Operative Techniques in Arterial Surgery

1. Basic Techniques.- Arterial mobilization.- Arterial control.- Heparinization.- Making and closing an arteriotomy.- Vascular sutures.- Basic suture technique.- End-to-end anasiomosis.- End-to-side anastomosis.- Patch graft angioplasty.- Endarterectomy.- Vascular grafts.- 2. Aneurysms of the Abdominal Aorta.- Preoperative assessment.- Preoperative preparation.- Intraoperative support measures.- Operative technique.- Inflammatory aneurysm.- Mycotic aneurysm.- Coexistent renal or visceral artery occlusive disease.- Accessory renal arteries.- Horseshoe kidney.- Aortic aneurysms involving the renal arteries.- Thoracoabdominal aortic aneurysms.- Ruptured infrarenal aortic aneurysm.- Unusual types of rupture.- 3. Aortoiliac Occlusive Disease.- Endarterectomy.- Bypass grafting.- Percutaneous transluminal angioplasty.- Preoperative assessment.- Aortofemoral bypass.- Variations.- Juxtarenal aortic occlusion.- Associated renal or visceral artery occlusive disease.- Retroperitoneal aortofemoral bypass.- Iliofemoral bypass.- Femorofemoral bypass.- Axillofemoral bypass.- Endarterectomy of the aorta and common iliac arteries.- Combined endarterectomy and bypass.- Iliofemoral endarterectomy.- 4. Surgery of the Common Femoral Bifurcation.- Pathology of the profunda femoris.- Exposure of the common femoral bifurcation and profunda femoris.- Techniques of reconstruction.- Common femoral aneurysms.- 5. Femoropopliteal Surgery.- General Considerations.- Essentials in femoro-distal bypass.- Graft material.- Bypass to the Popliteal Artery.- In situ vein bypass to the distal popliteal artery.- Variations.- Reversed vein bypass.- Bypass to the proximal popliteal artery.- Bypass to the isolated popliteal segment.- Femorotibial and Femoroperoneal Bypass.- Bypass to the posterior tibial artery.- Bypass to the anterior tibial artery.- Bypass to the peroneal artery.- Popliteal Aneurysms.- Surgical management.- Other Popliteal Conditions.- Popliteal entrapment.- Adductor canal syndrome.- Adventitial cystic disease of the popliteal artery.- Complications Of Femoropopliteal Surgery.- Wound complications.- Early graft occlusion.- Degenerative changes in vein grafts.- Late graft occlusion.- False aneurysm.- Infection.- 6. Arterial Embolization.- The management of major limb embolization.- Late embolectomy.- Advanced ischaemia.- Embolectomy in the presence of atherosclerosis.- Embolectomy in the upper limb.- Non-limb embolization.- Complications associated with use of the Fogarty catheter.- 7. Vascular Injuries.- General Considerations.- Operative management.- Late revascularization.- Traumatic false aneurysms.- Arteriovenous fistulae.- Regional Considerations.- Common femoral artery.- Popliteal artery.- Infrapopliteal vessels.- Vascular injuries associated with fractured pelvis.- Abdominal aorta.- Inferior vena cava and hepatic veins.- Carotid artery injuries.- Subclavian artery.- Axillary artery.- Brachial artery.- Radial and ulnar arteries.- Fasciotomy in the upper limb.- 8. Arteriovenous Fistulae.- Acquired Arteriovenous Fistulae.- Investigation.- Operative management.- Embolization.- Congenital Arteriovenous Fistulae.- Management.- 9. Surgery of the Carotid Bifurcation.- Carotid Endarterectomy.- Indications for surgery.- Contraindications to surgery.- Timing of operation.- Diagnostic studies.- Associated risk factors.- Cerebral protection during carotid surgery.- Technique of carotid endarterectomy.- Early postoperative complications.- Late postoperative complications.- The occluded internal carotid artery.- External carotid endarterectomy.- Internal Carotid Artery Bypass.- Indications.- Technique.- Other Lesions at the Carotid Bifurcation.- Kinking, coiling and tortuosity of the internal carotid artery.- Fibromuscular dysplasia.- Spontaneous dissection of the internal carotid artery.- Extracranial carotid artery aneurysms.- Carotid body tumours.- 10. Aortic Arch and Vertebral Revascularization.- Vertebral Artery Surgery.- Exposure of the vertebral artery.- Vertebral endarterectomy.- Reimplantation of the vertebral artery.- Subclavian-vertebral bypass.- Percutaneous transluminal angioplasty.- Revascularization of the distal vertebral artery.- Subclavian Artery Reconstruction.- Carotid-subclavian bypass.- Subclavian-carotid reimplantation.- Subclavian endarterectomy.- Crossover grafts.- Transluminal angioplasty.- Innominate Artery Reconstruction.- Ascending aorto-distal innominate bypass.- Innominate endarterectomy.- Transcervical bypass.- Common Carotid Artery Reconstruction.- Common carotid thromboendarterectomy.- Subclavian-carotid bypass.- Carotid-subclavian reimplantation.- Aorto-carotid bypass.- Multiple Arch Lesions.- Takayasu’s disease.- 11. Thoracic Outlet Syndrome and Upper Limb Revascularization.- Thoracic Outlet Syndrome.- Management.- Transaxillary resection of first rib.- Modification of the Roos technique.- Supplementary procedures.- Complications of transaxillary rib resection.- Alternative approaches for first rib resection.- Scalenectomy.- Arterial complications of the thoracic outlet syndrome.- Venous complications of the thoracic outlet syndrome.- Occlusive Arterial Disease of the Upper Limb.- Proximal disease.- Distal disease.- Upper Limb Aneurysmal Disease.- 12. Surgery of the Visceral Arteries.- Chronic Intestinal Ischaemia.- Bypass grafts.- Endarterectomy.- Reimplantation.- Transluminal angioplasty.- Coeliac artery compression syndrome.- Acute Intestinal Ischaemia.- Superior mesenteric artery embolization.- Superior mesenteric artery thrombosis.- Non-occlusive mesenteric ischaemia.- Superior mesenteric vein thrombosis.- Visceral Artery Aneurysms.- Splenic artery aneurysms.- Hepatic artery aneurysms.- Coeliac artery aneurysms.- Superior mesenteric artery aneurysms.- 13. Surgery of the Renal Arteries.- Renovascular surgery vs. transluminal angioplasty.- Pre- and intraoperative management.- Antegrade aortorenal bypass.- Retrograde aortorenal bypass.- Management of branch artery lesions.- Autotransplantation.- Other types of bypass.- Transaortic renal endarterectomy.- Combined aortic and renal artery surgery.- Coarctation of the abdominal aorta.- Renal artery aneurysms.- 14. Complications of Aortic Surgery.- Early Complications in the Reconstruction Zone.- Haemorrhage.- Thrombosis.- Arterial occlusion distal to the reconstruction.- Late Complications in the Reconstruction Zone.- Late graft occlusion.- Late endarterectomy failure.- False aneurysms.- Complications Outside the Reconstruction Zone.- Visceral ischaemia.- Renal and ureteric complications.- Sexual dysfunction.- Spinal cord ischaemia.- Infection in Aortic Surgery.- Management of infection in the groin.- Management of intra-abdominal graft infection.- Aortoenteric fistulae.- Prevention of infection in aortic surgery.- 15. Percutaneous Angioplasty.- Peripheral Angioplasty.- Indications.- Complications.- Technique.- Contralateral (crossover) angioplasty.- Angioplasty of vessels requiring selective Catheterization.- Renal angioplasty.- Angioplasty of other areas and of non-atheromatous lesions.- Fibrinolytic Therapy.