Atherectomy Devices Introduction Since the early 1990s, percutaneous peripheral atherectomy has provided an ancillary approach to the treatment of atherosclerotic occlusive disease beyond angioplasty and stenting. A variety of technologies have been developed to debulk atherosclerotic lesions, including directional excisional,…
The core elements of all endovascular procedures include gaining arterial access safely, placing a sheath with hemostasis valve, and navigating to a selected target using shaped diagnostic catheters and guidewires. In most cases, the intervention itself involves use of an…
Despite advances in endovascular interventions, the use of surgical bypass is still both relevant and fundamental to the treatment of a wide variety of vascular surgery conditions. The technical details of the bypass procedure and its subsequent outcomes are dependent…
Currently there are several imaging techniques used to image the vascular system. These techniques include catheter-based conventional digital subtraction angiography, Doppler ultrasound, magnetic resonance angiography (MRA), and computed tomography angiography (CTA). Conventional digital subtraction angiography (DSA) has long been the…
Introduction In the early days of vascular surgery, patient assessment was based on a careful history and physical examination. Although a few clinicians used the Collins oscillometer to estimate the pulse pressure in an extremity, there was little help available…
Introduction Arterial disease is the leading cause of death and significant morbidity in the United States and throughout the world. The American Heart Association estimates that 85.6 million (26.4%) Americans have cardiovascular disease, leading to 787,000 deaths annually. Patients with…
Introduction The term chronic critical limb ischemia (CLI) was first coined in 1982 and was intended to describe limb-threatening arterial insufficiency in the absence of diabetes mellitus (DM). Since the initial description of CLI, the incidence and prevalence of DM…
Introduction The use of antibiotics in vascular surgery has undergone significant change in the course of the past half-century. Initial experience with devastating arterial graft infections and significant data supporting antibiotic use led to overuse of antibiotics. More recent experience…
Definition, Incidence, and Clinical Significance Congenital vascular malformations (CVMs) are rare developmental abnormalities of the vascular system that include a broad spectrum of arterial, venous, lymphatic, and capillary lesions. The overall incidence is estimated at 1.2% to 1.5%. Congenital arterial…
Vascular malformations (VMs) are developmental abnormalities of the vascular system. They should be differentiated from vascular tumors or hemangiomas because they have different etiologies, growth patterns, treatments, and outcomes. Malformations can involve any segment of the vascular tree: arteries, capillaries,…