Clinical Scenarios in Vascular Surgery

1. Cover - p. Cover 2. Title Page - p. i 3. Copyright - p. iv 4. Dedication - p. v 5. Contributors - p. vii 6. Foreword - p. xix 7. Preface - p. xxi 8. Contents - p. xxiii 9. Section 1: Cerebrovascular - p. 1 10. 1. Workup of Patient With Atherosclerotic Arterial Vascular Disease: Focus on Risk Factor Modification - p. 2 11. Differential Diagnosis - p. 3 12. Workup - p. 3 13. Diagnosis, treatment, and focus on cardiovascular prevention - p. 4 14. 2. Asymptomatic Internal Carotid Artery Stenosis - p. 8 15. Differential Diagnosis - p. 8 16. Treatment Planning - p. 8 17. High-Risk Features Associated with TIA/Stroke - p. 9 18. Characteristics of Patients with High Risk for CEA - p. 10 19. Surgical Approach - p. 10 20. 3. Best Medical Therapy for Asymptomatic Carotid Artery Stenosis - p. 14 21. Differential diagnosis - p. 14 22. Workup - p. 14 23. Diagnosis and treatment - p. 15 24. Medical management - p. 16 25. Risk factor modification - p. 17 26. 4. Symptomatic Carotid Artery Stenosis - p. 20 27. Differential Diagnosis - p. 20 28. Discussion - p. 20 29. Diagnosis and Treatment - p. 21 30. Surgical Approach - p. 22 31. Discussion - p. 23 32. 5. Acute Stroke After CEA - p. 25 33. Differential Diagnosis - p. 25 34. Workup - p. 25 35. Diagnosis and Treatment - p. 26 36. Surgical Approach - p. 26 37. Special Intraoperative Considerations - p. 27 38. Postoperative Management - p. 28 39. 6. Cerebral Hyperperfusion After Carotid Artery Endarterectomy - p. 30 40. Preoperative Planning - p. 30 41. Differential Diagnosis - p. 30 42. Diagnostic Approach - p. 31 43. Treatment - p. 32 44. Discussion - p. 33 45. Special Considerations - p. 33 46. 7. Symptomatic Carotid Endarterectomy—Transfemoral Carotid Artery Stenting - p. 35 47. Differential Diagnosis - p. 35 48. Workup - p. 35 49. Diagnosis and Treatment - p. 36 50. Special Considerations - p. 37 51. Postoperative Management - p. 37 52. 8. Intimal Hyperplasia After Carotid Artery Stenting - p. 41 53. Differential Diagnosis - p. 41 54. Workup - p. 41 55. Discussion - p. 41 56. Diagnosis and Treatment - p. 41 57. Surgical Approach - p. 42 58. Postoperative Management - p. 45 59. 9. TCAR: Transcarotid Artery Revascularization - p. 47 60. Differential Diagnosis - p. 47 61. Workup - p. 47 62. Diagnosis and Treatment - p. 49 63. Surgical Approach - p. 49 64. Special Intraoperative Considerations - p. 51 65. Postoperative Management - p. 52 66. 10. Carotid Artery Aneurysm - p. 53 67. Differential Diagnosis - p. 53 68. WorkUp - p. 54 69. Diagnosis and Treatment - p. 55 70. Surgical Approach - p. 55 71. Special Intraoperative Considerations - p. 56 72. Postoperative Management - p. 57 73. 11. Internal Carotid Artery Fibromuscular Dysplasia - p. 59 74. Epidemiology, Classification, and Pathophysiology of FMD - p. 59 75. Differential Diagnoses - p. 60 76. Workup - p. 61 77. Treatment - p. 64 78. Surgical Approach - p. 64 79. Technical Considerations - p. 65 80. Postoperative Management - p. 65 81. 12. Occluded Internal Carotid Artery With Symptoms - p. 68 82. Differential Diagnosis - p. 68 83. Workup - p. 68 84. Diagnosis and Treatment - p. 68 85. Diagnosis and Management - p. 69 86. Surgical Approach - p. 69 87. Special Intraoperative Considerations - p. 70 88. Postoperative Management - p. 70 89. 13. Recurrent Carotid Stenosis - p. 72 90. Differential Diagnosis - p. 72 91. Workup - p. 72 92. Diagnosis and Treatment - p. 72 93. Surgical Approach - p. 74 94. Transfemoral Carotid Artery Stenting (TF-CAS) - p. 74 95. Transcarotid Artery Revascularization (TCAR) - p. 75 96. Redo Carotid Endarterectomy (Redo Cea) - p. 76 97. Carotid Bypass (Cb) - p. 76 98. Postoperative Management - p. 77 99. 14. Symptomatic External Carotid Artery Disease - p. 79 100. Differential Diagnosis - p. 79 101. Workup - p. 79 102. Diagnosis And Treatment - p. 79 103. Surgical Approach - p. 80 104. Special Intraoperative Considerations - p. 80 105. Postoperative Management - p. 81 106. 15. Carotid Artery Dissection - p. 83 107. Differential Diagnosis - p. 83 108. Workup and Etiology - p. 83 109. Diagnosis and Treatment - p. 86 110. 16. Carotid Body Tumors - p. 90 111. Differential Diagnosis - p. 90 112. Discussion - p. 90 113. Surgical Approach - p. 92 114. Discussion - p. 93 115. Discussion - p. 94 116. 17. Carotid Artery Trauma - p. 95 117. Work-up and Differential Diagnosis - p. 95 118. Diagnosis and Management - p. 96 119. Special Intraoperative Considerations - p. 100 120. Postoperative Management - p. 101 121. Conclusion - p. 101 122. 18. Aortic Arch Atherosclerosis (Open) - p. 103 123. Differential diagnosis - p. 103 124. Workup - p. 103 125. Diagnosis and treatment - p. 104 126. Surgical approach - p. 104 127. Postoperative management - p. 104 128. Section 2: Upper Extremity - p. 107 129. 19. Subclavian Steal Syndrome - p. 108 130. Differential Diagnosis - p. 109 131. Workup - p. 109 132. Diagnosis and Treatment - p. 111 133. Surgical Approach - p. 112 134. Special Intraoperative Considerations - p. 114 135. Postoperative Management - p. 114 136. 20. Aberrant Right Subclavian Artery - p. 117 137. Differential Diagnosis - p. 117 138. Discussion - p. 117 139. Treatment Approach - p. 118 140. 21. Subclavian and Axillary Artery Aneurysms - p. 121 141. Differential Diagnosis - p. 121 142. Workup - p. 121 143. Diagnosis and Treatment - p. 122 144. Surgical Approach - p. 123 145. Special Intraoperative Considerations - p. 123 146. Postoperative Management - p. 124 147. 22. Treatment of Combined Symptomatic Carotid and Subclavian Artery Atherosclerosis (Endovascular) - p. 125 148. Differential Diagnosis - p. 125 149. Workup - p. 125 150. Treatment - p. 126 151. Surgical Approach - p. 126 152. Special Intraoperative Considerations - p. 127 153. Postoperative Management - p. 127 154. 23. Upper Extremity Embolic Disease - p. 129 155. Differential Diagnosis - p. 129 156. Workup - p. 129 157. Diagnosis and Treatment - p. 129 158. Surgical Approach - p. 129 159. Special Intraoperative Considerations - p. 131 160. Postoperative Management - p. 131 161. 24. Thromboangiitis Obliterans - p. 133 162. Differential Diagnosis - p. 133 163. Workup - p. 133 164. Diagnosis and Treatment - p. 134 165. 25. Hypothenar Hammer Syndrome - p. 138 166. Differential Diagnosis - p. 138 167. Workup - p. 138 168. Diagnosis - p. 138 169. Discussion - p. 139 170. Treatment - p. 139 171. Surgical Approach - p. 140 172. 26. Innominate Artery Disease: Open Surgery - p. 143 173. Differential Diagnosis - p. 143 174. Workup - p. 143 175. Diagnosis and Treatment - p. 144 176. Surgical Approach - p. 145 177. Special Intraoperative Considerations - p. 147 178. Postoperative Management - p. 147 179. 27. Endovascular Management of Innominate Artery Disease - p. 150 180. Differential Diagnosis - p. 150 181. Diagnosis And Management - p. 150 182. Diagnosis And Treatment - p. 151 183. Postoperative Management - p. 154 184. 28. Neurogenic Thoracic Outlet Syndrome - p. 157 185. Differential Diagnosis - p. 157 186. Diagnostic Testing - p. 157 187. Diagnosis - p. 158 188. Discussion - p. 158 189. Treatment - p. 158 190. Treatment Continued - p. 159 191. Surgical Approach - p. 159 192. Discussion - p. 160 193. Postoperative Management - p. 161 194. 29. Venous Thoracic Outlet Syndrome - p. 163 195. Differential Diagnosis - p. 163 196. WorkUp and Initial Treatment - p. 163 197. Surgical Approach - p. 163 198. Special Intraoperative Considerations - p. 165 199. Postoperative Management - p. 166 200. 30. Arterial Thoracic Outlet Syndrome - p. 167 201. Differential Diagnosis - p. 167 202. Workup - p. 168 203. Diagnosis and Treatment - p. 168 204. Surgical Approach - p. 169 205. Special Intraoperative Considerations - p. 171 206. Postoperative Management - p. 171 207. 31. Vascular Access Evaluation - p. 173 208. Differential Diagnosis - p. 173 209. Workup - p. 173 210. Diagnosis And Treatment - p. 176 211. Surgical Approach And Special Intraoperative Considerations - p. 176 212. 32. AV—Access Forearm Graft - p. 178 213. Differential Diagnosis - p. 178 214. Workup - p. 178 215. Diagnosis and Treatment - p. 179 216. Surgical Approach - p. 180 217. Special Intraoperative Considerations - p. 181 218. Postoperative Management - p. 181 219. 33. AV Access (Salvage-Endovascular) - p. 183 220. Differential Diagnosis - p. 183 221. Workup - p. 183 222. Diagnosis and Treatment - p. 183 223. Surgical Approach - p. 184 224. Diagnosis and Treatment - p. 185 225. Surgical Approach - p. 185 226. Special Intraoperative Considerations - p. 186 227. Postoperative Management - p. 187 228. 34. Arteriovenous Hemodialysis Access—Beyond Traditional - p. 188 229. Differential Diagnosis - p. 188 230. Workup - p. 188 231. Diagnosis and Treatment - p. 189 232. Surgical Approach - p. 193 233. Special Nontraditional Access Considerations - p. 194 234. Postoperative Management - p. 196 235. Section 3: Aortic Aneurysm Disease - p. 199 236. 35. Open Abdominal Aortic Aneurysm Repair - p. 200 237. Differential Diagnosis - p. 201 238. Workup - p. 201 239. Diagnosis and Treatment - p. 203 240. Surgical Approach - p. 204 241. Special Intraoperative Considerations - p. 205 242. Postoperative Management - p. 205 243. Acknowledgments - p. 206 244. 36. Open Abdominal Aortic Aneurysm Repair for Rupture - p. 208 245. Differential Diagnosis - p. 208 246. Workup - p. 208 247. Diagnosis and Treatment - p. 208 248. Surgical Approach - p. 209 249. Special Intraoperative Considerations - p. 212 250. Postoperative Management - p. 212 251. 37. Endovascular Aneurysm Repair for Ruptured Aortic Aneurysm - p. 214 252. Differential Diagnosis - p. 214 253. Workup - p. 214 254. Endovascular Approach - p. 214 255. Special Intraoperative Considerations - p. 216 256. Postoperative Management - p. 217 257. 38. Elective Endovascular Repair of Abdominal Aortic Aneurysm - p. 219 258. Differential Diagnosis - p. 219 259. Workup - p. 219 260. Diagnosis and Treatment - p. 220 261. Special Intraoperative Considerations - p. 221 262. Postoperative Management - p. 222 263. Angiogram - p. 222 264. Diagnosis and Treatment (continued) - p. 222 265. 39. EVAR With Endoleak - p. 224 266. Differential Diagnosis - p. 224 267. Workup - p. 224 268. Diagnosis and Treatment - p. 224 269. Medical Management - p. 225 270. Endovascular Therapy - p. 225 271. Surgical Graft Explant - p. 226 272. Special Intraoperative Considerations - p. 227 273. Postoperative Care - p. 227 274. 40. Inflammatory Abdominal Aortic Aneurysm - p. 229 275. Differential Diagnosis - p. 229 276. Workup - p. 229 277. Diagnosis and Treatment - p. 230 278. Surgical Approach - p. 230 279. Special Intraoperative Considerations - p. 231 280. Postoperative Management - p. 231 281. Acknowledgments - p. 232 282. 41. Acute Type B Dissection Without Malperfusion - p. 234 283. Differential Diagnosis - p. 234 284. Workup - p. 234 285. Diagnosis and Treatment - p. 235 286. Discussion - p. 237 287. Nonoperative Management - p. 237 288. 42. Pararenal Abdominal Aortic Aneurysm: Open Repair - p. 239 289. Differential Diagnosis - p. 239 290. Diagnosis and Treatment - p. 239 291. Workup - p. 240 292. Surgical Approach - p. 241 293. Special Intraoperative Considerations - p. 244 294. Postoperative Management - p. 244 295. 43. Mycotic Abdominal Aortic Aneurysm - p. 246 296. Differential Diagnosis - p. 246 297. Workup - p. 246 298. Discussion - p. 246 299. Diagnosis and Treatment - p. 247 300. Options for Surgical Repair - p. 247 301. Postoperative Management - p. 248 302. 44. Aortocaval Fistula - p. 250 303. Differential Diagnosis - p. 250 304. Workup - p. 250 305. Diagnosis And Treatment - p. 251 306. Surgical Approach - p. 252 307. Special Intraoperative Considerations - p. 252 308. Postoperative Management - p. 253 309. 45. Primary Aortoenteric Fistulae - p. 254 310. Differential Diagnosis - p. 254 311. Workup - p. 254 312. Diagnosis and Treatment - p. 254 313. Surgical Approach - p. 255 314. Special Intraoperative Considerations - p. 259 315. Postoperative Management - p. 259 316. 46. Acute Limb Ischemia After Open Abdominal Aortic Aneurysm Repair - p. 261 317. Differential Diagnosis - p. 261 318. Workup - p. 261 319. Diagnosis and Treatment - p. 261 320. Surgical Approach - p. 262 321. Special Intraoperative Considerations - p. 263 322. Postoperative Management - p. 263 323. Acknowledgment - p. 263 324. 47. Intestinal Ischemia After Abdominal Aortic Aneurysm Repair - p. 265 325. Differential Diagnosis - p. 265 326. Workup - p. 265 327. Diagnosis and Treatment - p. 265 328. Differential Diagnosis - p. 266 329. Discussion - p. 266 330. Diagnosis and Treatment - p. 266 331. 48. Small Abdominal Aortic Aneurysm - p. 269 332. Differential Diagnosis - p. 269 333. Workup - p. 269 334. Treatment - p. 270 335. Recommendation - p. 270 336. 49. Isolated Iliac Artery Aneurysm - p. 273 337. Differential Diagnosis - p. 273 338. Workup - p. 273 339. Diagnosis and Treatment - p. 273 340. Surgical Approach for Endovascular Iliac Aneurysm Repair - p. 274 341. Surgical Approach for Open Iliac Aneurysm Repair - p. 275 342. Postoperative Management - p. 276 343. 50. Diagnosing and Managing Internal Iliac Artery Aneurysms - p. 278 344. Differential Diagnosis - p. 278 345. Workup - p. 278 346. Diagnosis And Treatment - p. 279 347. Endovascular Approach - p. 280 348. Surgical Approach - p. 283 349. 51. Thoracoabdominal Aortic Aneurysm - p. 287 350. Differential Diagnosis - p. 287 351. Workup - p. 287 352. Etiology - p. 287 353. Diagnosis and Treatment - p. 287 354. Surgical Approach - p. 288 355. Potential Pitfalls and Intraoperative Considerations - p. 290 356. Postoperative Management - p. 290 357. 52. Hybrid Repair of Thoracoabdominal Aortic Aneurysm - p. 292 358. Differential Diagnosis - p. 292 359. Workup - p. 292 360. Diagnosis and Treatment - p. 292 361. Surgical Approach - p. 294 362. Treatment - p. 295 363. Postoperative Management - p. 296 364. 53. Endovascular Thoracoabdominal Aortic Aneurysm Repair - p. 298 365. Thoracoabdominal Aneurysms - p. 298 366. Stage I—iliac Conduit Creation And Tevar - p. 300 367. Stage II—Tambe - p. 301 368. 54. Isolated Thoracic Aortic Aneurysm (Open) - p. 305 369. Differential Diagnosis - p. 305 370. Workup - p. 305 371. Diagnosis and Treatment - p. 306 372. Surgical Approach - p. 306 373. Special Intraoperative Considerations - p. 307 374. Postoperative Management - p. 308 375. 55. Isolated Thoracic Aortic Aneurysm: TEVAR - p. 310 376. Differential Diagnosis - p. 310 377. Workup - p. 310 378. Diagnosis and Treatment - p. 310 379. Evolution of TEVAR - p. 311 380. Surgical Approach - p. 312 381. Postoperative Management - p. 314 382. 56. TEVAR for Type B Dissection With Malperfusion - p. 316 383. Differential Diagnosis - p. 316 384. Workup - p. 316 385. Discussion - p. 316 386. Diagnosis and Treatment - p. 317 387. Surgical Approach for Endovascular Repair of Type B Aortic Dissection - p. 318 388. Postoperative Management: Surveillance Following TEVAR - p. 319 389. 57. Management of Left Subclavian Artery With TEVAR - p. 322 390. Differential Diagnosis - p. 322 391. Workup - p. 323 392. Diagnosis and Treatment - p. 323 393. Surgical Approach - p. 324 394. Special Intraoperative Considerations - p. 325 395. Postoperative Management - p. 328 396. 58. Aortic Arch Debranching - p. 330 397. Differential Diagnosis - p. 330 398. Workup - p. 330 399. Discussion - p. 331 400. Diagnosis and Treatment - p. 331 401. Surgical Approach for Thoracic Aortic Arch Debranching - p. 331 402. Surveillance - p. 332 403. 59. Type A Aortic Dissection After TEVAR - p. 335 404. Differential Diagnosis - p. 335 405. Workup - p. 335 406. Diagnosis and Treatment - p. 336 407. Special Intraoperative Considerations - p. 340 408. Postoperative Management - p. 340 409. Acknowledgments - p. 341 410. 60. EVAR Removal for Endoleak - p. 342 411. Differential Diagnosis - p. 342 412. Workup - p. 342 413. Diagnosis and treatment - p. 343 414. Surgical approach - p. 344 415. Special Intraoperative Considerations - p. 345 416. Postoperative Management - p. 345 417. 61. Complex Endoleak Endovascular Management - p. 347 418. Differential Diagnosis - p. 347 419. Workup - p. 347 420. Diagnosis And Treatment - p. 347 421. Surgical Approach - p. 349 422. Special Intraoperative Considerations - p. 349 423. Postoperative Management - p. 350 424. 62. Pediatric Midaortic Syndrome - p. 352 425. Differential Diagnosis - p. 352 426. Workup - p. 352 427. Diagnosis and Treatment - p. 353 428. Surgical Approach - p. 354 429. Special Intraoperative Considerations - p. 355 430. Postoperative Management - p. 355 431. 63. Aortoiliac Occlusive Disease - p. 357 432. Differential Diagnosis - p. 357 433. Diagnostic Tests And Result - p. 357 434. Diagnosis And Treatment - p. 358 435. Special Intraoperative Considerations - p. 360 436. Postoperative Management - p. 361 437. 64. Total Infrarenal Aortic Occlusion - p. 363 438. Differential Diagnosis - p. 363 439. Workup - p. 363 440. Diagnosis and Treatment - p. 364 441. Surgical Approach to Aortofemoral Bypass - p. 365 442. Special Intraoperative Considerations for Aortofemoral Bypass - p. 367 443. Surgical Approach to Axillobifemoral Bypass - p. 368 444. Special Intraoperative Considerations for Axillobifemoral Bypass - p. 369 445. Postoperative Management - p. 369 446. 65. Acute Aortic Occlusion in a Hostile Abdomen - p. 371 447. Differential Diagnosis - p. 371 448. Workup - p. 371 449. Diagnosis and Recommendation - p. 372 450. Surgical Approach - p. 372 451. Postoperative Management - p. 374 452. 66. Aortoiliac Occlusive Disease (Open Surgery) - p. 375 453. Differential Diagnosis - p. 375 454. Workup - p. 375 455. Medical Therapy - p. 376 456. Surgical Approach - p. 377 457. Special Considerations - p. 379 458. Postoperative Management - p. 379 459. 67. AIOD/PVOD-Critical Limb Ischemia - p. 380 460. Differential Diagnosis - p. 380 461. Workup - p. 380 462. Diagnosis and Treatment - p. 380 463. Surgical Approach - p. 381 464. Special Intraoperative Considerations - p. 381 465. Postoperative Management - p. 382 466. 68. Infected Aortic Graft - p. 383 467. Differential Diagnosis - p. 383 468. Workup - p. 383 469. Diagnosis and Treatment - p. 384 470. Surgical Approach - p. 385 471. Postoperative Management - p. 388 472. 69. Aortic Graft Infection With Aortoenteric Fistulae - p. 390 473. Differential Diagnosis - p. 390 474. Workup - p. 390 475. Discussion - p. 391 476. Diagnosis and Treatment - p. 391 477. Initial Management of AEF - p. 391 478. Initial Surgical Approach - p. 391 479. Definitive Surgical Approach - p. 392 480. Extra-anatomic Revascularization - p. 393 481. In Situ Aortic Reconstruction - p. 393 482. Exposure of the Aorta and Duodenum - p. 393 483. Postoperative Management - p. 394 484. 70. Infected Aortofemoral Bypass Limb With Pseudoaneurysm (With Local Flap Coverage) - p. 396 485. Differential Diagnosis - p. 396 486. Workup - p. 396 487. Diagnosis and Treatment - p. 397 488. Surgical Approach - p. 398 489. Special Intraoperative Considerations - p. 399 490. Postoperative Management - p. 399 491. Section 4: Mesenteric and Renal Disease - p. 401 492. 71. Renal Artery Fibromuscular Dysplasia - p. 402 493. Differential Diagnosis - p. 403 494. Epidemiology and Social Considerations - p. 403 495. Workup - p. 404 496. Diagnosis and Treatment - p. 405 497. Potential Pitfalls - p. 406 498. 72. Renal Artery Stenosis: Surgery - p. 408 499. Differential Diagnosis - p. 408 500. Workup - p. 408 501. Discussion - p. 408 502. Diagnosis and Treatment - p. 409 503. Surgical Approach - p. 409 504. Key Technical Steps and Potential Pitfalls - p. 410 505. Postoperative Management - p. 411 506. 73. Renal Artery Stenosis: Endovascular Therapy - p. 413 507. Differential Diagnosis - p. 413 508. Diagnostic Workup - p. 414 509. Treatment - p. 416 510. Endovascular Approach - p. 417 511. Complications - p. 419 512. Long-Term Management - p. 420 513. 74. Concomitant Renal and Aortic Pathology - p. 421 514. Differential Diagnosis - p. 421 515. Workup - p. 421 516. Diagnosis And Treatment - p. 422 517. Surgical Approach - p. 423 518. Special Intraoperative Considerations - p. 424 519. Postoperative Management - p. 424 520. 75. Renal Artery Aneurysm - p. 427 521. Workup - p. 427 522. Diagnosis and Treatment - p. 427 523. Surgical Approach - p. 427 524. Postoperative Management - p. 429 525. 76. Acute Mesenteric Ischemia - p. 431 526. Differential Diagnosis - p. 431 527. Workup - p. 431 528. Discussion - p. 431 529. Diagnosis and Treatment - p. 432 530. Surgical Approach - p. 433 531. Special Intraoperative Considerations - p. 435 532. Postoperative Management - p. 436 533. 77. Chronic Mesenteric Ischemia: Open Surgical Repair - p. 437 534. Differential Diagnosis - p. 437 535. Workup - p. 437 536. Diagnosis and Treatment - p. 437 537. Surgical Approach - p. 439 538. Special Intraoperative Considerations - p. 441 539. Postoperative Management - p. 441 540. 78. Endovascular (Including Hybrid) Approach to Chronic Mesenteric Ischemia - p. 444 541. Differential Diagnosis - p. 444 542. Workup - p. 444 543. Diagnosis and Treatment - p. 445 544. Surgical Approach - p. 446 545. Special Intraoperative Considerations - p. 447 546. Postoperative Management - p. 447 547. 79. Nonocclusive Mesenteric Ischemia - p. 450 548. Differential Diagnosis - p. 450 549. Workup - p. 450 550. Diagnosis and Treatment - p. 450 551. Surgical Approach - p. 451 552. Special Intraoperative Considerations - p. 452 553. Postoperative Management - p. 453 554. 80. Mesenteric Venous Occlusive Disease - p. 454 555. Differential Diagnosis - p. 454 556. Workup - p. 455 557. Diagnosis and Treatment - p. 455 558. Nonoperative Management - p. 455 559. Surgical Approach - p. 455 560. 81. Splenic Artery Aneurysm - p. 457 561. Differential Diagnosis - p. 457 562. Workup - p. 457 563. Diagnosis and Treatment - p. 459 564. Surgical Approach - p. 459 565. Special Intraoperative Considerations - p. 461 566. Postoperative Management - p. 461 567. 82. Superior Mesenteric Artery Aneurysm - p. 464 568. Differential Diagnosis - p. 464 569. Clinical Presentation of SMA Aneurysms - p. 464 570. Workup - p. 465 571. Diagnosis and Treatment - p. 465 572. Surgical Approach - p. 466 573. Special Intraoperative Considerations - p. 467 574. Postoperative Management - p. 467 575. 83. Celiac Occlusion With Pancreaticoduodenal Aneurysm - p. 470 576. Differential Diagnosis - p. 470 577. Workup - p. 470 578. Diagnosis and Treatment - p. 470 579. Surgical Approach - p. 470 580. Special Intraoperative Considerations - p. 471 581. Postoperative Management - p. 472 582. 84. Celiac Artery Aneurysm - p. 474 583. Epidemiology and Etiology - p. 474 584. Differential Diagnosis - p. 474 585. Workup - p. 474 586. Management - p. 474 587. Postoperative Management - p. 476 588. 85. Hepatic Artery Aneurysm - p. 478 589. Etiology, Incidence, and Clinical Presentation - p. 478 590. Assessment and Evaluation - p. 479 591. Treatment - p. 479 592. Postoperative Management - p. 480 593. Section 5: Lower Extremity Disease - p. 483 594. 86. Medical Management of Peripheral Artery Disease - p. 484 595. Differential Diagnosis - p. 485 596. Clinical Evaluation - p. 485 597. Physiologic Testing - p. 486 598. Anatomic Testing - p. 488 599. Medical Management Of Patients With Pad - p. 490 600. Indications For Revascularization - p. 493 601. 87. Peripheral Arterial Disease With Intermittent Claudication - p. 495 602. Differential Diagnosis - p. 495 603. Workup - p. 495 604. Diagnosis and Initial Treatment - p. 496 605. Decision to Intervene - p. 496 606. Intraoperative Technique and Considerations - p. 497 607. Postoperative Management - p. 498 608. 88. Peripheral Vascular Occlusive Disease (PVOD)—Femoropopliteal Bypass - p. 501 609. Differential Diagnosis - p. 501 610. Workup - p. 501 611. Diagnosis and Treatment - p. 502 612. Surgical Approach - p. 506 613. Special Intraoperative Considerations - p. 509 614. Postoperative Management - p. 510 615. 89. Rest Pain and Ischemic Ulcers (Open Approach) - p. 511 616. Differential Diagnosis - p. 511 617. Initial Management - p. 514 618. Discussion - p. 516 619. 90. Peripheral Vascular Occlusive Disease—Rest Pain/Ulcers - p. 518 620. Differential Diagnosis - p. 518 621. Background and Workup - p. 518 622. Diagnosis and Treatment - p. 519 623. Acknowledgments - p. 521 624. 91. PVOD (Subintimal Recanalization—SAFARI) - p. 522 625. Differential Diagnosis - p. 522 626. Workup - p. 522 627. Diagnosis and Treatment - p. 522 628. Endovascular Minimally Invasive Surgical Procedure - p. 525 629. Special Intraoperative Considerations - p. 527 630. Postoperative Management - p. 528 631. 92. Failing Lower Extremity Bypass - p. 530 632. Differential Diagnosis - p. 530 633. Workup - p. 530 634. Diagnosis and Treatment - p. 530 635. Surgical Approach - p. 531 636. 93. Acutely Thrombosed Bypass Graft (Including Lytics) - p. 534 637. Differential diagnosis - p. 534 638. Workup - p. 534 639. Diagnosis and treatment - p. 534 640. Surgical approach - p. 535 641. Special intraoperative considerations - p. 536 642. 94. Acute Limb Ischemia - p. 538 643. Differential Diagnosis - p. 538 644. Workup - p. 538 645. Diagnosis and Treatment - p. 540 646. Surgical Approach - p. 541 647. Special Intraoperative Considerations - p. 543 648. Postoperative Management - p. 543 649. 95. Paradoxical Embolism - p. 545 650. Differential diagnosis - p. 545 651. Initial workup - p. 545 652. Surgical approach - p. 546 653. Discussion - p. 547 654. 96. Diabetic Foot Ulcer - p. 550 655. Differential Diagnosis - p. 550 656. Workup - p. 551 657. Diagnosis and Treatment - p. 551 658. Ulcer Management - p. 552 659. Postoperative Management - p. 553 660. 97. Chronic Gangrenous Foot, Nonvascularizable (Primary Amputation) - p. 555 661. Differential diagnosis - p. 555 662. Workup - p. 555 663. Discussion - p. 555 664. Diagnosis and treatment - p. 556 665. Postoperative issues and rehabilitation potential - p. 557 666. 98. Wet Gangrene - p. 560 667. Differential Diagnosis - p. 560 668. Diagnosis - p. 561 669. Approach to Management - p. 562 670. Discussion - p. 562 671. 99. Transmetatarsal Amputation - p. 565 672. Differential Diagnosis - p. 565 673. Workup - p. 565 674. Diagnosis and Treatment - p. 566 675. Surgical Approach - p. 566 676. Special Intraoperative Considerations - p. 567 677. Postoperative Management - p. 567 678. 100. Above-Knee Amputation—No Profunda Inflow - p. 569 679. Differential Diagnosis - p. 569 680. Workup - p. 569 681. Diagnosis and Treatment - p. 570 682. Surgical Approach - p. 570 683. Discussion - p. 571 684. Postoperative Management - p. 572 685. 101. Popliteal Entrapment in Athletes - p. 574 686. Differential Diagnosis - p. 574 687. Workup - p. 574 688. Diagnosis and Treatment - p. 574 689. Surgical Approach - p. 577 690. Postoperative Management - p. 581 691. 102. Persistent Sciatic Artery - p. 582 692. Differential Diagnosis - p. 582 693. Workup - p. 582 694. Diagnostic Tests and Results - p. 582 695. Diagnosis and Treatment - p. 582 696. Special Intraoperative Considerations - p. 584 697. Postoperative Management - p. 584 698. 103. Popliteal Artery Aneurysm—Open Repair - p. 585 699. Differential Diagnosis - p. 585 700. Discussion - p. 585 701. Imaging - p. 585 702. Recommendation - p. 586 703. Surgical Approach - p. 586 704. Special Operative Considerations - p. 587 705. Postoperative Management - p. 587 706. 104. Endovascular Repair of a Popliteal Artery Aneurysm - p. 589 707. Differential Diagnosis - p. 589 708. Workup - p. 589 709. Diagnosis and Treatment - p. 589 710. Surgical Approach - p. 590 711. Special Intraoperative Considerations - p. 591 712. Postoperative Management - p. 592 713. Section 6: Venous/Lymphatic - p. 595 714. 105. Unilateral Leg Swelling Secondary to Venous Insufficiency - p. 596 715. Differential Diagnosis - p. 597 716. Workup - p. 597 717. Diagnosis and Treatment - p. 598 718. Surgical Approach: Endovenous Ablation - p. 599 719. Postoperative Management - p. 601 720. 106. Varicose Veins - p. 603 721. Differential Diagnosis - p. 603 722. Workup - p. 603 723. Diagnosis and Treatment - p. 604 724. Surgical Approach - p. 606 725. Special Intraoperative Considerations - p. 606 726. Postoperative Management - p. 607 727. 107. Acute Iliofemoral Deep Vein Thrombosis - p. 609 728. Differential Diagnosis - p. 609 729. Workup - p. 609 730. Discussion - p. 609 731. Diagnosis and Treatment - p. 609 732. Postoperative Management - p. 611 733. 108. Endovascular Treatment of Acute Iliofemoral DVT - p. 613 734. Differential diagnosis - p. 613 735. Workup - p. 614 736. Diagnosis and treatment - p. 614 737. Surgical approach - p. 617 738. Special intraoperative considerations - p. 618 739. Postoperative management - p. 619 740. 109. Calf Vein Thrombosis (or Tibial DVT) - p. 621 741. Differential Diagnosis - p. 621 742. Workup - p. 622 743. Treatment - p. 623 744. Special Considerations - p. 624 745. 110. Superficial Venous Thrombosis - p. 627 746. Differential Diagnosis - p. 627 747. Workup - p. 627 748. Treatment - p. 628 749. 111. Chronic Venous Insufficiency—Postthrombotic Syndrome - p. 629 750. Differential Diagnosis - p. 629 751. Workup - p. 629 752. Diagnosis and Treatment - p. 631 753. Surgical/Endovascular Approach - p. 632 754. Special Intraoperative Considerations - p. 632 755. Postoperative Management - p. 636 756. 112. Incompetent Venous Perforators - p. 640 757. Differential diagnosis - p. 640 758. Workup - p. 640 759. Diagnosis and treatment - p. 641 760. Incompetent perforator vein treatment guidelines - p. 642 761. Surgical approach - p. 643 762. Special intraoperative considerations - p. 645 763. Postoperative management - p. 646 764. 113. IVC Filter Placement - p. 648 765. Differential Diagnosis - p. 648 766. Workup - p. 648 767. Diagnosis and Treatment - p. 648 768. Surgical Approach - p. 649 769. Special Intraoperative Considerations - p. 649 770. Postoperative Management - p. 650 771. 114. Lymphedema - p. 652 772. Differential Diagnosis - p. 652 773. Workup - p. 652 774. Diagnosis - p. 653 775. Lymphedema - p. 653 776. Treatment - p. 655 777. Surgical Approach - p. 657 778. Section 7: Trauma - p. 661 779. 115. Brachial Artery Injury Following Humerus Fracture - p. 662 780. Differential diagnosis - p. 663 781. Workup - p. 664 782. Treatment decision - p. 665 783. Surgical approach - p. 665 784. Special considerations for operative repair - p. 666 785. Postoperative care and management - p. 666 786. 116. Endovascular Repair of Acute Aortic Transection - p. 669 787. Differential Diagnosis and Workup - p. 669 788. Discussion - p. 669 789. Case Planning - p. 670 790. Surgical Approach - p. 670 791. Postoperative Management - p. 671 792. 117. Intra-abdominal Vascular Trauma - p. 674 793. Differential Diagnosis - p. 674 794. Abdominal Vascular Injury - p. 674 795. ATLS Assessment - p. 675 796. Resuscitative Thoracotomy - p. 675 797. Balloon-Assisted Aortic Occlusion - p. 676 798. Hybrid OR - p. 676 799. Surgical Aortic Cross-Clamping - p. 677 800. Repair of Aortic Injuries - p. 678 801. Endovascular Approach to Aortic Injuries - p. 678 802. Venous injury - p. 679 803. Postoperative Management - p. 680 804. 118. Removal of IVC Filter Adherent to IVC Wall - p. 682 805. Workup - p. 682 806. Diagnosis and Treatment - p. 682 807. Surgical Approach - p. 683 808. Special Intraoperative Considerations - p. 686 809. Postoperative Management - p. 686 810. 119. Retroperitoneal Hematoma After Angiogram - p. 688 811. Differential Diagnosis - p. 688 812. Background And Workup - p. 688 813. Treatment - p. 689 814. 120. Traumatic Peripheral Arterial Venous Fistulas - p. 691 815. Differential Diagnosis - p. 691 816. Workup - p. 691 817. Diagnosis and Treatment - p. 692 818. Surgical Approach - p. 694 819. Special Intraoperative Considerations - p. 696 820. Postoperative Management - p. 696 821. 121. Posterior Knee Dislocation - p. 698 822. Differential Diagnosis - p. 698 823. Workup - p. 698 824. Diagnosis and Treatment - p. 699 825. Surgical Approach - p. 700 826. Special Intraoperative Considerations - p. 701 827. Postoperative Management - p. 701 828. 122. Penetrating Injury to the Lower Extremity - p. 703 829. Diagnosis - p. 703 830. Workup - p. 703 831. Treatment plan - p. 704 832. Surgical approach - p. 705 833. Special considerations - p. 707 834. Postoperative care and management - p. 708 835. 123. Compartment Syndrome - p. 710 836. Differential Diagnosis - p. 710 837. Workup - p. 711 838. Diagnosis and Treatment - p. 711 839. Surgical Approach - p. 712 840. Special Intraoperative Considerations: Measurement of Compartment Pressures - p. 713 841. Postoperative Management - p. 713 842. 124. Intravenous Drug Injection Into Femoral Artery - p. 715 843. Differential Diagnosis - p. 715 844. Workup - p. 715 845. Diagnosis and Treatment - p. 715 846. Special Intraoperative Consideration - p. 717 847. Postoperative Management - p. 717 848. Index - p. 719