Endovascular Therapy: Principles of Peripheral Interventions

310 Pages·2006·4.246 MB·English

Endovascular
Therapy
PRINCIPLES OF
PERIPHERAL
INTERVENTIONS
Alan B. Lumsden,
MD
Peter H. Lin,
MD
Ruth L. Bush,
MD
Changyi Chen,
MD, PhD
BaylorCollegeofMedicine,Houston,Texas
©2006byBlackwellPublishing
BlackwellFuturaisanimprintofBlackwellPublishing
BlackwellPublishing,Inc.,350MainStreet,Malden,Massachusetts02148-5020,USA
BlackwellPublishingLtd,9600GarsingtonRoad,OxfordOX42DQ,UK
BlackwellScienceAsiaPtyLtd,550SwanstonStreet,Carlton,Victoria3053,Australia
Allrightsreserved.Nopartofthispublicationmaybereproducedinanyformorbyany
electronicormechanicalmeans,includinginformationstorageandretrievalsystems,without
permissioninwritingfromthepublisher,exceptbyareviewerwhomayquotebriefpassages
inareview.
Firstpublished2006
ISBN-13:978-1-4051-24232
ISBN-10:1-4051-24237
LibraryofCongressCataloging-in-PublicationData
Endovasculartherapy:principlesofperipheralinterventions/edited
byAlanB.Lumsden...[etal.].
p.;cm.
Includesbibliographicalreferencesandindex.
ISBN-13:978-1-4051-2423-2(hardcover:alk.paper)
ISBN-10:1-4051-2423-7(hardcover:alk.paper)
1.Blood-vessels–Endoscopicsurgery.2.Peripheralvasculardiseases–Endoscopicsurgery.
[DNLM:1.ArterialOcclusiveDiseases–surgery.2.PeripheralVascularDiseases–surgery.
3.Angioplasty–methods.4.Angioscopy–methods.5.Stents.WG500E56652006]I.Lumsden,
AlanB.
RD598.5.E562006
(cid:1)
617.4130597–dc22
2005026041
AcataloguerecordforthistitleisavailablefromtheBritishLibrary
Acquisitions:SteveKorn
Production:SimoneDudziak
Setin9.5/12ptPalatino
byNewgenImagingSystems(P)Ltd,Chennai,India
PrintedandboundbyReplikaPressPVT.Ltd,India
ForfurtherinformationonBlackwellPublishing,visitourwebsite:
www.blackwellcardiology.com
Thepublisher’spolicyistousepermanentpaperfrommillsthatoperateasustainableforestry
policy,andwhichhasbeenmanufacturedfrompulpprocessedusingacid-freeandelementary
chlorine-freepractices.Furthermore,thepublisherensuresthatthetextpaperandcoverboard
usedhavemetacceptableenvironmentalaccreditationstandards.
Notice:Theindicationsanddosagesofalldrugsinthisbookhavebeenrecommendedinthe
medicalliteratureandconformtothepracticesofthegeneralcommunity.Themedications
describeddonotnecessarilyhavespecificapprovalbytheFoodandDrugAdministrationfor
useinthediseasesanddosagesforwhichtheyarerecommended.Thepackageinsertforeach
drugshouldbeconsultedforuseanddosageasapprovedbytheFDA.Becausestandardsfor
usagechange,itisadvisabletokeepabreastofrevisedrecommendations,particularlythose
concerningnewdrugs.
Contents
Editors,v
ListofContributors,vii
Foreword,xi
Preface,xiii
Acknowledgments,xv
1 Generalprinciplesofendovasculartherapy,1
ImranMohiuddin,PanagiotisKougias,RossMilner
2 Basicscienceofendovasculartherapy,20
PanagiotisKougias,LizNguyen,ChangyiChen
3 Pharmacotherapyinendovascularinterventions,38
LeilaMureebe,ColleenM.Johnson,ChangyiChen
4 Complicationsofendovasculartherapy,53
GordonM.Riha,ChangyiChen,RuthL.Bush
5 Carotidbifurcationdisease,68
WeiZhou,RuthL.Bush,PeterH.Lin,AlanB.Lumsden
6 Supra-aortictrunkandupperextremityarterialdisease,88
ImranMohiuddin,EricJ.Silberfein,EricPeden
7 Thoracicaorticdisease,103
AndyC.Chiou,KristenL.Biggs,PeterH.Lin
8 Abdominalaorticaneurysm,121
W.AnthonyLee,DanielJ.Martin,ImranMohiuddin
9 Mesentericarteryocclusivedisease,139
PanagiotisKougias,MitchellCox,PeterH.Lin
10 Renalarteryocclusivedisease,154
PeterH.Lin,RakeshSafaya,W.ToddBohannon
11 Aortoiliacocclusivedisease,170
EricPeden,RuthL.Bush,AlanB.Lumsden
iii
iv Contents
12 Lowerextremityarterialdisease,186
WeiZhou,MarlonA.Guerrero,AlanB.Lumsden
13 Arteriovenousgraftinterventions,206
JosephJ.Naoum,WeiZhou,EricPeden
14 Venousinsufficiencyandvaricoseveins,221
PanagiotisKougias,PatrickE.Duffy,E.JohnHarris,Jr
15 Ileofemoraldeepvenousthrombosis,239
JamesP.Gregg,EstebanA.Henao,AlanB.Lumsden
16 Vasculartrauma,252
UlisesBaltazar,EstebanA.Henao,W.ToddBohannon,MichaelB.SilvaJr
17 Endovasculardevicesinperipheralinterventions,268
RussellLam,MaiPham,RakeshSafaya
Index,283
Colourplatesarefoundbetweenpp.80–81
Editors
AlanB.Lumsden,MDProfessorofSurgery;andChief,DivisionofVascular
Surgery and Endovascular Therapy, Michael E. DeBakey Department of
Surgery,BaylorCollegeofMedicineHouston,Texas
Peter H. Lin, MDAssociate Professor of Surgery, Chief of Vascular Surgery,
MichaelE.DeBakeyVeteransAffairsMedicalCenter,DivisionofVascularSur-
geryandEndovascularTherapy,MichaelE.DeBakeyDepartmentofSurgery,
BaylorCollegeofMedicineHouston,Texas
Ruth L. Bush, MD Assistant Professor of Surgery; and Director, Vascular
Surgery Fellowship Program, Division of Vascular Surgery and Endovascu-
lar Therapy, Michael E. DeBakey Department of Surgery, Baylor College of
MedicineHouston,Texas
Changyi Chen, MD, PhD Professor of Surgery & Molecular and Cellular
Biology; and Director, Molecular Surgeon Research Center, Vice Chairman,
Surgical Research, Division of Vascular Surgery and Endovascular Therapy,
Michael E. DeBakey Department of Surgery, Baylor College of Medicine
Houston,Texas
v
List of Contributors
UlisesBaltazar,MD PatrickE.Duffy,MD
DivisionofVascularSurgery DivisionofVascularSurgeryandEndovascular
DepartmentofSurgery Therapy
EastTennesseeStateUniversity MichaelE.DeBakeyDepartmentofSurgery
JohnsonCity,Tennessee BaylorCollegeofMedicine
Houston,Texas
KristenL.Biggs,MD
SectionofVascularSurgery JamesP.Gregg,MD
DepartmentofSurgery DivisionofVascularSurgeryandEndovascular
WilfordHallUSAFMedicalCenter Therapy
LacklandAirForceBase,Texas MichaelE.DeBakeyDepartmentofSurgery
BaylorCollegeofMedicine
W.ToddBohannon,MD Houston,Texas
DivisionofVascularSurgery
DepartmentofSurgery MarlonA.Guerrero,MD
Scott&WhiteHospitalandClinic DivisionofVascularSurgeryandEndovascular
TexasA&MUniversityHealthScience Therapy
Center MichaelE.DeBakeyDepartmentofSurgery
Temple,Texas BaylorCollegeofMedicine
Houston,Texas
RuthL.Bush,MD
DivisionofVascularSurgeryandEndovascular E.JohnHarris,Jr.,MD
Therapy DivisionofVascularSurgery
MichaelE.DeBakeyDepartmentofSurgery DepartmentofSurgery
BaylorCollegeofMedicine StanfordUniversitySchoolofMedicine
Houston,Texas Stanford,California
ChangyiChen,MD,PhD EstebanA.Henao,MD
DivisionofVascularSurgeryandEndovascular DivisionofVascularSurgeryandEndovascular
Therapy Therapy
MichaelE.DeBakeyDepartmentofSurgery MichaelE.DeBakeyDepartmentofSurgery
BaylorCollegeofMedicine BaylorCollegeofMedicine
Houston,Texas Houston,Texas
AndyC.Chiou,MD,MPH ColleenM.Johnson,MD
SectionofEndovascularSurgery DivisionofVascularSurgery
DepartmentofSurgery UniversityofMissouri
UniversityofIllinoisCollegeofMedicine HealthSciencesCenter
Peoria,Illinois Columbia,Missouri
MitchellCox,MD PanagiotisKougias,MD
UniformedServicesUniversityoftheHealth DivisionofVascularSurgeryandEndovascular
Sciences Therapy
VascularSurgeryClinic MichaelE.DeBakeyDepartmentofSurgery
WalterReedArmyMedicalCenter BaylorCollegeofMedicine
Washington,DC Houston,Texas
vii
viii ListofContributors
RussellLam,MD LeilaMureebe,MD,FACS
DivisionofVascularSurgery DivisionofVascularSurgery
DepartmentofSurgery ColumbiaUniversityMedicalCenter
CornellUniversityWeilMedicalCollege NewYorkPresbyterianHospital
NewYork,NewYork NewYork,NewYork
W.AnthonyLee,MD JosephJ.Naoum,MD
DivisionofVascularSurgery
DivisionofVascularSurgery&Endovascular
DepartmentofGeneralSurgery
Therapy
TheUniversityofTexasMedicalBranch
UniversityofFlorida
Galveston,Texas
Gainesville,Florida
PeterH.Lin,MD LizNguyen,MD
DivisionofVascularSurgeryandEndovascular
DivisionofVascularSurgeryandEndovascular
Therapy
Therapy
MichaelE.DeBakeyDepartmentofSurgery
MichaelE.DeBakeyDepartmentofSurgery
BaylorCollegeofMedicine
BaylorCollegeofMedicine
Houston,Texas
Houston,Texas
MaiPham,MD
AlanB.Lumsden,MD
DepartmentofCardiothoracicandVascular
DivisionofVascularSurgeryandEndovascular Surgery
Therapy UniversityofTexasHealthScienceCenterat
MichaelE.DeBakeyDepartmentofSurgery Houston
BaylorCollegeofMedicine Houston,Texas
Houston,Texas
EricPeden,MD
DanielJ.Martin,MD DivisionofVascularSurgeryandEndovascular
DivisionofVascularSurgery Therapy
DepartmentofSurgery MichaelE.DeBakeyDepartmentofSurgery
BaylorCollegeofMedicine
UniversityofFlorida
Houston,Texas
Gainesville,Florida
RossMilner,MD GordonM.Riha,BS
DivisionofVascularSurgeryandEndovascular
DivisionofVascularSurgery
Therapy
DepartmentofSurgery
MichaelE.DeBakeyDepartmentofSurgery
EmoryUniversitySchoolofMedicine
BaylorCollegeofMedicine
Atlanta,Georgia Houston,Texas
ImranMohiuddin,MD RakeshSafaya,MD
DivisionofVascularSurgeryandEndovascular DivisionofVascularSurgeryandEndovascular
Therapy Therapy
MichaelE.DeBakeyDepartmentofSurgery MichaelE.DeBakeyDepartmentofSurgery
BaylorCollegeofMedicine BaylorCollegeofMedicine
Houston,Texas Houston,Texas
ListofContributors ix
EricJ.Silberfein,MD WeiZhou,MD
DivisionofVascularSurgeryandEndovascular DivisionofVascularSurgeryandEndovascular
Therapy Therapy
MichaelE.DeBakeyDepartmentofSurgery MichaelE.DeBakeyDepartmentofSurgery
BaylorCollegeofMedicine BaylorCollegeofMedicine
Houston,Texas Houston,Texas
MichaelB.Silva,Jr.,MD
DepartmentofVascularSurgery
ClevelandClinicFoundation
Cleveland,Ohio
Foreword
Alittlemorethanahalf-centuryhaselapsedsincethefirst“homemade”Dacron
graft was first used successfully to restore continuity following resection of
an aneurysm of the abdominal aorta. This, along with a number of other
essentialadvancementsinourbasicunderstandingoftheanatomic-pathologic
aspects of aneurismal and occlusive diseases of the aorta and major arteries
and innovative technologic surgical procedures to restore circulation, led to
theestablishmentofhighlysuccessfultherapyformostvasculardiseasesthat
previouslymeantonlysufferinganddeath.Concomitantwiththeseadvances
wasthedevelopmentofnewerandmoreprecisediagnosticprocedures,includ-
ingparticularlyultrasound,computerizedaxialtomography(CAT)scans,and
magnetic resonance imaging (MRI), all of which have led to the advent of a
newspecialtyinmedicine–vascularsurgery.
In many respects, these sophisticated scientific and technologic advances
setthestagewithinthepasttwodecadesforthehighlyinnovativedevelop-
mentofendovasculartherapy.Oncethisconceptwasrecognized,anincreasing
numberofinvestigatorsfromavarietyofdisciplines,rangingfromsurgery,car-
diology, andradiologytobioengineeringandindustrialtechnicians, focused
theirinterestandenergiesonimplementingthisconceptwithrapidlyimprov-
ingclinicalresults.Asaconsequence,endovasculartherapyhasnowreplaced
a number of open surgical procedures and expanded the therapy of some
patients,whowouldotherwisebeeliminatedbecauseoftheunacceptablerisk
ofoperation,as,forexample,anelderlypatientwitharupturedaneurysmof
theabdominalaortaandpoorcardiac,pulmonary,orrenalfunction.
Thistextbookonendovasculartherapyisnotonlytimely,butalsovaluable
in providing current knowledge of this expanding field. The authors, all of
whomarenotonlyhighlyexperiencedbutalsocontributorstothisadvancing
formofvasculartherapy,haveprovidedasuccinctbutcomprehensivetextthat
willbeusefulnotonlytothoseworkinginthisspecialty,buttoallphysicians
andsurgeonsconcernedwithvasculardisease.
MichaelE.DeBakey,md
ChancellorEmeritus
OlgaKeithWiessandDistinguishedServiceProfessor
MichaelE.DeBakeyDepartmentofSurgery
Director,DeBakeyHeartCenter
BaylorCollegeofMedicine
Houston,Texas
xi
Preface
The treatment of vascular disease has evolved significantly over the past
two decades with a greater emphasis on catheter-based interventions. This
evolution has been energized by various factors, including the widespread
acceptance of minimally invasive therapy, miniaturization of endovascular
devices, and enhanced healthcare cost-effectiveness due in part to increased
outpatient treatment. Vascular physicians and patients alike have largely
embraced this minimally invasive therapy with enthusiasm due to reduced
procedural-related discomfort and faster convalescence, when compared to
thetraditionaloperations. Thecontinualevolutionofcatheter-basedtechno-
logieshascreatedaneedforupdatingandeducatingphysiciansfromvarying
specialty disciplines with regards to the new treatment paradigm. Equally
important,thishasplacedanincreaseddemandonstudentsandresidentsto
learnnotonlythefundamentalknowledgeofvasculardiseasebutalsomodern
therapeuticmodality.
Because endovascular therapy has become an integral component of the
overall care in vascular disease management, an understanding of the fun-
damentalknowledgeregardingthevascularpathologyandmoderncatheter-
basedinterventionsforvasculardiseaseswillundoubtedlyenhancetheability
of physicians to provide quality care to their vascular patients. Toward that
effort, we have embarked on the development of this book to achieve two
objectives. The first is to provide a general overview of the vascular dis-
easesbasedontheirrespectivecirculatoryanatomy.Thisisparticularlygeared
toward medical students, residents, or healthcare providers with limited
background knowledge in vascular intervention. The second is to provide
a practical reference of catheter-based therapeutic modalities for vascular
physiciansspecializinginperipheralintervention.
Since endovascular interventions can be performed by physicians from
different specialty disciplines, this book is written to provide a general
understandingoftheclinicalmanifestations, treatmentindications, anddia-
gnostic evaluations for healthcare providers dedicated in the treatment of
vascular disease. In addition, a basic knowledge of the pathophysiology
of vascular disease, interventional techniques, and endovascular modalit-
ies of various disease categories is provided. Emphasis is also placed on
the relevant complications associated with the wide spectrum of endovas-
cular interventions. It is our hope that this book of Endovascular Therapy:
Principles of Peripheral Interventions will provide both a comprehensive and
xiii