This chapter discusses open surgical options for femoral, popliteal, and tibial arterial occlusive disease. Although some of these procedures may also be performed for disabling intermittent claudication, the vast majority should only be performed for critical lower limb ischemia, which…
Mesenteric Arterial Disease Chronic mesenteric ischemia (CMI) is an uncommon disorder, accounting for fewer than 1 per 100,000 hospital admissions in the United States. Since the first successful mesenteric endarterectomy by Shaw and Maynard in 1958, techniques of revascularization have…
Historical Background Renovascular Hypertension In 1934, Goldblatt demonstrated that constriction of the renal artery (renal artery stenosis [RAS]) produced atrophy of the kidney and hypertension in dogs. As a clinical pathologist, Goldblatt noticed that extensive vascular disease was often present…
Although the causal relationship between mesenteric vascular occlusion and intestinal gangrene was suspected in the 15th century, the first successful case of intestinal resection for infarction was not reported until 1895. Recognition of the chronic form soon followed, with the…
History of Endoluminal Treatment The concept of endovascular therapy of atherosclerotic occlusive disease was introduced in the 1960s when Dotter performed the first transluminal angioplasty in a patient with ischemic extremities. His novel technique, however, could not reliably maintain luminal…
In the Western world, atherosclerotic occlusive disease of the abdominal aorta and iliac arteries is a common cause of lower extremity ischemia in middle-aged and elderly patients. Although not as common as occlusive disease of the femoropopliteal arterial system, with…
Introduction Carotid body tumors (CBTs) are rare and usually benign neuroendocrine neoplasms that have a predictable but slow growth rate and a low potential for malignancy. They arise from the carotid body, which functions as the body's sensor, primarily to…
Each year in the United States, nearly 800,000 individuals experience a new or recurrent stroke, accounting for direct and indirect costs of more than $40 billion and untold damage to patients and their families. Stroke is responsible for 1 out…
The supra-aortic trunks (SATs) branch from the aortic arch and ascend through the mediastinum to terminate at the carotid bifurcations and the origins of the vertebral arteries. These trunks carry the entire blood supply to the head and upper extremities.…
Historical Review The development of surgery on the extracranial cerebrovascular circulation was dependent on three principal factors: (1) recognition of the pathologic relationship between extracranial cerebrovascular disease and subsequent cerebral infarction, (2) the introduction of cerebral angiography to identify lesions…