Atherosclerotic disease is the leading cause of mortality in developed countries. Better understanding of the pathophysiology of atherosclerosis has led to successful therapies and preventative strategies; however, treatment of conventional risk factors for atherosclerotic disease may only prevent 50% of…
Despite the focus on operative and endovascular interventions in vascular surgery, most patients with chronic lower extremity ischemia do not require surgical intervention. Nonoperative therapy and risk factor modification remain the primary components of management for the majority of patients.…
Chronic venous insufficiency (CVI) is common, ranging from primary varicose veins to valvular incompetence of the lower extremity veins. Most symptoms of CVI can be improved with bedrest and elevation of the legs. However, prolonged immobilization is impractical and dangerous…
Duplex scanning of the mesenteric vessels is performed to determine the presence, location, extent, and severity of stenosis, aneurysm, or other disease of the mesenteric arteries. It includes assessment of the superior mesenteric artery (SMA), the celiac artery (CA), and…
The preferred noninvasive test for evaluating patients with suspected chronic lower extremity ischemia depends upon individual circumstances. Doppler-derived ankle-to-brachial systolic blood pressure indices (ABIs) provide an accurate and reproducible measure of overall blood supply to the foot in patients without…
Historical Background The feasibility of arterial reconstruction was first realized in the early 1900s through pioneering early studies performed by Carrell and Guthrie at the University of Chicago, as well as Bernheim at Johns Hopkins University. The availability of a…
Clinical evaluation of possible mesenteric ischemia begins with an appropriate index of suspicion for the diagnosis followed by a careful history and physical examination. The major categories of mesenteric ischemia include chronic mesenteric ischemia (CMI), acute occlusive mesenteric ischemia (AMI),…
Mesenteric vascular disease can be characterized as acute or chronic, symptomatic or asymptomatic. Severe acute intestinal ischemia results from sudden symptomatic reduction in intestinal blood flow of sufficient magnitude to result potentially in intestinal infarction. Acute ischemia of the small…