Introduction Fibromuscular dysplasia (FMD) is an idiopathic, nonatheromatous, noninflammatory, proliferative disease of the musculature of arterial walls, first described in 1938 as a rare cause of renovascular hypertension with a “string-of-beads” appearance. The pathogenesis is still unknown, but up to…
Introduction Brachiocephalic arterial disease presents a complex surgical challenge due to the frequent involvement of other arch vessels, choice of inflow and access, as well as the inherent risks of complex surgery, embolization, and cerebral ischemia. This process may affect…
Management of infrainguinal arterial occlusive disease continues to move away from open surgery and toward percutaneous procedures, and the number of percutaneous options is growing rapidly. This chapter focuses on standard techniques for arterial access, diagnostic imaging, lesion crossing, and…
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 poor early results and marginal long-term durability of percutaneous transluminal angioplasty in the femoropopliteal segment has prompted growing interest in covered stents in the treatment of occlusive disease. The potential advantages of a minimally invasive internal bypass are significant.…
With the expanded application of the radiation therapy of malignancies has come the increased recognition of radiation-induced arteritis. Because ensuing vascular complications often develop insidiously, presenting as chronic ischemic syndromes, the role of earlier radiation is often overlooked. Radiation-associated arteriopathy…
Treatment of carotid fibromuscular dysplasia (FMD) in the past has been open graduated rigid carotid dilatation for symptomatic stenoses or segmental resection with saphenous vein interposition for aneurysms. The results of contemporary open surgical reports have shown the risk of…
Carotid angioplasty and stenting with cerebral protection has emerged as a minimally invasive alternative to endarterectomy and is a treatment option for carotid arteriosclerotic disease. Carotid angioplasty and stenting comprises the following steps: (1) preprocedural evaluation, (2) femoral access, (3)…
Historical Background Balloon angioplasty of the carotid artery was first described in the late 1970s as an intervention for carotid artery stenosis. It was proposed as an alternative to carotid endarterectomy (CEA) in medically high-risk patients and those with hostile…