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Medical Radiology
Diagnostic Imaging
Series Editors
Maximilian F. Reiser
Hedvig Hricak
Michael Knauth
Editorial Board
Andy Adam, London
Fred Avni, Brussels
Richard L. Baron, Chicago
Carlo Bartolozzi, Pisa
George S. Bisset, Durham
A. Mark Davies, Birmingham
William P. Dillon, San Francisco
D. David Dershaw, New York
Sam Sanjiv Gambhir, Stanford
Nicolas Grenier, Bordeaux
Gertraud Heinz-Peer, Vienna
Robert Hermans, Leuven
Hans-Ulrich Kauczor, Heidelberg
Theresa McLoud, Boston
Konstantin Nikolaou, Munich
Caroline Reinhold, Montreal
Donald Resnick, San Diego
Rüdiger Schulz-Wendtland, Erlangen
Stephen Solomon, New York
Richard D. White, Columbus
For further volumes:
http://www.springer.com/series/4354
Mark G. Cowling
Editor
Vascular Interventional
Radiology
Current Evidence in Endovascular Surgery
Second Edition
123
Foreword by
Maximilian F. Reiser
Editor
Mark G. Cowling
Department of Radiology
University Hospital North Staffordshire
Stoke-on-Trent
UK
ISBN 978-3-642-27877-8 ISBN 978-3-642-27878-5 (eBook)
DOI 10.1007/978-3-642-27878-5
Springer Heidelberg New York Dordrecht London
Library of Congress Control Number: 2012947065
Ó Springer-Verlag Berlin Heidelberg 2012
This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned,
specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilm
or in any other way, and storage in data banks. Duplication of this publication or parts thereof is permitted only under the
provisions of the German Copyright Law of September 9, 1965, in its current version, and permission for use must
always be obtained from Springer. Violations are liable to prosecution under the German Copyright Law.
The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the
absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and
therefore free for general use.
Product liability: The publishers cannot guarantee the accuracy of any information about dosage and application
contained in this book. In every individual case the user must check such information by consulting the relevant
literature.
Printed on acid-free paper
Springer is part of Springer Science+Business Media (www.springer.com)
For Lynn, Thomas and Oliver
Mark Cowling
https://t.me/med1917
Foreword
Interventional treatment in vascular disorders, both arterial and venous, has greatly
progressed in recent years. The socio-economic impact of these diseases is continuously
growing, not least because of the demographic changes. Since atherosclerosis is a disease
with gradual progression, the longevity of populations results in a higher incidence of
peripheral arterial obstructive diseases and aortic aneurysms. Moreover, the aging
population is frequently also affected by multiple other diseases so that minimally
invasive procedures are warranted.
Recent developments in imaging and interventional techniques allow for a more
accurate and less invasive diagnosis and a higher success rate in vascular interventions.
Well-designed multicenter trials in large patient populations have been performed which
provide increasing knowledge concerning clinical efficacy of various treatment options
in the management of patients suffering from arterial and venous vascular diseases.
These changes had major impacts on the practice of vascular interventions and made
an update of ‘‘Vascular Interventional Radiology’’ most desirable. The series editors of
Medical Radiology/Diagnostic Imaging are most indebted to Dr. Cowling and the co-
authors of this book for having taken the effort to update this important work. It
contains valuable and state-of-the-art information about vascular interventions in all
important vascular territories, both venous and arterial. The procedures enabling for
accurate diagnostics of the vessels, such as CT- and MR-angiography are dealt with.
There are also practically important chapters which help to guide the practitioner in the
daily work.
We are confident that this book will find enthusiastic acceptance by the readers.
Specialists of interventional radiology, vascular surgery, angiology, neurology, and
other disciplines may find valuable and concise information.
Munich Maximilian F. Reiser
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Preface
Since the publication of the first edition of this book 6 years ago there have been further
significant advances in endovascular therapy. As our patients survive longer because of
advances in treatment in other areas, such as coronary artery disease, peripheral vas-
cular disease is becoming an increasingly common problem. In addition, those requiring
treatment are increasingly likely to be elderly and less able to tolerate open surgical
procedures. Increasingly, published evidence supports the use of endovascular therapies
for a wide range of vascular conditions. While they are applicable to the whole spectrum
of patients, such procedures can be of particular benefit to those with significant co-
morbidities that can make open surgery hazardous.
Although in some countries the prevalence of smoking appears to be reducing in
response to public health measures, other risk factors such as hypertension and hy-
perlipidaemia remain common. In addition, the incidence of diabetes is actually
increasing, probably in association with obesity. As a result, there has been a gradual
shift in the type of peripheral vascular disease we now encounter clinically, so that
diabetic foot problems are much more prevalent than previously, for example.
It is possible to diagnose peripheral vascular problems non-invasively using Doppler
ultrasound, Computerised Tomographic angiography, and Magnetic Resonance angi-
ography. These techniques serve to further lower the risk involved in managing these
patients, as well as potentially reducing cost and as a result routine diagnostic catheter
angiography is now effectively a thing of the past. In recent years there have been
significant developments in the management of diabetic foot disease as well as further
developments in the management of aortic aneurysms, notably with the publication of
major clinical trials demonstrating the safety and efficacy of the endovascular aneurysm
repair.
There are also significant advances in management of venous disorders, such as
endovenous laser therapy for varicose veins, showing that Interventional Radiologists
have skills that can be applied ever more widely to assist in the management of
important clinical problems. This volume aims to provide up-to-date evidence on both
established and developing techniques. It is only with such information that practitio-
ners can encourage their more widespread use.
I would like to thank all of the authors who have contributed to this volume. I would
also like to thank Corinna Schaefer and Martina Wiese from Springer who have ably
supported me during this project.
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Contents
The Aetiology of Vascular Disease .................................... 1
R. D. Wells
Assessment of Peripheral Vascular Disease.............................. 9
Mark G. Cowling
Equipment and Environment........................................ 15
Vikramaditya Prabhudesai
Consent in Interventional Radiology .................................. 19
F. Coccia and J. S. Freedman
Drugs Used in Vascular Interventional Radiology......................... 25
Gordon Dent and Mark G. Cowling
Day Case Vascular Intervention...................................... 33
Ounali S. Jaffer, Dean Y. Huang, and Paul S. Sidhu
Sites of Arterial Access and the Role of Closure Devices in Percutaneous
Arterial Intervention .............................................. 43
Jon K. Bell and Nicholas Chalmers
Aortoiliac Intervention ............................................ 53
Rafiuddin Patel and Anthony A. Nicholson
Femoropopliteal Arterial Intervention ................................. 69
Stefan Müller-Hülsbeck and Heide Preuß
Crural Arterial Interventions........................................ 81
J. Reekers
Thrombolysis, Mechanical Thrombectomy and Percutaneous
Aspiration Thrombectomy .......................................... 89
Gerard S. Goh, Robert Morgan, and Anna-Maria Belli
Upper Limb Arterial Intervention .................................... 101
Douglas R. Turner and Steven M. Thomas
Carotid and Vertebral Artery Intervention ............................. 111
Stephen D. Goode and Trevor J. Cleveland
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Management of Renal and Visceral Arterial Stenoses ...................... 121
M. G. Cowling
Endovascular Abdominal Aortic Aneurysm Repair........................ 131
Andrew England, Micheal Murphy, and Richard G. McWilliams
Endovascular Repair of Thoracic Aortic Aneurysms ...................... 153
H. Rousseau, J. Auriol, C. Lions, V. Benouaich, E. Grunenwald,
V. Chabbert, B. Marcheix, C. Cron, M. A. Marachet, and P. Otal
Endovascular Repair of Iliac, Visceral and False Aneurysms ................ 167
Ralph Jackson and John Rose
Dialysis Access Management ........................................ 179
J. R. Asquith
Management of Venous Stenoses and Venous Thrombosis .................. 191
J. R. Asquith
Inferior Veno-Caval Filters ......................................... 201
Matthew Matson
Management of Venous Insufficiency .................................. 207
D. J. West
Index ......................................................... 217
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Contributors
J. R. Asquith University Hospital of North Staffordshire NHS Trust, Newcastle Road,
Stoke-on-Trent, ST4 6QG, UK, e-mail: john.asquith@uhns.nhs.uk
J. Auriol Department of Radi ology, University Hospital, Rangueil, 1, Av. Jean Poulhes,
TSA 50 032, Toulo use Cedex 9, France
Jon K. Bell Department of Radiology, Manchester Royal Infirmary, Oxford Road,
Manchester M13 9WL, UK
Anna-Maria Belli Department of Radiology, St George’s Hospital, Blackshaw Road,
London SW17 0QT, UK
V. Benouaich Department of Cardiovascular Surgery, University Hospi tal, Rangueil, 1,
Av. Jean Poulhes, TSA 50 032, Toulouse Cedex 9, France
V. Chabbert Department of Radiology, University Hospital, Rangueil, 1, Av. Jean
Poulhes, TSA 50 032, Toulouse Cedex 9, France
Nicholas Chalmers Department of Radiology, Manchester Royal Infirmary, Oxford
Road, Manchester M13 9WL, UK, e-mail: Nicholas.Chalmers@cmft.nhs.uk
Trevor J. Cleveland Sheffield Vascular Institute, Northern General Hospital, Herries
Road, Sheffield, UK
F. Coccia Birmingham and Solihull Mental Health, NHS Foundation Trust, The Bar-
berry, 25 Vincent Drive, Edgbaston, Birmingham B15 2FG, UK
Mark G. Cowling University Hospital of North Staffordshire, NHS Trust, Newcastle
Road, Stoke-on-Trent, ST4 6QG, UK, e-mail: mark.cowling@uhns. nhs.uk
C. Cron Department of Cardiovascular Surgery, University Hospital, Rangueil, 1, Av.
Jean Poulhes, TSA 50 032, Toulouse Cedex 9, France
Gordon Dent Institute of Science and Technology in Medicine, Keele University, Keele,
Staffordshire ST5 5BG, UK, e-mail: g.dent@hfac.keele.ac.uk
Andrew England Royal Liverpool University Hospital, Liverpool, UK
J. S. Freedman Heart of England NHS Foundation Trust, Heartlands Hospital, Bordesley
Green East, Birmingham B9 5SS, UK, e-mail: jonathan.freedman@heartofengland.nhs.uk
Gerard S. Goh Department of Radiology, St George’s Hospital, Blackshaw Road, Lon-
don SW17 0QT, UK, e-mail: Gerar d.Goh@stgeorges.nhs.uk
Stephen D. Goode Sheffield Vascular Institute, Northern General Hospital, Herries Road,
Sheffield, UK, e-mail: s.goode@sheffield.ac.uk
E. Grunenwald Department of Cardiovascular Surgery, University Hospital, Rangueil, 1,
Av. Jean Poulhes, TSA 50 032, Toulouse Cedex 9, France
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