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Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_3599_Библиотеки_им_академика_М_И_Перельмана

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x Experts
Professor Małgorzata Szczerbo-Trojanowska
Professor of Interventional Radiology Department of Interventional Radiology and Neuroradiology Medical University of Lublin Lublin Poland
Professor Peter Taylor
Professor of Vascular Surgery King’s College London Department of Vascular Surgery Guy’s and St Thomas’ NHS Foundation Trust London UK
Professor Anthony Watkinson
Professor of Interventional Radiology The Peninsular Medical School Department of Radiology Royal Devon and Exeter Hospital NHS Foundation Trust Exeter UK
Dr Andrew Winterbottom
Consultant Vascular and Interventional Radiologist Department of Radiology Cambridge University Hospitals NHS Foundation Trust Cambridge UK

CONTRIBUTORS

Dr Ali Alsafi
Specialist Registrar in Clinical Radiology Imperial College Healthcare NHS Trust London UK
Dr Christopher Burke
Fellow in Interventional Radiology Department of Radiology Guys’ and St Thomas’ NHS Foundation Trust London UK
Dr Alessandro Cannavale
Specialist Registrar in Radiology Vascular and Interventional Radiology Unit Department of Radiological Sciences Sapienza University Hospital Rome Italy
Dr Andrew Christie
Consultant Interventional Radiologist Department of Interventional Radiology Gartnavel General Hospital Glasgow UK
Dr Raj Das
Consultant Interventional Radiologist Department of Radiology St George’s University Hospitals NHS Foundation Trust London UK
Dr Athanasios Diamantopoulos
Consultant Vascular and Interventional Radiologist Department of Radiology Guy’s and St Thomas’ NHS Foundation Trust London UK
Dr Nicos Fotiadis
Consultant Interventional Radiologist Department of Radiology The Royal Marsden NHS Foundation Trust London UK
Dr Angie Galea
Specialist Registrar in Clinical Radiology Peninsula Radiology Academy Plymouth UK
Dr Raymond Chung
Fellow in Interventional Radiology Department of Radiology St George’s University Hospitals NHS Foundation Trust London UK
Mrs Rachel Clough
Vascular and Endovascular Fellow Department of Vascular Surgery Guy’s and St Thomas’ NHS Foundation Trust London UK
Dr Bhaskar Ganai
Lecturer in Interventional Radiology Royal College of Surgeons in Ireland Department of Radiology Beaumont Hospital Dublin Ireland
Dr Richard Guinness
Consultant Radiologist Royal Devon and Exeter Hospital NHS Foundation Trust Exeter UK
xii Contributors
Dr Venus Hedayati
Consultant Radiologist Department of Radiology King’s College Hospital NHS Foundation Trust, London UK
Dr Riccardo Inchingolo
Interventional Radiologist Diagnostic and Interventional Radiology Unit “Madonna delle Grazie” Hospital Matera Italy
Dr Magdalena Jarząbek
Fellow in Interventional Radiology, Department of Interventional Radiology and Neuroradiology Lublin University Hospital Lublin Poland
Dr Panagiotis Kitrou
Vascular and Interventional Radiologist Department of Interventional Radiology Patras University Hospital Rio Greece
Dr Miltiadis Krokidis
Consultant Vascular and Interventional Radiologist Department of Radiology Cambridge University Hospitals NHS Foundation Trust Cambridge UK
Dr Peter Mezes
Consultant Interventional Radiologist North Bristol NHS Trust Bristol UK
Dr Gianluigi Orgera
Interventional Radiologist Department of Radiological Oncological and Pathological Sciences Sapienza University of Rome Rome Italy
Dr Aneeta Parthipun
Fellow in Interventional Radiology Department of Radiology Guys’ and St Thomas’ NHS Foundation Trust London UK
Dr Vyzantios Pavlidis
Specialist Registrar in Radiology Second Department of Radiology Attikon University Hospital Athens University Medical School Athens
Mr Shirish Prabhudesai
Specialist Registrar in Surgery Department of Biosurgery and Surgical Technology Imperial College St Mary’s Hospital London UK
Mr Christos Lioupis
Vascular and Endovascular Fellow Department of Vascular Surgery Guy’s and St Thomas’ NHS Foundation Trust London UK
Dr Leto Maili
Consultant Vascular and Interventional Radiologist Department of Radiology St George’s University Hospitals NHS Foundation Trust London UK
Dr Nadeem Shaida
Consultant Vascular and Interventional Radiologist Department of Radiology Cambridge University Hospitals NHS Foundation Trust Cambridge UK
Dr Aidan Shaw
Fellow in Interventional Radiology Department of Radiology Guy’s and St Thomas’ NHS Foundation Trust London UK
xiiiContributors
Dr Stavros Spiliopoulos
Vascular and Interventional Radiologist Department of Interventional Radiology Patras University Hospital Rio Greece
Dr Victoria St Noble
Specialist Registrar in Clinical Radiology Department of Radiology Royal Brompton Hospital London UK
Dr Kendrick Tang
Specialist Registrar in Radiology Department of Radiology Pamela Youde Nethersole Eastern Hospital Chai Wan Hong Kong
Dr Piotr Trojanowski
ENT Surgeon, ENT Department Lublin University Hospital Lublin Poland
Dr Georgia Tsoumakidou
Interventional Radiologist Department of Radiology University Hospital of Strasbourg Strasbourg France
Dr Piero Venetucci
Vascular and Interventional Radiologist, Department of Cardiovascular and Interventional Radiology University Hospital Federico II Naples Italy

ABBREVIATIONS

A&E Accident and Emergency AAA abdominal aortic aneurysm ABC aneurysmal bone cyst ABF aorto-bifemoral ABI ankle–brachial pressure index ABPI ankle–brachial pressure index ACCF American College of Cardiology
Foundation ACT activated clotting time ADHF acute decompensated heart failure AFP alpha-fetoprotein AHA American Heart Association ALI acute limb ischaemia ALP alkaline phosphatase AP anteroposterior aPTT activated partial
thromboplastin time ASA American Society of
Anesthesiologists AST aspartate aminotransferase ATA anterior tibial artery AV arteriovenous AVM arteriovenous malformation BAE bronchial artery embolization BCLC pathway Barcelona Clinic Liver Cancer
pathway BCS Budd–Chiari syndrome BMS bare metal stent BPH benign prostate hypertrophy BTK below the knee CAS carotid artery stenting CCA common carotid artery CCT controlled clinical trial CDT catheter-directed thrombolysis CDU clinical decision unit, colour
Doppler ultrasound CEA carotid endarterecomy ce-CT contrast-enhanced computed
tomography CEMRA contrast-enhanced magnetic
resonance angiography CFA common femoral artery
CI condence interval CIA common iliac artery CKD chronic kidney disease CLI critical limb ischaemia COPD chronic obstructive pulmonary
disease CPR cardiopulmonary resuscitation Cr creatinine CSS cancer-specic survival CT computed tomography CTA CT angiography CTO chronic total occlusion CXR chest X-ray DEB drug-eluting balloon DFS disease-free survival DIC disseminated intravascular
coagulopathy DIPS direct intrahepatic portocaval
shunt DL diffusing capacity of lung for
carbon monoxide DMSO dimethyl sulphoxide DP dorsalis pedis DPA descending palatine artery,
dorsalis pedalis artery DSA digital subtraction angiography DU Doppler ultrasound DVT deep vein thrombosis ECA external carotid artery ECG electrocardiogram ECOG Eastern Cooperative Oncology
Group EDV end diastolic velocity eGFR estimated glomerular ltration
rate EIA external iliac artery EL endoleak ePTFE expanded polytetrauoroethylene ESC European Society of Cardiology ET essential thrombocythemia EVAR endovascular aortic repair FA facial artery
xvAbbreviations
FAST focused abdominal
ultrasonography FDG udeoxyglucose FEV1 forced expiratory volume
in 1 second FEVAR fenestrated endovascular aortic
repair FiO2 fraction of inspired oxygen FNA ne-needle aspiration FVC forced vital capacity GA general anaesthetic GCS Glasgow coma scale GFR glomerular ltration rate GGT gamma glutamyl transferase GI gastrointestinal GP general practitioner GTN glyceryl trinitrate Hb haemoglobin HCC hepatocellular carcinoma HE hepatic encephalopathy HFDU high-frequency duplex ultrasound HHT hereditary haemorrhagic
telangiectasia HoLAP holmium laser ablation of the
prostate HR hazard ratio HTC haematocrit HU Hounseld unit ICA internal carotid artery ICBT intercostal bronchial trunk ICER incremental cost-effectiveness
ratio ICU intensive care unit IIAOB internal iliac artery occlusion
balloon IM intramuscular IMA internal mammary artery, internal
maxillary artery INR international normalized ratio IPSS International Prostate
Symptom Score ISR in-stent re-stenosis ISV internal spermatic vein IVC inferior vena cava IVUS intravascular ultrasound JRA juxtarenal aneurysm LAD left anterior descending artery LAO lateral anterior oblique
LCA lateral calcaneal artery LPA lateral plantar artery LSA left subclavian artery LUTS lower urinary tract symptoms MAI mycobacterium avium-
intracellulare MCA medial calcaneal artery MDCTA multidetector computed
tomography angiography MDT multidisciplinary team MELD Model for End-Stage Liver Disease MFS metastasis-free survival MI myocardial infarction MIP multiple intensity projection MPA medial plantar artery MPR multiplanar reconstruction MRA magnetic resonance angiography MRI magnetic resonance imaging NAFLD non-alcoholic fatty liver disease NBCA n-butyl cyanoacrylate NIHSS National Institutes of Health
Stroke Scale NSCLC non-small-cell lung cancer NTT number needed to treat od once daily OLT orthotopic liver transplantation OS overall survival OSR open surgical repair PA peroneal artery PaCO2 partial pressure of carbon dioxide
in arterial blood PAD peripheral arterial disease PAE pelvic arterial embolization,
prostate artery embolization PaO2 partial pressure of oxygen in
arterial blood PAOD peripheral arterial occlusive
disease PCA patient-controlled anaesthesia PCD phlegmasia cerulea dolens PE pulmonary embolism PEI percutaneous ethanol injection PET positron emission tomography PMMA polymethylmethacrylate PMT pharmacomechanical
thrombectomy PN partial nephrectomy PP pampiniform plexus
xvi Abbreviations
PR per rectum PSA prostate-specic antigen PSV peak systolic velocity PT posterior tibia, prothrombin time PTA percutaneous transluminal
angioplasty, posterior tibial artery PTFE polytetrauoroethylene PTS post thrombotic syndrome PTT partial thromboplastin time PV percutaneous vertebroplasty PVA polyvinyl alcohol PVD peripheral vascular disease RAS renal artery stenosis RCC renal cell carcinoma RCT randomized controlled trial RFS recurrence-free survival r-tPA recombinant tissue plasminogen
activator SAFARI subintimal arterial ossing with
antegrade–retrograde intervention SEMS self-expanding metallic stent SFA supercial femoral artery SIA sub-intimal angioplasty SIRT selective internal radiation
treatment SLA superior labial artery SMA superior mesenteric artery SPA sphenopalatine artery SUV standard uptake value SVC superior vena cava SVS Society for Vascular Surgery
TAA thoracic aortic aneurysm TACE transarterial chemoembolization TAD thoracic aortic dissection TASC Transatlantic Inter-Society
Consensus
TEVAR thoracic endovascular aortic
repair TIA transient ischaemic attack TIPS transjugular intrahepatic
portosystemic shunt TLC total lung capacity TLR target-lesion revascularization TOE transoesophageal
echocardiography tPA tissue plasminogen activator TUEVP transurethral electrovaporization
of the prostate TUR transurethral resection TURP transurethral resection of the
prostate UCSD ultrasound colour Doppler UFE uterine broid embolization US ultrasound UTI urinary tract infection VA alveolar volume VAS visual analogue score VC vital capacity VCF vertebral compression fracture VRT volume rendering technique VTE venous thromboembolism
WIT warm ischaemia time
SECTION 1
Aortic pathology and peripheral arterial disease
Case 1 Thoracic endoprostheses for type B aortic dissections
Case 2 Management of endoleaks after thoracic endografts
Case 3 Juxtarenal abdominal aortic aneurysms: fenestrations
versus chimneys
Case 4 Management of endoleaks after abdominal aneurysm
endovascular repair
Case 5 Carotid artery stenting: how to treat restenosis
Case 6 Iliac artery occlusions: surgical bypass, covered and
uncovered stents
Case 7 SFA endoluminal bypass: the new era of critical limb
ischaemia treatment
Case 8 Below the knee angioplasty: bare versus drug-eluting
stents
Case 9 Thrombolysis for acute lower limb ischaemia
Case 10 Renal artery stenosis: angioplasty or stent?
Case 11 Below the ankle angioplasty: treatment rationale and
access techniques
CASE
1
Thoracic endoprostheses for type B aortic dissections
Christos Lioupis and Rachel Clough
Expert commentary Peter Taylor
Case history
A 45-year-old man who was previously t and well presented to the Accident and Emergency (A&E) department of a community hospital with a four-hour history of chest and abdominal pain, right loin pain, and loss of sensation of the right leg. His brother had died suddenly at the age of 38 of an unexplained cause. On examination his blood pressure was 170/110. There was a pulsatile mass in his left supraclavicu­lar fossa. His abdomen was soft and non-tender, and there were no pulses palpable in the right leg which had loss of sensation below the knee.
A computed tomography (CT) angiogram showed an aneurysm of the left sub­clavian artery and an acute type B aortic dissection. The primary entry tear was located in the proximal descending thoracic aorta, just distal to the left subclavian artery. The right vertebral artery was dominant. There was evidence of true lumen collapse, with no lling of the right renal and partial occlusion of the right common iliac arteries (Figure 1.1).
Clinical tip
Immediate treatment with analgesia and antihypertensive medication was started before transfer to our hospital. The patient underwent urgent endovascular treatment because the acute type B dissection was complicated by both renal and critical right lower limb ischaemia.
The CT scan demonstrated a 90° angulation of the aorta just distal to the origin of the left subclavian at its junction with the descending thoracic aorta. Coverage of the origin of the left subclavian artery was intended to secure an adequate proximal land­ing zone. The device was minimally oversized based on the non-dissected transverse aortic arch. The intima to intimal diameter was 25.5mm, the adventitia to adventitial diameter was 31.6mm, and the maximum diameter including the surrounding haema­toma was 40.3mm. A cTAG device (W.L. Gore & Associates, Flagstaff, AZ) measuring 31mm in diameter by 150mm in length was selected to provide no oversizing com­pared with the adventitia to adventitial diameter.
Expert comment
The use of a compliant device was essential to accommodate the 90° angulation in the aorta distal to the left subclavian artery origin. A short device was chosen to minimize the risk of paraplegia; the risk of this was increased because the left subclavian artery was covered by the device.
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