Introduction Infrainguinal arterial bypasses are major arterial reconstructions with the proximal anastomotic site below the inguinal ligament that are commonly used in the setting of chronic limb-threatening ischemia manifested by rest pain and/or tissue loss. The goal of these reconstructions…
Introduction Lower-extremity peripheral arterial disease (PAD) symptoms range from asymptomatic to claudication, which may be lifestyle limiting, to chronic limb-threatening ischemia consisting of rest pain and/or tissue loss. The usual minimum threshold for treatment is lifestyle-limiting claudication. However, this is…
Introduction Hemodialysis continues to be the predominant form of renal replacement. Arteriovenous fistulas (AVFs) are the preferred hemodialysis (HD) vascular access. Compared with arteriovenous grafts (AVGs) and tunneled central venous catheters (CVCs), they have lower complication and infection rates, reduced…
Introduction Mesenteric ischemia can be an acute or chronic process. Acute mesenteric ischemia is caused by embolism or thrombosis of one or more mesenteric blood vessels. Embolism is generally a result of a recent cardiac event or arrhythmia. Acute mesenteric…
Video 43.1 Abdominal Aortic Aneurysm Introduction Aneurysms and dissections are the most common disease processes of the aorta. Several factors contribute to their formation and growth. Although most aneurysms are now treated through endovascular techniques, open surgical reconstruction of the…
Subclavian Artery Reconstruction Introduction Cervical reconstruction of arch branch vessels requires detailed understanding of neck and thoracic outlet anatomy. Revascularization of the subclavian arteries using a carotid subclavian bypass or transposition can be used to improve or preserve blood flow…
Introduction Carotid endarterectomy (CEA) is one of the most commonly performed vascular operations, with the majority of these procedures being performed for carotid bifurcation atherosclerotic disease ( Fig. 41.1A ). Two landmark multicenter randomized trials, North American Symptomatic Carotid Endarterectomy…
Video 40.1 Open Transversus Abdominis Release (TAR) Introduction Approximately 300,000 to 400,000 ventral hernias are fixed yearly in the United States, encompassing primary defects as well as the 20% to 25% of incisional hernias that occur after midline laparotomy and…
Introduction Lumbar and flank hernias are caused by defects originating in the lateral abdominal wall. Such defects can be congenital or acquired as a consequence of surgery, trauma, or progressive weakening of native tissues. There are some specific challenges associated…
Introduction Chronic postoperative inguinal pain (CPIP) has become an increasingly appreciated complication of one of the most common operations performed in surgery, the inguinal hernia repair. The rate of CPIP after inguinal hernia repair is greater than the risk of…