Atlas of Vascular Anatomy: An Angiographic Approach

921 Pages·2006·65.49 MB·English

by  Renan Uflacker MD

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S E CO N D E D I T I O N
AT L A S
Vascular Anatomy
of
AN ANGIOGRAPHIC APPROACH
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Illustrations by
José Falcetti
Director, Center for Medical Arts, Hospital das Clinicas
Faculdade de Medicina da Universidade de São Paulo
Functional Neurosurgery
São Paulo, SP, Brazil
With Contributions by
Carlos Jader Feldman, M.D.
Chief, Department of Radiology
Hospital Hernesto Dornelles
Porto Alegre, RS, Brazil
—Vascular Anatomy of the Lower Genital Tract
Ronie L. Piske, M.D.
Interventional Neuroradiologist, Med–Imagem
Hospital Beneficência
Poruguesa, São Paulo, SP, Brazil
—Arteries of the Head and Neck
—Veins of the Head and Neck
Francisco J.B. Sampaio, M.D., Ph.D.
Professor of Anatomy and Urology
Head, Department of Anatomy
State University of Rio de Janeiro
Brazil
—Kidney Arterial Vascularization
—Kidney Venous Drainage
—Lymphatic Drainage of the Kidney
—Periprostatic Venous Plexus
J. Bayne Selby, M.D.
Professor of Radiology
Medical University of South Carolina
Charleston, SC, USA
—The Heart and Coronary Arteries
—The Heart Venous Circulation
—Pulmonary Arterial Circulation
—Pulmonary Venous Circulation
Luiz Maria Yordi, M.D.
Chief, Department of Hemodynamic and Cardiovascular Radiology
Hospital São Francisco
Porto Alegre, RS, Brazil
—The Heart and Coronary Arteries
—The Heart Venous Circulation
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S E CO N D E D I T I O N
AT L A S
Vascular Anatomy
of
AN ANGIOGRAPHIC APPROACH
Renan Uflacker, M.D.
Professor of Radiology
Interventional Radiology
Medical University of South Carolina
Charleston, South Carolina
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1stEdition, ©1997 Williams & Wilkins
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Library of Congress Cataloging-in-Publication Data
Uflacker, Renan.
Atlas of vascular anatomy : an angiographic approach / Renan Uflacker ; with
contributions by Bayne Selby. — 2nd ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-0-7817-6081-2
ISBN 0-7817-6081-X (case : alk. paper)
1. Blood-vessels—Atlases. 2. Angiography—Atlases. I. Selby, Bayne. II. Title.
[DNLM: 1. Blood Vessels—anatomy & histology—Atlases. 2. Angiography—Atlases.
3. Diagnostic Imaging—Atlases. WG 17 A88468 2007] QM191.A87
2007 611'.13—dc22 2006008945
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“Variability is the law of life,”
Sir William Osler
To Helena, Andre and Alice
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Preface to Second Edition
Imaging techniques have been very important both to benefit for the reader, and with it we welcome a new con-
demonstrate and to study the human vascular anatomy, tributor to the book.
helping therefore in the understanding and in the manage- As I mentioned in the first edition, the idea of produc-
ment of vascular diseases. As the cardiovascular diseases ing the Atlas of Vascular Anatomywas triggered by the need
have increased in prevalence among the population, the to have available a comprehensive book of vascular anato-
need for the knowledge of the anatomy has become para- my with high-quality illustrations and with as much as pos-
mount to the practice of medicine. The use of percutaneous sible correlation with angiograms and new imaging modali-
catheter angiography has been the gold standard for the ties. The Atlasis intended to respond to the many anatom-
demonstration of in vivo vascular anatomy and vascular ic challenges encountered in the daily practice of cardiovas-
pathology. However, in the last several years an increased cular medicine, interventional radiology, and vascular
number of new imaging modalities—including Doppler surgery. Our basic aim is to provide photographs of real clin-
ultrasound, angio computed tomography, and magnetic res- ical angiographic cases, presented with fine art color illus-
onance angiography—became available and to a great trations for the study of the details and spatial disposition of
extent have replaced invasive angiography, except when an anatomic vascular structures, as well as some of the varia-
intervention is planned. Therefore, a combination of imag- tions encountered in the human species.
ing modalities is more often than not utilized in clinical The overall format of the book has been redesigned to
practice for cardiovascular evaluation of patients. facilitate even further the usage of the anatomical informa-
The knowledge of the vascular anatomy is essential for tion, minimizing page turning by the assignment of individ-
the performance, understanding, and interpretation of diag- ual text topics to opposing pages, followed by a sequence of
nostic and interventional vascular procedures, as well as for complementary illustrations. An extensive redesign of the
the performance of surgical endovascular procedures. The pages and distribution of the illustrations in a more rational
analysis of vascular angiographic pictures by any modality, format has been accomplished by the publisher and techni-
in correlation with anatomic conventional illustrations, is cal staff. Again, the descriptive text has been somewhat
still the best way to understand normal vascular anatomy expanded and updated, but kept to a minimum necessary to
and to perceive minute anatomical variations without the understanding of the anatomical subjects and always
cadaveric dissection. preceding the actual illustrations.
The development of fast, multislice CT technology The revised, expanded, and updated edition of the Atlas
was one of the main technological developments after the of Vascular Anatomy: An Angiographic Approach is intended
publication of the first edition of the Atlas of Vascular to be a quick and practical reference book of vascular
Anatomy, allowing for impressive 2D and 3D reconstruc- anatomy for those involved with the study of anatomy, diag-
tions of multiplanar images of the cardiovascular system. nosis, and treatment of vascular diseases, such as vascular
The utilization of this technology has been extremely ben- and interventional radiologists, surgeons, cardiologists,
eficial for the noninvasive demonstration of the heart medical students, as well as residents and fellows in inter-
structures and thoracic and abdominal structures, particu- ventional radiology, surgery, and cardiovascular medicine.
larly solid organs such as the liver. A number of images The second edition of the Atlas of Vascular Anatomy is
using angio CT technology have been added to the second the result of a great effort toward updating and improving
edition of the Atlas, intending to help readers understand the previous book, for me as editor and for the contributors.
some of the complexities of the vascular anatomy in some All the vascular territories are covered, and as much as pos-
of these areas. The heart anatomy chapter uses a lot of the sible, correlation with functional anatomy and other criti-
new fast CT technology for illustration with tremendous cal anatomical structures related to clinical and surgical
vii
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viii Preface to Second Edition
application of the knowledge of vascular anatomy is readers, my appreciation for the work of my friends and con-
presented, when pertinent. The somewhat variable extension tributors, as well as for the continuing support and enthusi-
in coverage of some anatomical territories only translates my asm from the senior staff of Lippincott Williams & Wilkins,
own personal preferences for some areas of medicine and who made possible the commissioning of the fine art work
organs of interest, and I hope it will not mislead the readers. of José Falcetti, an amazing medical artist, and the produc-
I am sure this major publishing effort will not only fill a tion of the second edition of the Atlas.
niche in our field of work but will also persist as a major ref-
erence in vascular anatomy, as the first edition did for the Renan Uflacker, M.D.
last ten years. I would like to thank, and share with the Editor
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Preface to First Edition
The development of imaging techniques to study and the details and spatial disposition of anatomic vascular struc-
demonstrate the human vascular anatomy has been increas- tures, as well as some of the variations encountered.
ingly important for the modern understanding and manage- The format was designed to facilitate the use of the
ment of most vascular diseases. The use of angiograms as book, minimizing page turning by the assignment of indi-
roadmaps for vascular surgery and interventional procedures vidual topics to opposing pages, followed by a sequence of
is currently the best way to demonstrate the vascular anatomy. correlated illustrations. The descriptive text was kept to the
New several, different and modern imaging modalities minimum necessary for the understanding of the subjects
including ultrasound, computed tomography, magnetic res- and preceding the actual illustrations.
onance imaging, and magnetic resonance angiography have This edition of the Atlas of Vascular Anatomy: An
been developed to evaluate vascular diseases with unprece- Angiographic Approach, First Edition, is intended to be a quick
dented and unparalleled noninvasive means of assessing and practical reference of vascular anatomy for those
patients. Although further improvement in these tech- involved with anatomy, diagnosis and treatment of vascular
niques may obviate the need for the more invasive diagnos- diseases. Vascular and Interventional Radiologists, Surgeons,
tic angiography, the angiographic perception of the vessels Cardiologists, Medical Students as well as Residents and
is hitherto the gold standard to learn vascular anatomy. Fellows in Radiology and Surgery compounds the target
The knowledge of the vascular anatomy is essential for population of the book.
the performance, understanding, and interpretation of diag- All the vascular territories are covered and correlation
nostic and interventional vascular procedures, as well as with function and other critical anatomical structures related
performing surgical procedures. The analysis of angiographic to the clinical and surgical application of vascular anatomy
pictures, correlated to the anatomic conventional illustra- is presented when pertinent.
tions is still the best way to understand normal vascular I hope that the major effort on the part of the editor of
anatomy and to perceive minute anatomical variations the book and the contributing authors will fill a niche in our
without cadavers dissection. field of work. I would like to thank and share with the read-
The idea of producing an Atlas of Vascular Anatomywas ers the continuing support and enthusiasm with this project
triggered by the need to have available a high-quality book from the Publisher’s senior staff, who made possible the com-
with illustrations and correlation with normal angiograms. missioning of the art work from an amazing medical artist,
The Atlas of Vascular Anatomy is intended to provide a José Falcetti, who frequently exceeded the requirements of
response to clinical anatomic challenges that abound in the color pictures only for the sake of quality and perfection.
many aspects of vascular surgery and vascular radiology prac-
tice. The basic aim is to provide photographs of real angio- Renan Uflacker, M.D.
graphic cases and fine art color illustrations for the study of Editor
ix
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