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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_3953_Библиотеки_им_академика_М_И_Перельмана
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Ascending Venography :::: 105
Transfemoral Descending Venography :::: 105
Transfemoral Ascending (Antegrade) Venography :::: 105
Intravascular Ultrasound :::: 107
Conclusion :::: 109
Key Points :::: 109
References :::: 110
10. Diagnosis of Deep Vein Thrombosis . . . .................... 113
Luis Leon and Nicos Labropoulos
Introduction and Magnitude of the Problem ::::
113
Pathophysiology :::: 113
Natural History of Venous Thrombosis :::: 114
Diagnosis :::: 116
Key Points :::: 125
References :::: 126
SECTION C: MANAGEMENT OF DEEP VENOUS THROMBOSIS
11. The Pathophysiology of Deep Venous Thrombosis ............ 131
Ahmad Bhatti and Nicos Labropoulos
Background ::::
131
Stasis :::: 131
Hypercoagulability :::: 132
Vessel Injury :::: 135
Other Causes :::: 135
Natural History of DVT :::: 136
Key Points :::: 137
References :::: 137
12. Epidemiology of Venous Thrombosis . . .................... 143
Patrick Kesteven
Introduction ::::
143
Historical Perspective :::: 143
Pathophysiology :::: 143
Incidence :::: 144
Risk Factors :::: 146
Rosendaal’s Multicausal Model and Recurrences :::: 151
Key Points :::: 151
References :::: 152
13. Venous Thromboembolism and Malignant Diseases . . . ........ 155
Paolo Prandoni, Andrea Piccioli, and Anna Falanga
Pathogenesis of Thrombosis in Cancer ::::
155
Epidemiology and Risk Factors of Thromboembolism
in Cancer Patients ::::
157
Thromboprophylaxis :::: 160
Contentsviii
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Treatment of Established Venous Thromboembolism :::: 161
Impact of Antithrombotic Drugs on Cancer Evolution
and Development ::::
162
Risk of Cancer in Patients with Venous Thromboembolism :::: 163
Key Points :::: 166
References :::: 166
14. Venous Thrombosis Prophylaxis . . ........................ 173
Joseph A. Caprini and Dereck W. Wentworth
Incidence and Magnitude of the Problem ::::
173
Risk Assessment :::: 176
Key Points :::: 189
References :::: 190
15. Venous Thrombolysis of the Extremities .................... 197
Ahmad Bhatti, Nicos Labropoulos, and Marc Borge
Introduction ::::
197
Indications :::: 197
Technique :::: 198
Flow-Directed Thrombolysis :::: 198
Catheter-Directed Thrombolysis :::: 198
Mechanical Thrombectomy :::: 199
Pharmacologic Adjuncts :::: 200
Outcome :::: 201
Key Points :::: 202
References :::: 203
16. Role of Surgery and Endovascular Therapies in Lower Limb
Deep Venous Thrombosis . . . ............................ 205
Olivier Hartung, Yues S. Alimi, and Claude Juhan
Aims of the Treatment ::::
205
Surgical Thrombectomy :::: 206
IVC Interruption and Filters :::: 214
Endovascular Techniques :::: 215
Respective Indications :::: 219
Key Points :::: 219
References :::: 220
17. Inferior Vena Cava Filters . . ............................ 223
Sumaira Macdonald
The Scope of the Clinical Problem ::::
223
Inferior Vena Cava Interruption: An Evolution :::: 224
Filter Types and Design :::: 225
Indications for Use :::: 226
The Use of Caval Filters Outside of the Trauma
Setting: The Evidence Base ::::
229
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Clinical Controversies Concerning Vena Cava Filters :::: 231
Key Points :::: 233
References :::: 233
SECTION D: VARICOSE VEINS
18. Etiology and Pathophysiology of Varicose Veins . . ............ 237
Jonathan Golledge
Introduction ::::
237
Risk Factors for Varicose Veins :::: 237
Duplex Findings in Varicose Veins :::: 237
Pathology of Varicose Veins :::: 238
Theories Regarding Varicose Vein Etiology :::: 238
Valve Dysfunction in Varicose Veins :::: 239
Primary Vein Wall Weakness and Varicose Veins :::: 240
Arteriovenous Communications and Varicose Veins :::: 241
Conclusion :::: 241
Key Points :::: 242
References :::: 242
19. Indications for Treatments of Varicose Veins ................ 245
Simon Palfreyman and Jonathan Michaels
Introduction ::::
245
Background :::: 245
Indications for Treatment of Varicose Veins :::: 249
Conclusion :::: 253
Key Points :::: 254
References :::: 254
20. Conservative Treatments: Medical/Drug Therapies . . . ........ 257
Stavros K. Kakkos, Michel Perrin, Keith F. Cutting,
and George Geroulakos
Compression ::::
257
Intermittent Pneumatic Compression :::: 261
Supervised Exercise :::: 261
Skin Substitutes :::: 261
Pharmacological Treatment of Chronic Venous Disorders :::: 263
Key Points :::: 269
References :::: 270
21. Surgical Treatment of Varicose Veins . . .................... 277
Steven S. Kang
Great Saphenous Vein Ligation and Stripping ::::
277
Small Saphenous Ligation and Stripping :::: 279
Stab Avulsions :::: 280
Postoperative Care :::: 281
Key Points :::: 281
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22. Assessment and Surgical Treatment of Recurrent
Varicose Veins ....................................... 283
James E. McCaslin, Ronald K. G. Eifell, and Gerard Stansby
Introduction ::::
283
Assessment :::: 283
Surgical Management :::: 284
Complications :::: 285
Conclusion :::: 285
Key Points :::: 285
References :::: 286
23. Surgical Treatments and New Technologies/
Day Care Strategies . . . ................................ 289
Ronald K. G. Eifell and Tim A. Lees
Introduction ::::
289
Surgical Treatments :::: 290
Saphenofemoral Disconnection (SFD) Combined
with LSV Stripping ::::
291
SFD Only :::: 292
Saphenopopliteal Junction Disconnection (SPJ) :::: 292
Saphenofemoral Junction (SFJ) Recurrence
and Redo Surgery ::::
293
Multiple Phlebectomies (Stab Avulsions) :::: 294
Perforator Surgery :::: 294
Open Perforator Surgery :::: 295
Heparin Prophylaxis :::: 295
Non-surgical procedures :::: 295
New Technologies :::: 297
Day Care Strategies :::: 309
Appendix I :::: 311
Appendix II :::: 312
Key Points :::: 312
References :::: 313
24. Varicose Veins, Pregnancy, and Venous Disorders
of the Pelvic Veins . . . . . ................................ 319
Linda de Cossart
Introduction ::::
319
Varicose Veins and Pregnancy :::: 319
Pelvic Congestion Syndrome :::: 326
Key Points :::: 330
References :::: 331
25. Superficial Vein Thrombosis: Natural History and
Clinical Significance . . . ................................ 335
Athanasios D. Giannoukas and Nicos Labropoulos
Demographic Characteristics ::::
335
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Varicose Veins, Location, and STP :::: 336
Hypercoagulable States and STP :::: 336
Pregnancy and STP :::: 337
Malignancy and STP :::: 337
DVT and STP :::: 338
PE and STP :::: 339
Diagnosis of STP :::: 340
Management of STP :::: 342
Final Remarks and Conclusion :::: 342
Key Points :::: 343
References :::: 343
26. Medicolegal Aspects ................................... 347
Bruce Campbell
Introduction ::::
347
Determining the Frequency of Medicolegal Claims :::: 347
Varicose Veins :::: 348
New Treatments for Varicose Veins :::: 349
Venous Thromboembolism as a Complication of
Varicose Vein Operations ::::
349
Venous Thromboembolism Requiring Expert Opinion :::: 350
Swollen Legs—Postphlebitic Syndrome and
Lymphatic Disease ::::
350
Communicating Risks and Benefits :::: 350
Spotting High-Risk Cases :::: 351
When Things Go Wrong :::: 352
The Uncertainties of Medicolegal Decisions :::: 352
Key Points :::: 353
References :::: 353
SECTION E: CHRONIC VENOUS INSUFFICIENCY
27. Pathophysiology of Leg Ulceration ........................ 355
Peter J. Pappas, Brajesh K. Lal, Walter N. Dura
´
n,
Frank T. Padberg, Jr., and Robert W. Zickler
Introduction ::::
355
The Venous Macrocirculation :::: 355
Varicose Veins :::: 356
Historical Theories of CVI :::: 359
Conclusion :::: 366
Key Points :::: 366
References :::: 367
28. Compression Therapy and Nursing Care
for Venous Leg Ulcers . . . ............................... 371
Jill Robson and Hany Hafez
Background ::::
371
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Assessment :::: 372
Treatment :::: 377
Compression :::: 377
Key Points :::: 381
References :::: 381
29. Surgical Therapies for Chronic Venous Disease:
Superficial Venous Surgery . . ............................ 383
Frank C. T. Smith
Introduction ::::
383
The Role of Superficial Incompetence in
Chronic Venous Insufficiency ::::
383
Surgery for Superficial Venous Reflux :::: 384
Key Points :::: 390
References :::: 391
30. Surgical Therapies in Chronic Venous Insufficiency:
Deep Venous Surgery/Valve Transplantation/SEPS . . . ........ 393
Michael C. Dalsing
Introduction ::::
393
Etiology/Pathophysiology of Valvular Damage :::: 394
Diagnosis :::: 395
Indications and Goals for Surgical Intervention :::: 397
Treatment Options and Results :::: 398
Summary :::: 403
Key Points :::: 403
References :::: 404
31. Management of Deep Venous Obstruction of the Lower
Extremity: Endovascular Intervention and Surgery . . . ........ 411
Peter Negle
´
n and Seshadri Raju
Introduction ::::
411
Venous Outflow Obstruction :::: 411
Diagnosis and Selection of Patients :::: 412
Open Surgical Reconstruction :::: 413
The Cross-Over Bypass :::: 413
The In-Line Bypass :::: 415
Sapheno-Popliteal Bypass :::: 416
Femoro-Ilio-Caval Stenting :::: 416
Iliocaval Stenting Following Thrombolysis/Thrombectomy
for Acute DVT ::::
419
Stenting of Chronic Nonmalignant Obstruction :::: 419
Endovascular Technique :::: 421
Summary :::: 423
Key Points :::: 423
References :::: 424
Contents xiii
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SECTION F: OTHER VENOUS CONDITIONS
32. Upper-Extremity Venous Thrombosis . . .................... 427
Klaus Overbeck, Shankat N. Khan, Gerard Stansby,
and Nicos Labropoulos
Introduction ::::
427
Etiology :::: 427
Clinical Presentation :::: 429
Assessment :::: 430
Management :::: 431
Natural History :::: 436
Conclusions :::: 436
Key Points :::: 437
References :::: 437
33. Mesenteric and Portal Vein Thrombosis .................... 445
Klaus Overbeck, Derek Manas, and Gerard Stansby
Introduction ::::
445
Mesenteric Venous Thrombosis :::: 445
Portal Vein Thrombosis :::: 449
Key Points :::: 454
References :::: 454
34. Superior Vena Caval Obstruction . ........................ 461
Enrico Ascher and Anil Hingorani
Etiology ::::
461
Presentation :::: 461
Diagnosis :::: 462
Treatment :::: 462
Key Points :::: 463
References :::: 464
35. Congenital Venous Malformations: Venous Tumors . . . ........ 467
Sachiendra V. Amaragiri and Nicos Labropoulos
Congenital Venous Malformations ::::
467
Venous Tumors :::: 475
Key Points :::: 478
References :::: 478
36. Popliteal Vein Entrapment . . . . . . ........................ 483
Seshadri Raju and Peter Negle
´
n
Incidence ::::
483
Clinical Features :::: 483
Venography :::: 484
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Other Imaging Techniques :::: 484
Functional Tests :::: 484
Pathology :::: 484
Operative Lysis :::: 486
Clinical Results :::: 486
Key Points :::: 487
References :::: 487
37. Management of Venous Trauma . . ........................ 489
Denis W. Harkin and Paul H. Blair
Introduction and Magnitude of Problem ::::
489
Pathophysiology of Venous Trauma :::: 490
Diagnosis of Venous Trauma :::: 492
Management Principles for Venous Trauma :::: 493
Extremity Venous Trauma :::: 496
Neck Venous Trauma :::: 501
Thoracic Venous Trauma :::: 503
Abdominal Venous Trauma :::: 505
Key Points :::: 507
References :::: 508
SECTION G: LYMPHATIC DISORDERS
38. Lymphedema: Clinical Features and Investigation ............ 511
Alok Tiwari and George Hamilton
Introduction ::::
511
Etiology of Lymphedema :::: 512
Key Points :::: 522
References :::: 522
39. Lymphedema: The Role of Conservative Medical and
Surgical Treatments . . . ................................ 527
Alok Tiwari and George Hamilton
Introduction ::::
527
Aim of Treatment :::: 527
Conservative Treatment :::: 527
Medical Treatment :::: 530
Surgical Treatment :::: 531
Limb Reduction Procedures :::: 531
Bypass Procedures :::: 532
Prophylactic Surgery :::: 533
Summary :::: 534
Key Points :::: 534
References :::: 534
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40. Surgical Management of Chylous Ascites and Chylothorax . .... 537
Ian Nichol
Chylous Ascites ::::
537
Chylothorax :::: 543
Key Points :::: 544
References :::: 545
Index :::: 549
Contentsxvi
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Contributors
Yues S. Alimi Service de Chirurgie Vasculaire, Centre Hospitalier Universitaire Nord,
Marseille, France
Sachiendra V. Amaragiri Freeman Hospital, University of Newcastle upon Tyne,
Newcastle upon Tyne, U.K.
Enrico Ascher Division of Vascular Surgery, Department of Surgery, Maimonides
Medical Center, Brooklyn, New York, U.S.A.
Ahmad Bhatti Division of Vascular Surgery, Loyola University Medical Center,
Maywood, Illinois, U.S.A.
Paul H. Blair Regional Vascular Surgery Unit, Royal Victoria Hospital, Belfast,
Northern Ireland
Marc Borge Interventional Radiology, Department of Radiology, Loyola
University Medical Center, Maywood, Illinois, U.S.A.
Alberto Caggiati Department of Anatomy, University “La Sapienza,” Rome, Italy
Bruce Campbell Royal Devon and Exeter Hospital, Exeter, U.K.
Joseph A. Caprini Feinberg School of Medicine, Northwestern University, Chicago,
Illinois; Evanston Northwestern Healthcare, Evanston, Illinois; and Glenbrook Hospital,
Glenview, Illinois, U.S.A.
Keith F. Cutting Vascular Unit, Ealing Hospital, Southall, U.K.
Michael C. Dalsing Indiana University School of Medicine, Indianapolis, Indiana, U.S.A.
Gudmundur Danielsson Department of Vascular Diseases, Lund University,
Lund, Sweden
Alun H. Davies West of London Vascular Service, Charing Cross Hospital,
London, U.K.
Meryl Davis West of London Vascular Service, Charing Cross Hospital, London, U.K.
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