Emergency Vascular and Endovascular Surgical Practice

Emergency vascular and endovascular practice comprises almost half the workload undertaken by the majority of vascular surgeons. Most vascular emergencies are characterised by the sudden occlusion, rupture or injury of a blood vessel placing organ, limb and life at risk. An attitude of urgency and of good judgement, both in diagnostic assessment and the application of evidence-based vascular and endovascular techniques, is crucial to the achievement of optimal outcomes.

This book is structured with the emphasis on clinical presentation, the objective being to provide accessible and highly practical advice to the vascular surgeon faced with a particular emergency. Distinguished vascular surgeons, vascular radiologists and other specialists around the world have enriched this book with authoritative contributions reflecting their experience and expertise. For ease of reference the text is divided into nine sections, leading with introductory chapters on general considerations such as pathophysiology, preoperative diagnosis, risk assessment and medico-legal aspects of vascular emergencies. That is followed by a series of clinical sections covering acute cerebrovascular syndromes, acute limb ischaemic states, the acutely swollen limb, thoraco-abdominal catastrophes, acute complications of endovascular aortic repair, regional vascular trauma and iatrogenic injuries. It concludes with a section on miscellaneous, but important, acute vascular challenges. Throughout the book, wherever appropriate, modern endovascular techniques are given full coverage.

International in its approach, this book will fast become established as the text devoted to the surgical management of vascular and endovascular emergencies. It is essential reading for vascular surgeons and radiologists and a useful reference source for general and trauma surgeons, angiologists and emergency physicians.

# Evidence-based approach to treatment
# Clear practical advice on the management of emergencies
# Authoritative, internationally recognized contributors

Table of contents:

SECTION I. GENERAL CONSIDERATIONS
~ Emergency vascular services in the United Kingdom ~ Emergency vascular services in Denmark ~ Emergency vascular services in the USA ~ Pathophysiology of acute vascular insufficiency ~ Intestinal ischaemia in aortic surgery ~ Ischaemia reperfusion injury, SIRS and MODS ~ Pathophysiology of stroke ~ Assessing the risk in vascular emergencies ~ Perioperative care in emergency vascular practice ~ Emergency vascular access ~ Imaging for vascular emergencies ~ Outcomes of emergency vascular procedures: a view from the British Isles ~ Outcomes of emergency vascular procedures in Scandinavia ~ Medico-legal aspects of emergency vascular care in the United Kingdom
SECTION II. ACUTE CEREBROVASCULAR SYNDROMES
~ The developing stroke ~ Role of the vascular surgeon in managing stroke ~ Surgical experience in evolving stroke arising from the carotid ~ Post-carotid endarterectomy stroke
SECTION III. ACUTE LOWER LIMB ISCHEMIC STATES
~ Acute limb ischaemia: surgical options ~ Acute limb ischaemia: endovascular options ~ Graft maintenance and graft failure ~ Acute ischaemia secondary to occult prosthetic graft infection ~ The acute diabetic foot
SECTION IV. THE ACUTELY SWOLLEN LIMB
~ Deep vein thrombosis ~ Pulmonary embolism ~ Upper limb vein thrombosis
SECTION V. ABDOMINAL CATASTROPHES
~ The emergency aortic aneurysm ~ Stenting in acute aortic dissection ~ Prosthetic aortic graft infection ~ The acutely compromised renal artery ~ Renal artery aneurysms ~ Visceral artery aneurysms ~ Mesenteric ischaemia
SECTION VI. ACUTE COMPLICATIONS OF ENDOVASCULAR AORTIC REPAIR (EVAR)
~ Endoleak complicating EVAR ~ Graft breakdown and migration complicating EVAR ~ Atheroembolism complicating EVAR
SECTION VII. REGIONAL VASCULAR TRAUMA
~ Vascular injuries of the limbs ~ Vascular injuries of the chest ~ Vascular injuries of the neck ~ Abdominal vascular injuries ~ Limb replantation
SECTION VIII. IATROGENIC INJURIES
~ Injuries of arterial catheterisation ~ Injuries of peripheral endovascular procedures ~ Specialty-related iatrogenic vascular injuries
SECTION IX. SPECIAL ACUTE VASCULAR PROBLEMS
~ Acute upper limb ischaemic states ~ Emergency aspects of Buerger’s Disease ~ Acute limb vascular inflammatory conditions ~ Vascular emergencies caused by substance abuse ~ HIV/AIDS-related vascular emergencies ~ Portal hypertension and variceal bleeding ~ Cold injury

About the Author:

Aires A.B. Barros D’Sa OBE MD FRCS FRSCEd, Honorary Professor of Vascular Surgery, The Queen’s University of Belfast and Consultant Vascular Surgeon, Royal Victoria Hospital, Belfast, UK.
Anthony D.B. Chant BA BSc MS FRCS, Medical Director, British Vascular Foundation, UK and Wessex Nuffield Hospital, Hants