTATIONS
		MANAGEMENT
		RESULTS
	139
Descending Thoracic Aorta to Femoral Bypass
		INDICATIONS
		SURGICAL TECHNIQUE
		RESULTS
	140
Axillofemoral Bypass
		GENERAL PRINCIPLES AND PATIENT SELECTION
		PREOPERATIVE EVALUATION
		TECHNIQUE
		POSTOPERATIVE CARE ANDFOLLOW-UP
		RESULTS AND INFLUENCE OF PATIENT AND GRAFT FACTORS
		CONTINUING EVOLUTION OF THE ROLE OF AXILLOFEMORAL BYPASS
	141
Unilateral Retroperitoneal Iliofemoral Bypass
		TREATMENT ALGORITHM FOR ILIAC OCCLUSIVE DISEASE
		RETROPERITONEAL ILIOFEMORAL BYPASS: SURGICAL TECHNIQUE
		RESULTS
	142
Femorofemoral Bypass for Aortoiliac Occlusive Disease
		GENERAL PRINCIPLES AND PATIENT SELECTION
		PREOPERATIVE EVALUATION
		TECHNIQUE
		POSTOPERATIVE CARE ANDFOLLOW-UP
		RESULTS AND INFLUENCE OF PATIENT AND GRAFT FACTORS
		CONTINUING EVOLUTION OF THE ROLE OF FEMOROFEMORAL BYPASS
	143
Diagnosis of Aortic Graft Infection
		PRESENTATION
		DIAGNOSISThe diagnosis of aortic graft
			Computed Tomography
			Magnetic Resonance Imaging
			Sinography
			Endoscopy
			Other Techniques
		CONCLUSIONS
	144
Treatment of Aortic Graft Infection with Autologous Femoral Vein
		GRAFT EXCISION
		OPTIONS FOR RECONSTRUCTION
			Extraanatomic Reconstruction
			In-Situ Reconstruction
		PREOPERATIVE EVALUATION
		SURGICAL MANAGEMENTAND TECHNIQUE
		POSTOPERATIVE CARE ANDFOLLOW-UP
	145
In-Situ Treatment of Aortic Graft Infection with Prosthetic Grafts and Allografts
		ANTIBIOTIC OR SILVER-COATED PROSTHETIC GRAFTS
		CRYOPRESERVED ARTERIAL ALLOGRAFTS
		PROSTHETIC GRAFT PRESERVATION
	146
Aortic Graft–Enteric Fistula
		PRESENTATION
		PREOPERATIVE EVALUATION
		MANAGEMENT
			The Stable Patient
			The Unstable Patient
	147
Vasculogenic and Postoperative Neurogenic Impotence
		NORMAL ERECTILE AND EJACULATORY FUNCTION
		VASCULOGENIC ERECTILE DYSFUNCTION
		CORRELATION BETWEEN ERECTILE DYSFUNCTION AND CARDIOVASCULAR DISEASE
		THE METABOLIC SYNDROME AND ERECTILE DYSFUNCTION
		POSTOPERATIVE NEUROGENIC SEXUAL DYSFUNCTION
		CONCLUSION
	148
Drug Therapy of Erectile Dysfunction
		BASIC PRINCIPLES
		PHOSPHODIESTERASE 5 INHIBITORS
		PENILE INJECTION THERAPY
		INTRAURETHRAL ALPROSTADIL
		TESTOSTERONE
		NONDRUG TREATMENTS FOR ERECTILE DYSFUNCTION
			Vacuum Constriction Devices
			Penile Implants
		THE PRINCETON GUIDELINES
	149
Management of Groin Lymphocele and Lymph Fistula
		INCIDENCE
		CLINICAL PRESENTATION AND DIAGNOSIS
		PREVENTION
		TREATMENT
			Treatment Options
			Operative Technique
	150
Management of Chyloperitoneum and Chylothorax after Aortic Reconstruction
		LYMPHATIC ANATOMY IN THE ABDOMEN AND THORAX
		DIAGNOSIS OF CHYOPERIOTNEUM AND CHYLOTHORAX
		MANAGEMENT OF CHYLOPERITONEUM AND CHYLOTHORAX
		SUMMARY
	151
Coronary Artery Disease in Patients with Aortoiliac Occlusive Disease and Abdominal Aortic Aneurysm
		IMPORTANCE OF CORONARY ARTERY DISEASE
		PREOPERATIVE CARDIAC RISK ASSESSMENT
		POSTOPERATIVE CARE
	152
Pulmonary Risks in Patients Being Treated for Aortic Aneurysms and Occlusive Disease
		PULMONARY COMPLICATIONS OF OPEN VASCULAR SURGERY
		IMPACT OF PULMONARY COMPLICATIONS FOLLOWING OPEN ABDOMINAL AORTIC ANEURYSM REPAIR ON PATIENT OUTCOMES
		APPROACHES TO REDUCE PULMONARY COMPLICATIONS VASCULAR SURGERY
			Endovascular Repair
			Anesthesia Technique
			Administration of Prophylactic Noninvasive Perioperative Ventilation
		RISK FACTORS FOR PULMONARY COMPLICATIONS
		MODIFICATION OF RISK FACTORS
		CONCLUSIONS
	153
The Metabolic Syndrome in the Modern World
		DEFINITION
		ETIOLOGY
			Obesity
			Hypertension: The Role of Adipocytes
			Atherosclerosis: Disturbed Endothelium andthe Inflammatory Process
		TREATMENT
			Hypertension
			Hyperlipidemia
			Insulin Resistance
	154
Smoking as a Risk Factor in Atherosclerotic Cardiovascular Disease
		PATHOPHYSIOLOGY
			Vasomotor Dysregulation
			Inflammation
			Thrombosis
			Metabolism
		EVIDENCE IN CARDIOVASCULAR DISEASE
			Coronary Heart Disease
			Cerebrovascular Disease
			Aortic Aneurysm
			Peripheral Arterial Disease
		SMOKING CESSATION
		CONCLUSIONS
	155
Smoking Cessation
		IDENTIFYING SMOKERS
		MOTIVATING PATIENTS TO QUIT
		HELPING THOSE WHO WISH TO QUIT
		SUCCESSFUL STRATEGIES
	156
Treatment of Dyslipidemia and Hypertriglyceridemia
		RISK ASSESSMENT AND LDL CHOLESTEROL GOALS
		GOALS FOR NON-HDL CHOLESTEROL
		DIET AND EXERCISE GUIDELINES AND RECOMMENDATIONS
		PHARMACOTHERAPY FOR HIGH LDL CHOLESTEROL
		PHARMACOTHERAPY FOR LOWNON-HDL CHOLESTEROL
		ADVERSE EFFECTS OF LIPID TREATMENT
	157
Hypertension as a Risk Factor in Atherosclerotic Cardiovascular Disease
		MEASUREMENT OF BLOOD PRESSURE IN THE OFFICE
		MEASUREMENT OF BLOOD PRESSURE IN THE HOSPITAL
		HYPERTENSION AND CARDIOVASCULAR RISK
		TREATMENT OF HYPERTENSION
			Initial Treatment
			Combination Therapies
			Therapeutic Blood Pressure Targets
	158
Homocysteine as a Risk Factor in Atherosclerotic Cardiovascular Disease
		NOMENCLATURE
		PATHOPHYSIOLOGY
		HOMOCYSTEINE AND PERIPHERAL VASCULAR DISEASE EXPRESSION
			Aortic Disease
			Cervical Artery Disease
			Peripheral Artery Occlusive Disease
		TREATMENT
	159
Nitric Oxide and Vascular Disease
		PHYSIOLOGY OF NITRIC OXIDE IN THE VASCULATURE
		PATHOPHYSIOLOGY OF NITRIC OXIDE IN THE VASCULATURE
			Atherosclerosis
			Restenosis
			Hypertension
			Angiogenesis
		CONCLUSIONS
	160
Integrative Therapies in Vascular Disease
		DIET
		EXERCISE
		SMOKING CESSATION
		MIND–BODY CONNECTION
		NATURAL PRODUCTS FOR PERIPHERAL ARTERIAL DISEASE
			Ginkgo biloba Leaf Extract
			Inositol Nicotinate
			Propionyl-l-Carnitine
			Padma 28
			Policosanol
			l-Arginine
			Mesoglycan
			Others
		NATURAL PRODUCTS FOR PERIPHERAL VENOUS DISEASE
			Hesperidin
			Horse Chestnut Seed Extract (Aesculus hippocastanum)
			Grape Seed Extract (Vitis vinifera)
			Rutin
			Gotu Kola Extract (Centella asiatica)
			Pycnogenol (Pinus pinaster)
			Others
		SURGICAL ISSUES RELATED TO NATURAL PRODUCTS
			Coagulation Issues
			Sedative–Hypnotic Interactions
			Drug–Herb Interactions
		CARDIAC EFFECTS OF NONCARDIAC HERBS
		CONCLUSION
Lower Extremity
Occlusive Disease
	161
Magnetic Resonance Arteriography for Assessment of Infrainguinal Occlusive Disease
		FUNDAMENTAL PRINCIPLESOF MAGNETIC RESONANCEARTERIOGRAPHY
		CLINICAL EXPERIENCE WITHMAGNETIC RESONANCEARTERIOGRAPHY
	162
Doppler Pressure Evaluation of Infrainguinal Occlusive Disease
		PHYSIOLOGY OF ARTERIAL OBSTRUCTION
		TECHNIQUE
		ANKLE PRESSURE MEASUREMENT
		SEGMENTAL LIMB PRESSURE MEASUREMENT
		EXERCISE TESTING
		TOE PRESSURES
		LIMITATIONS
		SUMMARY
	163
Duplex Imaging of Infrainguinal Occlusive Disease
		EQUIPMENT AND TECHNIQUE
		VELOCITY WAVEFORMS AND CRITERIA DEFINING STENOSES
		CLINICAL APPLICATIONS
			Color Flow Duplex Scanning in Preparationfor Endovascular Therapy
			Arterial Duplex Mapping Instead of Arteriography before Operation
			Arterial Duplex-Guided Endovascular Therapy
	164
Intravascular Ultrasound for Imaging of Diseased Arteries
		INTRAVASCULAR ULTRASOUND IMAGING
		CLINICAL UTILITY
		ANGIOPLASTY
		ATHERECTOMY
		STENT DEPLOYMENT
		ABDOMINAL ENDOLUMINAL GRAFTS
		THORACIC ENDOLUMINAL GRAFTS
	165
Selecting Patients for Open Surgical or Endovascular Treatment of Lower Extremity Occlusive Disease
		PATIENT SELECTION FOR TREATMENT AND THERAPEUTIC OPTIONS
		ENDOVASCULAR INTERVENTIONS
		OPEN SURGICAL PROCEDURES
	166
Percutaneous Angioplasty With and Without Stenting for Lower Extremity Occlusive Disease
		SUPERFICIAL FEMORAL ARTERY
			Angioplasty
			Angioplasty with Stenting
		POPLITEAL ARTERY
			Angioplasty
			Stenting
		INFRAPOPLITEAL ARTERIES
			Angioplasty
			Stenting
	167
Subintimal Recanalization for Lower Limb Occlusive Disease
		TECHNIQUE
		OUTCOMES
	168
Endovascular Grafts in the Treatment of Lower Extremity Occlusive Disease
		INDICATIONS
		TECHNIQUE
		RESULTS
	169
Percutaneous Cryoplasty and Laser Treatment of Lower Extremity Occlusive Disease
		LASER PHYSICS
		LASER EFFECTS ON TARGET TISSUE
		SPECIFIC LASER SYSTEMS
			Yttrium–Aluminum–Garnet Laser
			Argon Laser
			CO2 Laser
			Excimer Laser
		CLINICAL APPLICATION OF LASER ANGIOPLASTY
		CRYOPLASTY
	170
Duplex-Guided Balloon Angioplasty for Infrainguinal Arterial Occlusive and Aneurysmal Disease
		DUPLEX-GUIDED INFRAINGUINAL ARTERIAL ANGIOPLASTY
			Preoperative Evaluation
			Technique
			Technical Success and Predictors of Technical Failure
			Thromboembolic Complications
			Adjunctive Infrapopliteal Balloon Angioplasty
			Follow-up, Patency, and Limb Salvage
		DUPLEX-GUIDED ENDOVASCULAR REPAIR OF POPLITEAL ARTERY ANEURYSMS
			Technique
			Follow-up, Patency, Morbidity, and Mortality
		CONCLUSION
	171
Reversed and Nonreversed Transposed Autogenous Vein Grafting for Atherosclerotic Lower Extremity Occlusive Disease
		PATIENT SELECTION AND PREOPERATIVE EVALUATION
		OPERATIVE TECHNIQUE
		POSTOPERATIVE CARE
		RESULTS
	172
Short Vein Grafts from the Distal Superficial Femoral, Popliteal, or Infrapopliteal Arteries to More Distal Arteries for Limb Salvage
		GENERAL CONSIDERATIONS
		IMPROVED GRAFT PATENCY RATES
		DECREASED INCIDENCEOF VEIN GRAFT STENOSES
		INCREASED VEIN UTILIZATION
		FEWER VEIN HARVEST COMPLICATIONS
		OTHER ADVANTAGES
		DISADVANTAGES
	173
In-Situ Saphenous Vein Graft for Lower Extremity Occlusive Disease
		OPERATIVE TECHNIQUE
			Preparation
			Equipment
			Procedure
		TECHNICAL COMMENTARY
		POSTOPERATIVE FOLLOW-UP
	174
Arm Veins for Lower Extremity Arterial Reconstruction
		ANATOMY
		PREOPERATIVE ASSESSMENT
		INDICATIONS AND CONTRAINDICATIONSFOR ARM VEIN GRAFTS
		OPERATIVE TECHNIQUE
			Harvesting of the Vein
			Implantation
		RESULTS
		COMPLICATIONS AND MANAGEMENT
		COMMENTS
	175
Composite Sequential Bypass for Lower Extremity Occlusive Disease
		INDICATIONS
		TECHNIQUE
		RESULTS
	176
Expanded Polytetrafluoroethylene and Dacron Grafts for Atherosclerotic Lower Extremity Occlusive Disease
		INDICATIONS FOR PROSTHETIC BYPASS
		DATA
		TECHNICAL CONSIDERATIONS
		CONCLUSIONS
	177
Human Umbilical Vein and Other Biografts for Atherosclerotic Lower Extremity Occlusive Disease
		HUMAN UMBILICAL VEIN GRAFTS
			Technical Features
			Patency Data
			Comparative Studies
			Complications
		CRYOPRESERVED VASCULAR CONDUITS
			Preparation of the Allograft
			Immunology
			Clinical Outcomes
			Complications
			Infected Field
		COLD-PRESERVED VESSELS
		BOVINE GRAFTS
		CONCLUSIONS
	178
Deep Femoral Patch Angioplasty for Atherosclerotic Occlusive Disease of the Lower Extremity
		INDICATIONS
		TECHNIQUES
	179
Superficial Femoral Artery Endarterectomy for Atherosclerotic Lower Extremity Occlusive Disease
		OPEN ENDARTERECTOMY
		SEMICLOSED ENDARTERECTOMY
		COMPARISON OF ENDARTERECTOMY TO BYPASS
		ENDARTERECTOMY IN PERSPECTIVE
		INDICATIONS
	180
Percutaneous Mechanical Thrombectomy and Fibrinolytic Therapy for Acute Thrombosis of Lower Extremity Arteries and Grafts
		PERCUTANEOUS MECHANICAL THROMBECTOMY DEVICES
		MECHANISMS OF CLOT FORMATION AND DISSOLUTION
		FIBRINOLYTIC AGENTS
		INDICATIONS FOR THROMBOLYTIC THERAPY
			Patient Selection
			Lesion Selection
		TECHNIQUES OF THROMBOLYSIS
			Initiation of Thrombolytic Therapy
		RESULTS
		COMPLICATIONS
	181
Operative Thrombectomy for Acute Thrombosis of Lower Extremity Bypass Grafts
		PREOPERATIVE PLANNING
		TECHNIQUE
	182
Surveillance of Lower Extremity Bypass Grafts
		MECHANISMS AND HEMODYNAMICS OF GRAFT FAILURE
		ESSENTIALS OF GRAFT SURVEILLANCE
	183
Open Surgery and Endovascular Management of Failing Infrainguinal Bypass Graft
		PATHOLOGY OF THE FAILING VEIN GRAFT
		FACTORS INFLUENCING REPAIR CHOICE
			Time after Graft Implantation
			Stenosis Length
			Lesion Location
			Graft Occlusion
		TECHNICAL CONSIDERATIONSFOR REPAIR
			Endovascular Repair
			Open Operation
		OUTCOMES
		CONCLUSIONS
	184
Complications and Treatment of Persistent Sciatic Arteries
		CLINICAL CHARACTERISTICS
		DIAGNOSTIC CONSIDERATIONS
		TREATMENT
	185
Popliteal Artery Adventitial Cystic Disease
		ETIOLOGY
		CLINICAL PRESENTATION
		DIAGNOSIS
		TREATMENT
	186
Chronic Compartment Syndrome and Functional Popliteal Artery Entrapment
		EVALUATION
		TREATMENT
			Chronic Compartment Syndrome
			Popliteal Entrapment
			Recovery
		RESULTS AND DISCUSSION
	187
Exercise in Peripheral Arterial Disease
		SYSTEMIC DISEASES ALWAYS REQUIRE SYSTEMIC CARE
		EFFICACY OF EXERCISE TRAINING
		SCIENCE AND MECHANISMS OF EXERCISE BENEFIT
			Blood Flow
			Change in Muscle Metabolism
			Inflammation and Muscle Injury
			Changes in Microcirculation and Endothelial Function
			Hemorheologic Response
			Walking Economy
		CLAUDICATION TRAINING TREATMENT PROTOCOL
		EFFECT OF EXERCISE ON ATHEROSCLEROSIS RISK FACTORS
		ALL CLAUDICATION THERAPIES ARE EFFECTIVE AND CAN BE USED TOGETHER
		POTENTIAL OBSTACLES TO THERAPEUTIC SUCCESS
		CONCLUSIONS
	188
Pharmacologic Management of Intermittent Claudication
		NATURE OF THE PROBLEM
		CONCOMITANT CORONARY ARTERY DISEASE
		RHEOLOGIC AGENTS
		VASODILATOR THERAPY
		ADDRESSING ENDOTHELIAL DYSFUNCTION
		CONCLUSION
	189
Cutaneous Ulcers in the Neuroischemic Diabetic Foot
		ETIOLOGY AND PATHOPHYSIOLOGY
		DISTRIBUTION
		CLASSIFICATION OF DIABETICFOOT ULCERS
		REVASCULARIZATION
		ACHIEVING ULCER CLOSURE
	190
Lumbar Sympathectomy for Lower Extremity Ischemic Ulcers
		ANATOMY AND PHYSIOLOGY
		CLINICAL RESULTS
		INDICATIONS AND PATIENT SELECTION
		SURGICAL TECHNIQUE
		COMPLICATIONS
		RECOMMENDATIONS
	191
Biologic Therapies for Patients with Critical Limb Ischemia
		GENE THERAPY TRIALS
		STEM CELL THERAPY TRIALS
		SUMMARY
	192
Bone Marrow Stem Cell Treatment for Critical Limb Ischemia
		CELL BIOLOGY OF VASCULOGENESIS
		PIONEERING WORK
		CURRENT CLINICAL TRIALS
	193
Prothrombotic States and Vascular Thromboses
		ANTITHROMBIN III DEFICIENCY
		PROTEIN C AND S DEFICIENCY
		ANTIPHOSPHOLIPID SYNDROME
		FACTOR V LEIDEN
		PROTHROMBIN G20210A MUTATION
		HEPARIN-INDUCED THROMBOCYTOPENIA AND THROMBOSIS
		GUIDELINES
	194
Role of Antithrombotic Drugs in Maintaining Graft Patency
		PLATELET INHIBITORS
			Cilostazol
			Aspirin
			Thienopyridines
			Clopidogrel
			Glycoprotein IIb/IIIa Antagonists
			Dextran-like Compounds
			Bleeding Risks with Antiplatelet Agents
		ANTICOAGULATION
			Vitamin K Antagonists
			Vitamin K Antagonists Plus Aspirin
		CONCLUSION
	195
Complications of Heparin Anticoagulation Therapy
		NONBLEEDING COMPLICATIONS
			Heparin-Induced Thrombocytopenia
			Heparin-Induced Osteoporosis
			Heparin-Induced Skin Lesions
		BLEEDING COMPLICATIONS
		CONCLUSIONS
Embolic Diseases of
the Extremities
	196 Arterial Macroembolism
		DIAGNOSIS AND ANATOMY
		PERIOPERATIVE AND POSTOPERATIVE MEDICAL THERAPY
		OPERATIVE SETTING AND TECHNIQUES
		POSTOPERATIVE MANAGEMENT AND COMPLICATIONS
	197
Paradoxical Embolism
		PATHOPHYSIOLOGY
		DIAGNOSIS
		TREATMENT
	198
Atheroembolism
		PATHOGENESIS
		CLINICAL SYNDROMES
		CLINICAL PICTURES
		EVALUATION
		TREATMENT
	199
Operative Revascularization for Trash Foot
		CLINICAL PRESENTATIONAND DIAGNOSIS
		MEDICAL THERAPY AND THROMBOLYSIS
		PEDAL AND PERIMALLEOLAR THROMBOEMBOLECTOMY
		PEDAL ARTERY BYPASS
	200
Anticoagulant and Lytic Therapy for Arterial Thromboembolism in Extremities
		PERIOPERATIVE MANAGEMENT
		THROMBOLYSIS AND RESULTS
			Pharmacology of Fibrinolytic Agents
			Outcome Studies of Thrombolysis versusPrimary Operation
			New-Generation Fibrinolytics
		THROMBECTOMY DEVICES
		POSTINTERVENTION TREATMENT
		CONCLUSIONS
	201
Balloon Catheter Embolectomy for Macroembolization in the Extremities
		PREOPERATIVE DIAGNOSIS AND MANAGEMENT
		OPERATIVE TECHNIQUE
		OPERATIVE ADJUNCTS
		OUTCOMES
	202
Noninvasive Methods of Diagnosing Cardiac and Noncardiac Sources of Macroemboli
		ECHOCARDIOGRAPHY
		DIAGNOSTIC VASCULAR LABORATORY STUDIES
		COMPUTED TOMOGRAPHY AND MAGNETIC RESONANCE IMAGING
		DIAGNOSTIC APPROACH TOA PATIENT WITH PERIPHERAL ARTERIAL EMBOLI
Amputation
	203
Minor Amputations
		INDICATIONS
		SURGICAL TECHNIQUE
			Transphalangeal Toe Amputation
			Transmetatarsal (Ray) Toe Amputation
			Transmetatarsal Foot Amputation
		POSTOPERATIVE MANAGEMENT
		COMPLICATIONS
		OUTCOMES
	204
Below-Knee Amputation
		DETERMINING AMPUTATION LEVEL
		SURGICAL TECHNIQUE
		POSTOPERATIVE CARE
		RESULTS AND COMPLICATIONS
	205
Above-Knee Amputation and Hip Disarticulation
		ABOVE-KNEE AMPUTATION
			Indications
			Operative Technique
			Postoperative Care and Perioperative Outcome
			Long-Term Outcome
		HIP DISARTICULATION
	206
Upper Extremity Amputations
		SHOULDER DISARTICULATION
		TRANSHUMERAL AMPUTATION
		TRANSRADIAL AMPUTATION
		KRUKENBERG AMPUTATION
		WRIST DISARTICULATION
	207
Rehabilitation of the Amputee
		BEFORE AMPUTATION
		AMPUTATION LEVEL
		POSTOPERATIVE RESIDUAL LIMB MANAGEMENT AND THERAPY
		PROSTHETIC RESTORATION
Vascular Trauma
	208 Conventional and
Computed Tomographic Arteriography in Penetrating Vascular Injuries
		IMAGING FOR PENETRATINGVASCULAR INJURIES OF THE NECK
		IMAGING FOR PENETRATINGVASCULAR INJURIES OF THE THORAX
		IMAGING FOR PENETRATINGVASCULAR INJURIES OF THEABDOMEN
		IMAGING FOR PENETRATING VASCULAR INJURIES OF THE EXTREMITIES
	209
Nonarteriographic Diagnosis of Penetrating Vascular Trauma
		HISTORICAL BACKGROUND
		ARTERIAL PRESSURE MEASUREMENTS
		DUPLEX ULTRASONOGRAPHY
		MINIMAL ARTERIAL INJURY
		ROLE OF THE SERIAL PHYSICAL EXAMINATION
	210
Penetrating and Blunt Injuries of the Carotid Artery
		PENETRATING CAROTID ARTERY INJURIES
			Operative Approach
			Outcomes
		BLUNT CAROTID ARTERY INJURIES
			Treatment
			Outcomes
	211 Penetrating and
Blunt Injuries ofthe Vertebral Artery
		ETIOLOGY
		TREATMENT
	212
Blunt Arterial Injuries of the Shoulder: Open and Endovascular Therapy
		PRESENTATION AND DIAGNOSIS
		OPEN OPERATIVE MANAGEMENT
		ENDOVASCULAR MANAGEMENT
	213
Penetrating Injuries to the Aortic Arch and Intrathoracic Great Vessels
		ARTERIAL INJURIES IN THE MEDIASTINUM
			Epidemiology
			Clinical Presentation
			Diagnosis
			Management
			Outcomes
		SPECIFIC ARTERIAL INJURIES
			Innominate Injury
			Subclavian Injury
			Common Carotid Injury
	214
Open and Endovascular Management of Blunt and Penetrating Nonaortic Abdominal Vascular Injury
		ZONES OF INJURY
		VENA CAVA INJURIES
		CELIAC ARTERY INJURIES
		HEPATIC ARTERY INJURIES
		PORTAL VEIN INJURIES
		SUPERIOR MESENTERIC ARTERY INJURIES
		RENAL ARTERY INJURIES
	215
Aortic Injury
		INCIDENCE
		PATHOPHYSIOLOGY
		PRESENTATION AND DIAGNOSIS
		TIMING OF REPAIR
		OPERATIVE REPAIR
			Open Thoracic Technique
			Open Abdominal Technique
			Endovascular Technique
		CHANGE IN PARADIGM
	216
Complications of Upper and Lower Extremity Percutaneous Arterial Puncture and Catheterization
		COMPLICATIONS OF LOWER EXTREMITY ARTERIAL PUNCTURES
			Bleeding
			Pseudoaneurysm
			Arteriovenous Fistula
			Thrombosis, Dissection, and Distal Embolization
			Femoral Neuropathy
			Vascular Closure Devices
		COMPLICATIONS OF UPPER EXTREMITY PUNCTURES
	217
Open and Endovascular Treatment of Penetrating Extremity Arterial Injuries
		RESUSCITATION AND SURGICAL ASSESSMENT
		OPEN OPERATIVE MANAGEMENT
		ENDOVASCULAR MANAGEMENT
		COMPLETION IMAGING
		POSTOPERATIVE CONSIDERATIONS
	218
Blunt Popliteal Artery Injuries
		DIAGNOSIS
			Physical Examination
			Imaging
		TREATMENT
			Vascular Repair
			Fasciotomy
			Orthopedic and Soft Tissue Injury
			Postoperative Management
		OUTCOME
	219
Fasciotomy for Compartmental Hypertension and Acute Compartment Syndrome
		PATHOPHYSIOLOGY
		CLINICAL PRESENTATION AND DIAGNOSIS
		OBJECTIVE TESTS IN THE DIAGNOSIS OF COMPARTMENTAL HYPERTENSION
		FASCIOTOMY
			Indications
			Techniques
			Immediate and Late Effects
	220
Ischemia-Induced Muscle Myonecrosis, Myoglobinuria, and Secondary Kidney Failure
		PATHOPHYSIOLOGY
		DIAGNOSIS
		MANAGEMENT
	221
Vascular Injury Secondary to Drug Abuse
		ARTERIAL INJURY
			Pathophysiology
			Presentation
			Evaluation and Diagnosis
			Treatment
		VENOUS INJURY
			Superficial Thrombophlebitis
			Deep Vein Thrombophebitis
			Mycotic Venous Aneurysm
			Chronic Venous Disease
	222
Cold Injury
		HYPOTHERMIA
		FROSTBITE
		NONFREEZING INJURIES
		TREATMENT
	223
Pediatric Iatrogenic Vascular Injury
		LOWER EXTREMITY AND FEMORAL ARTERY
		UPPER EXTREMITY AND BRACHIAL ARTERY
		ABDOMINAL AORTA
		CERVICAL AND CAROTID ARTERY
Mesenteric
Vascular Disease
	224 Arteriography
Evaluation of Splanchnic Artery Occlusive Disease
		VASCULAR ANATOMY
			Celiac Artery
			Superior Mesenteric Artery
			Inferior Mesenteric Artery
		TECHNIQUE
		ARTERIOGRAPHY DIAGNOSIS
			Occlusive Disease at the Origins ofthe Splanchnic Arteries
			Occlusive Disease of Splanchnic Artery Branches
			Distal Splanchnic Arterial Occlusive Disease
			Nonocclusive Mesenteric Ischemia
	225
Duplex Scanning in the Diagnosis of Splanchnic Artery Occlusive Disease
		TECHNIQUE OF MESENTERIC DUPLEX SCANNING
		FASTING DOPPLER MESENTERIC ARTERY WAVEFORMS
		FASTING DUPLEX CRITERIA FOR MESENTERIC ARTERY STENOSIS
		POSTPRANDIAL MESENTERIC DUPLEX SCANNING
		EVALUATION OF MESENTERIC ARTERY BYPASS GRAFTS
		EVALUATION OF STENTED SUPERIOR MESENTERIC ARTERIES
		INTERMITTENT CELIAC AXIS COMPRESSION
	226
Acute Embolic and Thrombotic Mesenteric Ischemia
		CLINICAL PRESENTATION
			Acute Embolic Mesenteric Ischemia
			Acute Thrombotic Mesenteric Ischemia
		DIAGNOSIS
		TREATMENT
			Surgical Treatment
			Endovascular Treatment
			Surgical versus Endovascular Therapy for Acute Mesenteric Embolus and Thrombosis
	227 Endovascular Therapy for Chronic Mesenteric Ischemia
		DIAGNOSIS
		TREATMENT
			Selection
			Techniques
		RESULTS
			Symptom Relief
			Morbidity and Mortality
			Restenosis, Symptom Recurrence,and Reintervention
			Survival
	228
Transaortic Splanchnic Endarterectomy for Chronic Mesenteric Ischemia
		DIAGNOSIS AND EVALUATION OF CHRONIC MESENTERIC ISCHEMIA
		TECHNIQUE OF TRANSAORTIC SPLANCHNIC ENDARTERECTOMY
		OUTCOME
		PATIENT SELECTION
	229
Arterial Bypass for Chronic Mesenteric Ischemia
		TREATMENT OPTIONS
		ANTEGRADE VERSUS RETROGRADE BYPASS
		SINGLE- VERSUS MULTI-VESSEL BYPASS
		TECHNICAL DETAILS
		SURGICAL RESULTS
	230
Operative Treatment of Pediatric Splanchnic Arterial Occlusive Disease
		CLINICAL PRESENTATION
		ETIOLOGY OF SPLANCHNIC ARTERIAL OCCLUSIVE LESIONS
		OPERATIVE THERAPY
		OUTCOMES
	231
Celiac Artery Compression Syndrome
		CLINICAL MANIFESTATIONS
		ANATOMIC BASIS OF ARTERIAL ENTRAPMENT
		PHYSIOLOGIC CONSEQUENCESOF ARTERIAL ENTRAPMENT
		DIAGNOSTIC EVALUATION
		OPERATIVE TREATMENT
			Conventional Open Surgical Approach
			Laparoscopic and Endoscopic Surgical Approaches
			Endovascular Management
		SURGICAL OUTCOMES
	232
Nonocclusive Mesenteric Ischemia
		PATHOPHYSIOLOGY
		CLINICAL PRESENTATION
		DIAGNOSIS
		MANAGEMENT
	233
Venous Thrombosis Within the Splanchnic Circulation
		MESENTERIC VEIN THROMBOSIS
			Epidemiology
			Risk Factors
			Clinical Presentation
			Diagnosis
			Medical Management
			Surgical and Interventional Management
			Outcomes
		PORTAL VEIN THROMBOSIS
		SPLENIC VEIN THROMBOSIS
		BUDD–CHIARI SYNDROME
	234
Celiac, Hepatic, and Splenic Artery Aneurysms
		CELIAC ARTERY ANEURYSMS
			Clinical Presentation
			Management
		HEPATIC ARTERY ANEURYSMS
			Clinical Presentation
			Management
		SPLENIC ARTERY ANEURYSMS
			Clinical Presentation
			Management
	235
Mesenteric Artery Aneurysms
		SUPERIOR MESENTERIC ARTERY ANEURYSMS
		INFERIOR MESENTERIC ARTERY ANEURYSMS
		JEJUNAL, ILEAL, AND COLIC ARTERY ANEURYSMS
	236
Gastroduodenal and Pancreaticoduodenal Artery Aneurysms
		PSEUDOANEURYSMS
			Clinical Manifestations
			Diagnosis
		TREATMENT
		TRUE ANEURYSMS
			Diagnosis
			Clinical Manifestations
			Treatment
	237
Vascular Malformations and Arteriovenous Fistulas of the Gastrointestinal Tract
		ARTERIOVENOUS FISTULAS
		VASCULAR MALFORMATIONS
Renovascular
Disease
	238 Pathology of
Arteriosclerotic, Fibrodysplastic, and Developmental Renal Artery Occlusive Disease
		RENAL ARTERY FIBRODYSPLASIA
			Intimal Fibroplasia
			Medial Fibroplasia
			Perimedial Dysplasia
		DEVELOPMENTAL RENAL ARTERY STENOSES
		RENAL ARTERY ARTERIOSCLEROSIS
	239
Conventional Arteriographic and Computed Tomography Arteriographic Diagnosis of Renovascular Hypertension
		CATHETER ANGIOGRAPHY
		COMPUTED TOMOGRAPHY ARTERIOGRAPHY
	240
Magnetic Resonance Angiographic Diagnosis of Renovascular Disease
		PATIENT PREPARATION
		INTERPRETING THE IMAGE
	241
Duplex Scanning in the Evaluation of Renal Arterial Occlusive Disease
		SCANNING TECHNIQUE
		INTERPRETATION
		CLINICAL APPLICATIONS
	242
Renovascular Hypertension and Renal Artery Occlusive Disease
		PATHOPHYSIOLOGY OF RENOVASCULAR HYPERTENSION
		CLINICAL EVIDENCE OF RENIN–ANGIOTENSIN ACTIVATION
	243
Renal Insufficiency and Renal Artery Occlusive Disease
		PATHOPHYSIOLOGY
		PREVALENCE
		NATURAL HISTORY
		DIAGNOSIS
		MANAGEMENT
		Selected References
	244
Selection of Patients for Open Surgical or Endovascular Treatment of Renal Artery Arteriosclerotic Disease
		CONDITIONS IN FAVOR OF OPEN RENAL ARTERY REVASCULARIZATION
		CONDITIONS IN FAVOR OF ENDOVASCULAR RENAL ARTERY REVASCULARIZATION
		CONCLUSION
		Selected References
	245
Percutaneous Arterial Dilation and Stenting for Arteriosclerotic Renovascular Hypertension and Ischemic Nephropathy
		PATIENT SELECTION
		TECHNIQUES OF RENAL ARTERY STENTING
		ASTRAL AND STAR TRIALS
		RESULTS OF RETROSPECTIVE OBSERVATIONAL STUDIES OFRENAL ARTERY STENTING
		Selected References
	246
Percutaneous Arterial Dilation for Fibrodysplastic Renovascular Hypertension
		TREATMENT
		OUTCOMES
	247
Transaortic Renal Artery Endarterectomy for Renal Artery Atherosclerosis
		OPERATIVE TECHNIQUE
			Exposure
			Axial Aortorenal Endarterectomy
			Transaortic Renal Artery Endarterectomy
			Direct Renal Artery Endarterectomy
		POSTOPERATIVE CARE
	248
Aortorenal Bypass for Renovascular Hypertension in Adults
		PREOPERATIVE PREPARATION
		OPERATIVE MANAGEMENT
			Surgical Strategy
			Operative Exposure
			Renal Artery Bypass
			Operative Duplex Sonography
		OUTCOMES
	249
Alternative Renal Artery Reconstruction Techniques: Hepatorenal, Splenorenal, Iliorenal, and Mesorenal Bypass Procedures
		SPLENORENAL BYPASS
		HEPATORENAL AND GASTRODUODENAL BYPASS
		ILIORENAL BYPASS
		MESORENAL BYPASS
	250
Ex Vivo Arterial Repair for Renovascular Hypertension Secondary to Fibrodysplasia
		THERAPY
		SURGICAL TECHNIQUE
			Incision
			Nephrectomy
			Ex Vivo Reconstruction
			Autotransplantation of the Kidney
		RESULTS
			Complications
	251
Operative Evaluation of Renal and Visceral Arterial Reconstructions Using Duplex Sonography
	252
Surgical Treatment of Renovascular Hypertension in Children
		OPERATIVE THERAPY
			Types of Surgery
			General Tenets
			Concomitant Nonrenal Procedures
		DISCUSSION
		OUTCOMES
	253
Renal Artery Dissection
		ENDOVASCULAR PROCEDURE-INDUCED DISSECTION
		BLUNT TRAUMA–RELATED DISSECTION
		SPONTANEOUS DISSECTION
	254
Renal Artery Atheroembolism
		ETIOLOGY
		DIAGNOSIS
		TREATMENT
	255
Renal Vein Thrombosis
		PATHOPHYSIOLOGY
		CLINICAL PRESENTATION
		DIAGNOSIS
		TREATMENT
			Neonates
			Adults
	256
Treatment of Renal Artery Aneurysms
		PATHOGENESIS
		CLINICAL PRESENTATION
		TREATMENT
			Indications
			Surgical Exposure
			Specific Interventions
		OUTCOMES
	257
Renal Arteriovenous Malformations And Arteriovenous Fistulas
		CLASSIFICATION
		INCIDENCE
		CLINICAL FEATURES
		ANGIOGRAPHIC DIAGNOSIS
		MANAGEMENT
			Congenital Arteriovenous Malformations
			Arteriovenous Fistula
			Traumatic Arteriovenous Fistula
	258
Endovascular Renal Denervation
		RESISTANT HYPERTENSION ANDTHE ROLE OF SYMPATHETIC NERVOUS SYSTEM
		ENDOVASCULAR RENAL DENERVATION
		CLINICAL EVALUATION OF RENAL DENERVATION
		ALTERNATIVE APPROACHESTO RENAL DENERVATION
		EFFECT OF RENAL DENERVATION ON PHYSIOLOGIC PARAMETERS
		SAFETY OF THE PROCEDURE
		RENAL DENERVATION FOR OTHER CONDITIONS
Arteriovenous Fistulas and
Arteriovenous Malformations
	259
Classification of Peripheral Arteriovenous and Venous Malformations
	260
Imaging of Peripheral Vascular Fistulas and Arteriovenous Malformations
		IMAGING MODALITIES
		MAGNETIC RESONANCE IMAGING AND MAGNETIC RESONANCE ANGIOGRAPHY
		ULTRASONOGRAPHY
		COMPUTED TOMOGRAPHY
		IMAGING FEATURES OF VASCULAR ANOMALIES
			Capillary Malformations
			Venous Malformations
			Lymphatic Malformations
			Arteriovenous Malformations
			Mixed Malformations and Syndromes
			Vascular Tumors
			Arteriovenous Fistulas
	261
Treatment of Congenital Vascular Malformations in Children and Adults
		TREATMENT GUIDELINES
			Surgical Treatment
			Endovascular Treatment
	262
Treatment of Traumatic Arteriovenous Fistulas
		ETIOLOGY AND PATHOPHYSIOLOGY
		CLINICAL PRESENTATION AND DIAGNOSIS
		TREATMENT
			Management Options
			Treatment at Specific Sites
Angioaccess Surgery
	263
External Methods of Angioaccess
		INDICATIONS FOR CENTRAL VENOUSACCESS
			Chemotherapy
			Hemodialysis
		TYPES OF CENTRAL VENOUSCATHETERS
			Acute-Care Devices
			Transition Access Devices
			Tunneled Catheters
			Implanted Ports
		TECHNIQUES FOR INSERTION
			Internal Jugular Approach
			Subclavian Vein Approach
			Femoral Vein Approach
			Other Approaches
		COMPLICATIONS OF CENTRAL VENOUS CATHETERIZATION
			Pneumothorax
			Vascular Injury
			Arrhythmia
			Air Embolism
			Infection
			Mechanical Complications
	264
Direct Arteriovenous Communication Angioaccess
		PREOPERATIVE EVALUATION
		LOCATION OF THE FISTULA
		TECHNIQUE
		COMPLICATIONS
			Graft Stenosis
			Steal Syndrome with Hand Ischemia
			Central Vein Stenosis
		MATURATION OF THE FISTULA
		FOLLOW-UP
	265
Bridge Grafts for Angioaccess
		PREOPERATIVE CONSIDERATIONS
		BRIDGE GRAFTS
		SURGERY
	266
Role of Surveillance for Hemodialysis Access
		JUSTIFICATION
		CLINICAL MONITORING AND SURVEILLANCE TECHNIQUES
		RECOMMENDATIONS FROM NATIONAL GUIDELINES
		EVIDENCE TO SUPPORT SURVEILLANCE
		PRACTICAL RECOMMENDATIONS
	267
Thrombotic Complications of Arteriovenous Access
		RISK FACTORS FOR THROMBOSISOF ARTERIOVENOUS ACCESS
			Inflow Disease
			Anastomotic Factors
			Complications with the Type of Conduit
			Systemic Factors
			Intradialytic Factors
		CLINICAL PRESENTATION
		MANAGEMENT
			Patient Selection
			Contraindications to Thrombectomy
		TREATMENT TECHNIQUES
			Standard Percutaneous Technique
			Standard Open Technique
			Thrombolysis
			Mechanical Thrombectomy
			Balloon Angioplasty
			Stent and Stent-Graft Placement
		COMPLICATIONS OF THROMBOLYSIS AND THROMBECTOMY
			Local Complications
			Distant Complications
			Systemic Complications
	268
Ambulatory Treatment of Dialysis Access Stenosis
		TECHNIQUE OF ULTRASOUND-GUIDED FISTULA TREATMENT
		OFFICE-BASED MANAGEMENT OF ARTERIOVENOUS ACCESS UNDER FLUOROSCOPIC GUIDANCE
		FOLLOW-UP
Venous Disease
	269
Coagulation Cascade and Thrombosis
		BASIC COAGULATION PATHWAYS
		NATURAL ANTICOAGULANTS BALANCE THROMBOSIS
		PHYSIOLOGIC THROMBOLYSIS
		ORGAN HEMOSTASIS: ENDOTHELIUM
		INFLAMMATION AND THROMBOSIS
		863RESOLUTION OF THROMBOSIS
		INTERPLAY OF ARTERIAL AND VENOUS THROMBOSIS
		FACTORS THAT INCREASE RISK OF VENOUS THROMBOEMBOLISM
		BIOMARKERS FOR VENOUS THROMBOEMBOLISM
	270
Pathophysiology of Acute Venous Thrombosis
		RISK FACTORS FOR ACUTE VENOUS THROMBOEMBOLISM
		PATHOPHYSIOLOGY OF ACUTE VENOUS THROMBOEMBOLISM
		SUMMARY
	271
Ultrasonography for the Diagnosis of Venous Disease
		EVALUATION OF REFLUX
		EVALUATION OF OBSTRUCTION
		EVALUATION OF CONGENITAL MALFORMATION
	272
Computed Tomographic Venography and Magnetic Resonance Venography
		COMPUTED TOMOGRAPHY VENOGRAPHY
		MAGNETIC RESONANCE VENOGRAPHY
	273
Invasive Methods of Diagnosing Acute and Chronic Venous Disease
		INTRAVASCULAR ULTRASONOGRAPHY
		CONTRAST VENOGRAPHY
		IMAGING OF ACUTE AND CHRONIC VENOUS THROMBOSIS
	274
Natural History of Acute Venous Thrombosis
		VENOUS THROMBOGENESIS ANDTHE EARLY NATURAL HISTORY OF DEEP VEIN THROMBOSIS
		COMPLICATIONS OF ACUTE DEEP VEIN THROMBOSIS
		CLINICAL IMPLICATIONS OF NATURAL HISTORY STUDIES
		SUMMARY
	275
Nonoperative Treatment of Acute Lower Extremity Venous Thrombosis
		PATIENTS WITH DEEP VEIN THROMBOSIS
		PATIENTS WITH THE POST-THROMBOTIC SYNDROME
	276
New and Alternative Anticoagulants
		FONDAPARINUX
		APIXABAN
		RIVAROXABAN
		EDOXABAN
		DABIGATRAN
		FUTURE ANTICOAGULANTS
	277
Warfarin-Induced Skin Necrosis
		CLINICAL PRESENTATION
		LABORATORY PRESENTATION
		PATHOPHYSIOLOGY
		PREVENTION AND MANAGEMENT
		PROGNOSIS
	278
Endovascular Thrombolysis and Mechanical Clot Removal for Acute Symptomatic Lower Extremity Deep Vein Thrombosis
		MECHANISM OF THROMBOLYSIS
		EVALUATION
		ENDOVASCULAR STRATEGIESOF THROMBUS REMOVAL
		QUALITY OF LIFE, VEIN VALVE FUNCTION, AND RECURRENCE
		CONCLUSION
	279
Open Surgical Treatment of Acute Iliofemoral and Inferior Vena Cava Thrombosis
		INDICATIONS FOR INTERVENTION
		SURGICAL THROMBECTOMY
		COMPLICATIONS AND RESULTSOF SURGICAL THROMBECTOMY
		NEW DEVELOPMENTS TO IMPROVE SURGICAL VENOUS THROMBECTOMY
	280
Treatment of Acute Upper Extremity Venous Occlusion
		CATHETER-ASSOCIATED DEEP VEIN THROMBOSIS OF THE UPPER EXTREMITY
		TREATMENT
		COMPLICATIONS
	281
Lower Extremity Superficial Vein Thrombophlebitis
	282
Pathology and Classification of Chronic Venous Disease
		IN SEARCH OF COMPLETEAND ACCURATE DIAGNOSIS
		CLUES TO CHRONIC VENOUS DISEASE
		SKIN PATHOLOGY AND CLINICAL CLASSIFICATION
		REFINEMENT IN C, E, A, AND P:2004 CONSENSUS
		VENOUS CLINICAL SEVERITY SCORING
		DISABILITY SCORE
		QUALITY OF LIFE
		SUMMARY
	283
Endovascular Treatment of Chronic Venous Occlusion
		PATHOPHYSIOLOGY
		DIAGNOSIS
		TREATMENT
		RESULTS
	284
Endovascular Laser Treatment of Varicose Veins
		PATIENT SELECTION
		TECHNIQUE
		FOLLOW-UP
		COMPLICATIONS
		CLINICAL EXPERIENCE
	285
Endovascular Radiofrequency Treatment of Varicose Veins
		PROCEDURE
		POST-TREATMENT CARE
		RESULTS
	286
Injection Treatment of Lower Extremity Varicose Veins
		SCLEROSANTS
		LIQUID SCLEROTHERAPY
		FOAM SCLEROTHERAPY
		SCLEROTHERAPY FOR SUPERFICIAL VARICES AND TELANGIECTASES
		SAPHENOUS SCLEROTHERAPY
		RESULTS OF CLINICAL TRIALS
		SYSTEMIC COMPLICATIONS
	287
Excision of Varicose Veins
		IMPORTANCE OF TREATING TRUNCAL INCOMPETENCE
		PRINCIPLES OF TREATING VARICOSITIES
		EXCISION OF VARICOSE VEINS
	288
Open Surgical Treatment of Chronic Venous Insufficiency
		INDICATIONS FOR DETAILED VENOUS EVALUATIONS
		PRIMARY VENOUS INSUFFICIENCY
		SECONDARY VENOUS INSUFFICIENCY
		RESULTS
		COMPLICATIONS
		CONCLUSION
	289
Nonoperative Management of Chronic Venous Insufficiency
		COMPRESSION THERAPY
			Elastic Stockings
			Paste Boots
			Compressive Bandages
			Legging Orthosis
			Pneumatic Compression Devices
		PHARMACOLOGIC THERAPIES
			Diuretics
			Zinc
			Fibrinolytic Agents
			Phlebotrophic Agents
			Hemorheologic Agents
			Prostaglandins
		TOPICAL THERAPIES
	290
Pathophysiology of Venous Varicosities and Venous Ulcers
		MACROSCOPIC ALTERATIONS
		MICROSCOPIC ALTERATIONS
		EXTRACELLULAR MATRIX ALTERATIONS
		CYTOKINE REGULATION AND TISSUE FIBROSIS
		MATRIX METALLOPROTEINASES AND THEIR INHIBITORS IN VENOUS ULCER HEALING
		REGULATION OF VENOUS ULCER FORMATION AND HEALING
		SUMMARY
	291
Open Surgical, Endoscopic, and Endovascular Treatment of Perforating Veins
		ANATOMY AND FUNCTION OF PERFORATORS
			New Nomenclature
			Common Sites of Perforating Veins
		PATHOPHYSIOLOGY
		DIAGNOSIS OF PERFORATOR INCOMPETENCE
		CLINICAL OUTCOMES FOLLOWING PERFORATOR ABLATION
			Determining the Role of and Indication for Ablation
			Effect of Interrupting ICPVs on Ulcer Healingand Recurrence
			Effect of Treating GSV Incompetence Aloneon Ulcer Healing and Recurrence
		NEWER TECHNIQUES FOR ICPV ABLATION
			Sclerotherapy
			Endovenous Ablation
			Radiofrequency Ablation for Venous Ulcer
		CURRENT APPROACH
	292
Nonoperative Treatment of Venous Ulcers
		COMPRESSION THERAPY AND CHRONIC VENOUS ULCERWOUND THERAPY
		PHARMACOLOGIC TREATMENT
		TREATMENT WITH TOPICAL GROWTH FACTORS
		THERAPEUTIC MODULATION OF MATRIX METALLOPROTEINASE
		HUMAN SKIN EQUIVALENTS AND BIOLOGIC MATRICES
	293
Renal Vein Entrapment: The Nutcracker Syndrome
		ANATOMIC FEATURES
		CLINICAL FEATURES
		DIAGNOSTIC STUDIES
		TREATMENT
			Surgical Treatment
			Endovascular Treatment
	294
Pelvic Venous Flow Disorder
		VENOUS ANATOMY OF THE PELVIS
		PATHOPHYSIOLOGY
		SYMPTOMS
		DIAGNOSIS
		TREATMENT
		RESULTS AND OUTCOMES
	295
Endovascular Treatment of Vena Cava Occlusion
		CLINICAL PRESENTATION
		IMAGING EVALUATION
		VASCULAR ACCESS FOR ENDOVASCULAR TREATMENT
		TECHNIQUE OF VENOUS RECANALIZATION
		TREATMENT ENDPOINTS
		SPECIAL CASES
		POSTOPERATIVE FOLLOW-UP
		AREAS OF UNCERTAINTY AND OPPORTUNITY FOR FUTURE DEVELOPMENT
	296
Open Surgical Treatment of Thrombotic Vena Cava Occlusion
		SUPERIOR VENA CAVA SYNDROME
			Clinical Presentation
			Surgical Technique
			Results
		INFERIOR VENA CAVA THROMBOSIS
			Clinical Presentation
			Open Surgical Treatment
			Results
	297
Primary and Secondary Vena Cava Tumors
		TUMOR TYPES
		CLINICAL PRESENTATION
		EVALUATION
		TREATMENT
		OUTCOMES
	298
Nonoperative Treatment of Acute Pulmonary Embolism
		RISK STRATIFICATION
		TREATMENT STRATEGIES
			Systemic Fibrinolysis
			Catheter-Directed Therapy
			Local Fibrinolytic Therapy
			Pigtail Fragmentation
			Rheolytic Thrombectomy
			Rotational Thrombectomy
			Ultrasound-Accelerated Thrombolysis
		PRACTICAL PERSPECTIVE
	299
Surgical Treatment of Acute and Chronic Pulmonary Embolism
		ACUTE PULMONARY EMBOLISM
		CHRONIC PULMONARY EMBOLISM
		CONCLUSION
	300
Permanent and Temporary Inferior Vena Cava Filters
		INDICATIONS FOR PLACING FILTERS
		TYPES OF FILTERS
		PLACING THE FILTER
		RETRIEVING THE FILTER
		COMPLICATIONS OF FILTER PLACEMENT
		PROPHYLACTIC FILTER PLACEMENT
	301
Venous Aneurysms
		POPLITEAL VENOUS ANEURYSMS
		ANEURYSMS OF THE SUPERFICIAL VEINS OF THE EXTREMITIES
		VENOUS ANEURYSMS OF THE DEEP VEINS OF THE EXTREMITIES
		VENOUS ANEURYSMS OF THE VEINS OF THE NECK AND FACE
		THORACIC VENOUS ANEURYSMS
		AZYGOS VEIN ANEURYSMS
		SUBCLAVIAN AND INNOMINATE VENOUS ANEURYSMS
		ABDOMINAL VENOUS ANEURYSMS
Lymphatic Disease
	302
Lymphedema
		ANATOMY AND PHYSIOLOGY
		PATHOPHYSIOLOGY
		CLASSIFICATION
		EVALUATION AND DIAGNOSIS
		TREATMENT
	303
Lymphedema: Medical and Physical Therapy
		STRUCTURE AND FUNCTION OF THE LYMPHATIC SYSTEM
		PATHOPHYSIOLOGY
		PRIMARY AND SECONDARY LYMPHEDEMA
		GRADES OF LYMPHEDEMA
		TREATMENT
		REHABILITATIVE TREATMENT
			Elevation
			Skin Hygiene
			Exercise
			Specialized Massage
			Compression
			Intermittent Vasopneumatic Compression
	304
Surgical Treatment of Lymphedema
		INDICATIONS FOR SURGICAL TREATMENT
		EXCISIONAL OPERATIONS
		MICROSURGICAL LYMPH VESSEL RECONSTRUCTIONS
		LYMPHATIC GRAFTING
		CONCLUSION