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…
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…