Table Of ContentJ.
PETER LANZER • ERIC TOPOL
Pan Vascular Medicine
Springer-Verlag Berlin Heidelberg GmbH
J.
PETER LANZER ERIC TOPOL
P a nV ascular
M e d i c i n e
Integrated Clinical Management
With 18oo Figures and 291 Tables
Springer
Editors
PETER LANZER, MD
Herz-Zentrum Coswig
Klinik fiir Kardiologie und Angiologie
Lerchenfeld 1
06869 Coswig (Anhalt)
Germany
J.
ERIC TOPOL, MD
The Cleveland Clinic Foundation
One Clinic Center
9500 Euclid Avenue
Cleveland, OH 44195
USA
ISBN 978-3-642-62565-7 ISBN 978-3-642-56225-9 (eBook)
DOI 10.1007/978-3-642-56225-9
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Preface
Vascular diseases are the leading cause of taken. First, interactive and permeable inter-
morbidity and mortality in developed faces have replaced interdisciplinary
nations. The numbers presented by the boundaries (Fig. 2). Second, vascular
American Heart Association in the teams have supplanted soloist
2002 Heart and Stroke Statistical vascular specialists. The teams
Update (www.americanheartorg) have been assembled based on
are staggering. In 2000 an esti- the complementary character
mated 22.iYo of US citizens of the vascular (vertical inte-
suffered from at least one gration) and vascular-related
cardiovascular disease (CVD); organ (horizontal integra-
for nearly one million, the tion) expertise of individual
CVD was deadly. Coronary members, allowing profes-
artery disease accounted for sional handling of a compte-
the largest share of deaths te spectrum of vascular
(55%), with cerebrovascular diseases. Third, vascular-
disease contributing an addi- and organ-based disciplines
tiona! 17%. With 13 million have been integrated into pan-
patients suffering from clinical vascular centers.
coronary artery disease and This textbook provides a
nearly 5 million patients from comprehensive state-of-the-art
cerebrovascular disease, CVD mor- review of current vascular medicine.
bidity was also high. Comparable num- Instead of following the traditional
hers were reported for other industrial interdisciplinary divides, the vascular
nations (www.cdc.gov/nccdphp/vd!international. system is viewed as a functional unity. To pro-
htm; www.who.it/dsa/cat98/card8.htm). Figure 1 vide a balanced multidisciplinary perspective, individu-
We are in the midst of an epidemic of obesity and dia- al vascular topics are reviewed in successive order by the
betes; more than one in four Americans now fulfill the crite- respective organ, interventional, and surgical specialists.
ria for obesity. Concurrently, physical activity continues to Due to the early stage of panvascular concept formation,
decline markedly. At the outset of the 21st century the world certain redundancies and overlaps in the interdisciplinary
is becoming a new place at a fast pace. Technical progress, review of individual topics could not be avoided. Attempts
urbanization and improving living standards have become were not made to artificially graft or to implement integra-
important perpetrators of vascular disease worldwide. In ted interdisciplinary perspectives if they were not a part of
addition, lifestyles that promote vascular disease are now established science or clinical practice at the time of wri-
also being spread with an unprecedented efficacy throug- ting. Furthermore, in the course of the production phase of
hout the world (and this includes the low-income countries) this textbook, we have gained a better understanding of the
by a simple push of an electronic button. If unchecked, the needs and requirements of structuring and directing the
costs of vascular treatments will rapidly outpace the slowing multidisciplinary process, yet due to real life constraints and
rates of economical growth and exhaust available resources. limitations they could only be implemented in part in this
Current vascular medicine and care - fraught with edition. Nevertheless, the principle features of the panva-
inconsistency and fragmentation - have failed to meet the scular concept have been maintained throughout the text-
dual challenge of increasing vascular risk and mounting
economic pressure. The unpromising state of vascular
affairs has spurred the search for better forms of vascular Basic Vascular
Sciences
management. Closer links between organ specialties have
been proposed by some, whereas expansion of individual
vascular specialties has been practiced by others. However, Neurovascular Laboratory
Surgery Neurology Vascular
although these new concepts broadened the current appro
Sciences
ach to vascular medicine and care, in principle, they preser
ved and even reinforced the organ-related approach in an OSprgeacnia lties Angiology
increasingly unregulated environment. Radiology
Panvascular medicine represents a new approach, pro
Cardiology
viding cohesive and comprehensive quality vascular care.
Reflecting the systemic nature of vascular diseases, a vascu Cardiac
Vascular
lar field that is heterogeneous in character and torn apart by Surgery Surgery
turf battles has been integrated into an all-inclusive vascular
unity (Fig. 1). To unify the field, three major steps have been Figure 2
VI PREFACE
book, providing the reader with a novel multidisciplinary ve and integrated multidisciplinary vascular environment.
perspective on a broad range of important and clinically Establishing the first panvascular platforms, it remains the
relevant vascular topics. task for the first wave of panvascular scholars, residents, and
To provide a systematic review of the immense vascular fellows to successively flesh out this new concept with an
field, the textbook has been divided into ten parts. Parts I exciting and stimulating clinical life, and in this way usher
and II summarize the principles of vascular sciences and in an era of comprehensive and highly efficient vascular
diagnostics. In accordance with their key clinical importan care serving the interest of each individual vascular patient.
ce, the diseases of the coronary, cerebrovascular, and peri If this textbook manages to serve as a point of departure
pheral vascular beds have been discussed next, being inte toward an integrated, interdisciplinary panvascular culture,
grated into Parts III-V. In the subsequent Parts VI-X, it will have served its mission admirably.
discussion of the venous, lymphatic, aortic, visceral, end It is a great pleasure and honor to thank to our collea
ocrine, and genitourinary vascular disorders completes the gue-authors, many of them trusted friends, who by kindly
vascular review. To assist the reader in quickly locating the agreeing to the very first panvascular team memberships
topic of his or her interest, selected parts of the textbook worldwide and by devoting their time to expert contribu
were further subdivided into sections. Individual chapters tions made this exciting interdisciplinary enterprise possi
then provide definitive reviews of vascular diseases of spe ble. We also wish to give thanks to Cornelia Thieme for
cific vascular beds. The elaborate index at the back of the superbly indexing the text and to Springer-Verlag for its
book facilitates expert multidisciplinary cross-reference to vision in carrying out this demanding project. Without the
individual items.
continual support and perseverance of Jorg Engelbrecht,
It is critical to recognize that the new era of panvascu Neil Solomon, Willi Bischoff, and Gisela Schmitt, this text
lar medicine and management is only now beginning. Thus, book would never have become a reality in the budding
this textbook represents an early effort toward an interacti- panvascular world.
Peter Lanzer Eric J. Topol
Co swig Cleveland
Contents
PART 1: 18 Molecular and Cellular Hemostasis and Fibrinolysis
INTEGRATED VASCULAR SYSTEM: GENERAL PRINCIPLES Kathleen E. Brummel, Nancy Swords Jenny,
Section 1: Epidemiology of Vascular Diseases . . . . . . . 1 Kenneth G. Mann . . . . . . . . . . . . . . . . . . . . . . . . . . 287
Epidemiology of Atherosclerotic Vascular Disease Section 6: Atherosclerotic Lesions. . . . . . . . . . . . . . . . . 319
Christopher J. O'Donnell, William B. Kannel . . . . 3 19 Atherosclerotic Lesions: Evolution and Regression
Section 2: Vascular Embryology. . . . . . . . . . . . . . . . . . . 17 Herbert C. Stary . . . . . . . . . . . . . . . . . . . . . . . . . . . 320
2 Molecular Vascular Embryology 20 Atherosclerotic Lesions: Vulnerability
Trine-Line Korsholm, Line Graven Lyngdorf,
Steven A. Vokes, Paul A. Krieg ............... . 18
Erling Falk. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327
3 Genetic Vascular Embryology
Jeffrey A. Towbin, John Belmont ............. . 21 Atherosclerotic Lesions: Mechanical Properties
Tim Topoleski . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 340
Section 3: Vascular Anatomy and Pathology ....... . 49
Section 7: Vascular Immunobiology and Heterogeneity 353
4 Integrated Vascular Anatomy
Jorg Wilting .............................. . so 22 Vascular Immunobiology and Immunopathology
Cora Jean S. Edgell, J. Charles Jennette ......... 354
5 Integrated Vascular Pathology
William E. Stehbens ....................... . 76 23 Vascular Heterogeneity
Maarten Bergwerff, Marco C. DeRuiter, Robert E.
Section 4: Vascular Physiology ................... . 115 Poelmann, Adriana C. Gittenberger-de Groot ... 366
6 Principles of Vascular Physiology
Patrick Segers, Pascal Verdonck .............. . 116
7 Hemodynamics PART II:
Ajit P. Yoganathan, George P. Chatzimavroudis .. 138 INTEGRATED VASCULAR DIAGNOSTIC EVALUATIONS
8 Arterial Wall Mechanics Section 1: Clinical Examination ................... 377
Alan J. Bank, Daniel R. Kaiser . . . . . . . . . . . . . . . . 151
24 Coronary Artery Disease
9 Microcirculation Function: Coronary Vasculature Kanu Chatterjee . . . . . . . . . . . . . . . . . . . . . . . . . . . 379
Gianmario Sambuceti, Mario Marzilli,
Antonio L'Abbate . . . . . . . . . . . . . . . . . . . . . . . . . . 162 25 Cerebrovascular Disease
Michael Hennerici, Michael Daffertshofer . . . . . . 382
10 Neurovegetative Regulation of the Vascular System
Blair P. Grubb, Daniel J. Kosinski, Yousuf Kanjwal 175 26 Peripheral Vascular Disease
Peter Lanzer. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 388
Section 5: Vascular Biology . . . . . . . . . . . . . . . . . . . . . . . 189
Section 2: Vascular Laboratory. . . . . . . . . . . . . . . . . . . . 397
11 Vascular Endothelium
Zhihong Yang, Thomas F. LUscher . . . . . . . . . . . . . 190 27 Peripheral Vascular Diagnostic Methods
Todd D. Lovelace, Gregory L. Moneta . . . . . . . . . . 398
12 Vascular Smooth Muscle Cells
Gordon R. Campbell, Johnny L. Efendy, 28 Cerebrovascular Ultrasonography
Julie H. Campbell . . . . . . . . . . . . . . . . . . . . . . . . . . 205 Stephen Meairs, Michael Hennerici. . . . . . . . . . . . 420
13 Vascular Extracellular Matrix Section 3: Computed Tomography. . . . . . . . . . . . . . . . . 441
Colin M. Fitzsimmons, Catherine M. Shanahan. . 217 29 Technical Principles of CT
14 Principles of Vascular Remodeling Bernd Ohnesorge, Andreas F. Kopp,
Seymour Glagov, Clifford Ko, Hisham S. Bassiouny, Christoph R. Becker, Andreas Knez, Stephen Schroder,
Christopher K. Zarins. . . . . . . . . . . . . . . . . . . . . . . 232 Thomas Flohr . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 443
15 Molecular Biology of Vascular Remodeling 30 Coronary Artery Imaging Using CT
Philip S. Tsao, Jay Wohlgemuth, Mehrdad Rezaee, Christoph R. Becker . . . . . . . . . . . . . . . . . . . . . . . . 453
Frances L. Johnson, Stephane C. Boutet, 31 Peripheral and Visceral Vascular Imaging Using CT
Bahaa M. Fadel, Thomas Quertermous. . . . . . . . . 242 Everett Y. Lam, Robert A. Andrews,
16 Molecular Biology of Collateral Circulation Gregory L. Moneta . . . . . . . . . . . . . . . . . . . . . . . . . 458
Dimitri Scholz, Tibor ZiegelhOffer, 32 Pulmonary Vascular Imaging Using CT
Christian Friedrich. . . . . . . . . . . . . . . . . . . . . . . . . 265 Christoph Engelke, Mathias Prokop . . . . . . . . . . . 466
17 Molecular and Cellular Angiogenesis 33 Coronary Artery Imaging Using EBT
Peter Carmeliet, Desire Collen, Edward M. Conway 273 Paolo Raggi . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 496
VIII CONTENTS
Section 4: Magnetic Resonance Angiography . . . . . . . 513 51 Coronary Artery Revascularization:
Percutaneous Approach
34 Technical Principles of MRA
Antonio Colombo, Bernhard Reimers. . . . . . . . . . 820
Rene M. Botnar, Matthias Stuber, Kraig V. Kissinger,
Warren J. Manning . . . . . . . . . . . . . . . . . . . . . . . . . 515 52 Coronary Artery Revascularization: Adjunctive
Pharmacology in the Percutaneous Approach
35 Coronary Artery Imaging Using MRA
Dean J. Kereiakes, Thomas M. Shimshak . . . . . . . 841
Oliver M. Weber, Peter Boesiger. . . . . . . . . . . . . . . 526
53 Coronary Artery Revascularization:
36 Cerebrovascular Artery Imaging Using MRA
Surgical Approach - Standard Management
Andreas Sommer, Michael Hennerici . . . . . . . . . . 533
Anno Diegeler, Francis G. Duhaylongsod,
37 Peripheral Artery Imaging Using MRA Friedrich Wilhelm Mohr . . . . . . . . . . . . . . . . . . . . 854
Everett Y. Lam, Robert A. Andrews,
54 Coronary Artery Revascularization: Surgical
Gregory L. Moneta . . . . . . . . . . . . . . . . . . . . . . . . . 546
Approach - Minimally Invasive Management
Section 5: Perfusion Measurements . . . . . . . . . . . . . . . . 553 Valavanur A. Subramanian, Nilesh U. Patel. . . . . . 879
38 Myocardial Blood Flow and Perfusion: 55 Coronary Artery Disease and Endothelial Function
Radionuclide Techniques Volker Schachinger, Andreas M. Zeiher . . . . . . . . 887
Heinrich R. Schelbert ...................... . 555 56 Coronary Artery Spasm: Basic Aspects
39 Cerebrovascular Blood Flow and Perfusion Hiroaki Shimokawa, Masahiro Mohri,
Peter Horn ............................... . 577 Akira Takeshita . . . . . . . . . . . . . . . . . . . . . . . . . . . . 912
Section 6: X-Ray, Angiography ................... . 591 57 Coronary Artery Spasm: Clinical Aspects
Masahiro Mohri, Hiroaki Shimokawa,
40 Technical Principles of X-Ray Angiography
Akira Takeshita . . . . . . . . . . . . . . . . . . . . . . . . . . . . 921
Frits Van der Meer ........................ . 593
58 Coronary Artery Syndrome X
41 X-Ray Coronary Angiography
Junbo Ge, Juying Qian, Raimund Erbel. . . . . . . . . 930
Stephan Windecker, Bernhard Meier. ......... . 602
59 Inflammatory Diseases of the Coronary Artery
42 X-Ray Peripheral and Visceral Angiography
Joseph C. Shanahan, E. William St. Clair. . . . . . . . 935
Peter M. T. Pattynama ...................... . 636
6o Drug-Related Diseases of the Coronary Artery
Section 7: Intravascular Ultrasonography ......... . 659 Shereif H. Rezkalla, Robert A. Kloner . . . . . . . . . . 970
43 Technical Principles of Intravascular 61 Hypertrophic Cardiomyopathy and
Ultrasonography Coronary Arteries
Nicolaas Born, Anton F.W. van der Steen, Nico Barry J. Maron............................. 980
Bruining, Chris L. de Korte, Stephane G. Carlier,
Charles T. Lancee ......................... . 661 62 Dilated Cardiomyopathy and Coronary Arteries
Kanu Chatterjee . . . . . . . . . . . . . . . . . . . . . . . . . . . 987
44 Coronary Intravascular Ultrasonography
Peter Stahr, Yasuhiro Honda, Peter J. Fitzgerald, 63 Vascular Disease in Diabetes Mellitus
Michael Poon, Elliot Rayfield. . . . . . . . . . . . . . . . . 995
Paul G. Yock .............................. . 667
64 Coronary Artery Function in Diabetes Mellitus
45 Peripheral Intravascular Ultrasonography
Luis Afonso, Marcelo F. Di Carli. . . . . . . . . . . . . . . 1008
Elma J. Gussenhoven, Tjebbe Hagenaars,
Jeroen A. van Essen, Trude C. Leertouwer, 65 Systemic Hypertension
Nicolaas Born ............................. . 678 Shawn A. Gregory, Suzanne Oparil . . . . . . . . . . . . 1015
Section 8: Special Vascular Examination Techniques. 689
46 Clinical Assessment of Endothelial Function PART IV
Joseph A. Vita ............................ . 691 CEREBROVASCULAR DISEASES
47 Functional Coronary Artery Diagnostic Evaluations Section 1: Vascular Diseases of the Central Nervous
Stuart T. Higano . . . . . . . . . . . . . . . . . . . . . . . . . . . 701 System: Review and Special Considerations. . . . . . . . . 1065
66 Cerebrovascular Anatomy: Special Considerations
Stephan Behrens, Oliver Sedlaczek,
PART III Michael Hennerici. . . . . . . . . . . . . . . . . . . . . . . . . . 1067
CORONARY VASCULAR DISEASES 67 Cerebrovascular Pathobiology and
Pathophysiology: Special Considerations
48 Integrated Coronary Physiology
Michael Hennerici, Stephen Meairs............ 1071
and Pathophysiology
Eberhard Bassenge, Michael Schwemmer. . . . . . . 717 68 Cerebrovascular Diseases
Michael Daffertshofer. . . . . . . . . . . . . . . . . . . . . . . 1075
49 Coronary Atherosclerosis:
Acute Coronary Syndromes Section 2: Vascular Diseases of the Central Nervous
Peter Lanzer, Tilman Markert, Axel Frey, System: Percutaneous and Surgical Therapy . . . . . . . . 1113
Rolf Weser . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 746 69 Vascular Diseases of the Central Nervous System:
50 Coronary Atherosclerosis: Percutaneous Approach
Chronic Coronary Syndromes Peter J. Mitchell, Randall T. Higashida,
K. Lance Gould . . . . . . . . . . . . . . . . . . . . . . . . . . . . 779 Christopher F. Dowd, Van V. Halbach . . . . . . . . . . 1115
CoNTENTs IX
70 Intracranial Aneurysms: Surgical and 88 Arterial Disease of the Lower Extremity:
Endovascular Approach Surgical Approach
Erich Donauer, Hans Henkes, Johannes Reif, Sabine Alexander D. Nicoloff, W. Kent Williamson,
Fuhrmann, Klaus Terstegge, Dietmar Kiihne .... 1154 John M. Porter ............................. 1433
71 Intracerebral Hemorrhage: Surgical Approach 89 Peripheral Artery Disease: Aging and Comorbidity
Frieder Cortbus, Wolf-Ingo Steudel. ........... 1217 Christian F.A. Kugler ....................... 1449
72 Cerebral Arteriovenous Malformations: 90 Hemodialysis Access Dysfunction
Single-Step Combined Approach Dierk Vorwerk ............................. 1470
Ulrich Grzyska, Manfred Westphal ............ 1235
91 Foreign Body Retrieval
73 Aneurysms Associated with Cerebral Arteriovenous Haresh Mehta, Stephan Windecker,
Malformations: Therapeutic Options Bernhard Meier ............................ 1480
Manfred Westphal, Ulrich Grzyska ............ 1240
74 Cranial Dural Arteriovenous Fistulas:
Therapeutic Options PART VI
Eva Neumaier Probst, Ulrich Grzyska, PERIPHERAL VENOUS AND LYMPHATIC DISEASES
Manfred Westphal, Herman Zeumer ........... 1245
92 Peripheral Venous Anatomy and Physiology
75 Spinal Vascular Malformations: Sebastian Schellong, Thomas Schwarz ......... 1489
Therapeutic Options
93 Peripheral Venous Pathomorphology and
Christoph Koch, Hermann Zeumer,
Pathophysiology
Manfred Westphal. ......................... 1253
Sebastian Schellong, Thomas Schwarz ......... 1491
76 Intracranial Angiomas: Surgical Approach
94 Peripheral Venous Diseases: Nonsurgical Therapy
Erich Donauer, Hans Henkes ................. 1265
Sebastian Schellong, Thomas Schwarz ......... 1497
77 Cerebral and Spinal Cavernomas:
95 Peripheral Venous Diseases: The Surgical Approach
Surgical Approach
Gerhard Salzmann ......................... 1526
Jiirgen Meixensberger, Klaus Roosen .......... 1282
96 Lymphatic Vascular Diseases
78 Moyamoya Disease: Surgical Approach
Jiirgen Meixensberger, Erich Donauer ......... 1292 Etelka Foldi ............................... 1538
79 Neurovascular Cross-Compression Syndromes:
Surgical Approach
PART VII
Abolghassem Sepehrnia ..................... 1297
THORACIC VASCULAR DISEASES
So Carotis Artery Disease: Percutaneous Approach
Klaus Mathias, Hans Martin Gissler ........... 1302 Section 1: Diseases of the Thoracic Aorta ........... 1547
81 Carotis and Vertebralis Artery Disease: 97 Diseases of the Thoracic Aorta:
Percutaneous Approach
Surgical Approach
Brajesh K. Lal, Robert W. Hobson II ........... 1316 Christoph A. Nienaber ...................... 1549
98 Diseases of the Thoracic Aorta: Surgical Approach
Magdi Yacoub ............................. 1561
PARTY
PERIPHERAL ARTERIAL DISEASES Section 2: Diseases of the Supra-aortic Great Vessels. 1573
82 Peripheral Artery Physiology and 99 Supra-aortic Great Vessels: Surgical and
Percutaneous Approach
Pathophysiology: Special Considerations
Caroline Schmidt-Lucke, Manju Kalra, Kenneth J. Cherry. .............. 1575
Jan Andre Schmidt-Lucke .................... 1333 Section 3: Vascular Diseases of the Lungs ........... 1597
83 Peripheral Artery Tomographic Imaging: 100 Pulmonary Vasculitides
Special Considerations Richard A. DeRemee ........................ 1599
Mathias Goyen, Stefan G. Ruehm, Jorg F. Debatin 1341
101 Hypertensive Pulmonary Vasculopathies:
84 Prevention of Peripheral Artery Atherosclerosis Pathological Findings
Knuth Kroger ............................. 1347 Giuseppe G. Pietra, Enrico Dessy .............. 1609
85 Peripheral Arterial Disease: 102 Hypertensive Pulmonary Vasculopathies:
Acute Ischemic Syndromes Pathogenesis
Gottfried Rudofsky ......................... 1351 Alfred P. Fishman .......................... 1618
86 Peripheral Arterial Disease: 103 Hypertensive Pulmonary Vasculopathies:
Chronic Ischemic Syndromes Diagnostic Evaluations
Gottfried Rudofsky ......................... 1363 Harold I. Palevsky, Alfred P. Fishman .......... 1632
87 Arterial Disease of the Upper Extremity: 104 Hypertensive Pulmonary Vasculopathies:
Special Considerations Clinical Management
Edward B. Diethrich ........................ 1423 Tim Higenbottam .......................... 1641
