Difficult Decisions in Vascular Surgery

1. Front Matter

   Pages i-xviii

   PDF

2. Aortic Disease

   1. Front Matter

      Pages 1-1

      PDF

   2. In Patients with Acute Type B Aortic Dissection, Do Current Operative Therapies Reduce Complications Compared to Medical Management?

      • Nadia Awad, Joseph Lombardi

      Pages 3-12

   3. In Patients with a Chronic Type B Dissection, Does Endovascular Treatment Reduce Long Term Complications?

      • Yana Etkin, Ronald M. Fairman

      Pages 13-22

   4. In Patients with a Retrograde Type A Aortic Dissection, Does Treatment Like a Type B Aortic Dissection Improve Outcomes?

      • Reilly D. Hobbs, Prashanth Vallabhajosyula, Wilson Y. Szeto

      Pages 23-35

   5. In Patients with Small AAA, Does Medical Therapy Prevent Growth?

      • Kenneth R. Ziegler, John A. Curci

      Pages 37-48

   6. Challenging AAA Neck Anatomy: Does the Fenestrated or Snorkel/Chimney Technique Improve Mortality and Freedom from Reintervention Relative to Open Repair?

      • Brant W. Ullery, Jason T. Lee

      Pages 49-61

   7. In Patients Who Require Hypogastric Artery Coverage to Treat an AAA with EVAR, Does Preservation Improve Outcomes When Compared to Exclusion of the Vessel?

      • Sina Iranmanesh, Edward Y. Woo

      Pages 63-76

   8. In Patients with Aortic Graft Infections, Does EVAR Improve Long Term Survival Compared to Open Graft Resection?

      • M. J. E. van Rijn, E. V. Rouwet, S. ten Raa, J. M. Hendriks, H. J. M. Verhagen

      Pages 77-86

   9. Does EVAR Improve Outcomes or Quality of Life in Patients Unfit for Open Surgery?

      • Tadaki M. Tomita, Andrew W. Hoel

      Pages 87-97

   10. In Patients with Type 2 Endoleaks Does Intervention Reduce Aneurysm Related Morbidity and Mortality Compared to Observation?

       • Lisa Kang, Brian Funaki

       Pages 99-112

   11. Ruptured Abdominal Aortic Aneurysm Treated with Endovascular Repair; Does Decompressive Laparotomy Result in Improved Clinical Outcomes?

       • Chandler A. Long, Veer Chahwala, Ravi K. Veeraswamy

       Pages 113-120

   12. In a Patient with Blunt Traumatic Aortic Injury, Does TEVAR Improve Survival Compared to Open Repair or Expectant Management?

       • Gerald R. Fortuna Jr., Ali Azizzadeh

       Pages 121-133

3. Lower Extremity Arterial Disease

   1. Front Matter

      Pages 135-135

      PDF

   2. In Patients with Aortoiliac Occlusive Disease, Does Endovascular Repair Improve Outcomes When Compared to Open Repair?

      • Michael S. Hong, William C. Pevec

      Pages 137-148

   3. In Patients with Aortoiliac Occlusive Disease, Does Extra-anatomic Bypass Improve Quality of Life and Limb Salvage?

      • George E. Havelka, William H. Pearce

      Pages 149-162

   4. In Patients with Critical Limb Ischemia Does Bypass Improve Limb Salvage and Quality of Life When Compared to Endovascular Revascularization?

      • Jeffrey J. Siracuse, Alik Farber

      Pages 163-170

   5. In Patients with Limb-Threatening Ischemia Who Are Not Candidates for Revascularization Do Non-operative Options Improve Outcomes Compared to Amputation?

      • Craig Weinkauf, Joseph L. Mills Sr.

      Pages 171-184

   6. In the Patient with Profunda Artery Disease, Is Open Revascularization Superior to Endovascular Repair for Improving Rest Pain?

      • Jordan R. Stern, Victor M. Bernhard

      Pages 185-197

   7. In Patients with Limb-Threatening Vascular Injuries, Is There a Role of Prophylactic Fasciotomy to Reduce Ischemic Injury?

      • Melanie Hoehn, Megan Brenner, Todd E. Rasmussen

      Pages 199-206

This book looks at specific vascular surgery questions that have arisen and where careful analysis is given according to the level of supporting evidence available. As new technology is introduced to treat the cardiovascular system, alternative therapies begin to challenge and also complement traditional vascular surgery. All chapters contain the PICO table to summarise specific characteristics relative to the questions posed in each chapter.

Difficult Decisions in Vascular Surgery- An Evidence-Based Approach is a current and timely reference source for practicing surgeons, surgeons in training, and educators, that describes the recommended ideal approach, rather than customary care, in selected clinical situations.

• Aortic aneurysm
• Carotid artery stenosis
• Mesenteric Revascularization
• Peripheral Arterial Disease
• Vascular Therapy
• Visceral artery aneurysms

“This is a useful resource for vascular trainees or vascular attendings throughout their careers as they face difficult situations that they do not encounter on a routine basis. … This is an accessible and well‐organized resource for dissecting the components of decision-making for clinical scenarios in vascular surgery. It provides a useful overview of the literature for each scenario and management recommendations graded by level of evidence. I found it to be a good resource.” (Katherine Hekman, Doody's Book Reviews, April, 2017)

• The University of Chicago Medical Center and Biological Science Division, Chicago, USA

  Christopher L. Skelly, Ross Milner

Christopher L. Skelly, MD FACS 

Associate Professor of Surgery, Chief of Vascular Surgery & Endovascular Therapy; Director of Vascular Surgery Fellowship Program and Director of Vascular Lab. 

Christopher Skelly, MD specializes in vascular surgery. He performs a full range of open and endovascular procedures, including the treatment of carotid disease, complex aortic pathologies and peripheral vascular disease. In addition, he performs minimally invasive surgery for the treatment of median arcuate ligament syndrome.

In addition to his clinical practice, Dr. Skelly directs a research laboratory aimed at improving outcomes and durability of vascular graft repairs. As a 2008 recipient of the NHLBI Jointly Sponsored Mentored Clinical Scientist Development Award, his research is funded by the American Vascular Association (AVA)/American College of Surgeons (ACS) and the National Heart, Lung and Blood Institute (NHLBI). Dr. Skelly has authored more than 35 scientific articles in peer-reviewed journals, and several book chapters and reviews. He is working on numerous clinical trials, including a below-knee arterial bypass trial, for which he serves as site-principal investigator.

Ross Milner, MD

Director at the Center for Aortic Diseases

Ross Milner, MD, is an internationally recognized expert in vascular surgery. He specializes in the treatment of complex aortic diseases.

Dr. Milner has been the primary investigator on numerous endovascular device trials. In one study, he examined the use of remote pressure sensor monitoring for surveillance after endovascular aortic aneurysm repair. He also is working on the development of a prosthetic vein valve. His research has been funded by the Wallace H. Coulter Foundation.

A dedicated educator and mentor, Dr. Milner teaches medical students, residents and fellows about vascular disease management, including the use of aortic stents. In addition, he is frequently invited to speak at national and international conferences on vascular surgery and aortic aneurysms.

Policies and ethics