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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_4041_Библиотеки_им_академика_М_И_Перельмана
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194
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J. Xu and D.E. Hall
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195© Springer International Publishing AG 2017
R. Chaer (ed.), Vascular Disease in Older Adults,
DOI 10.1007/978-3-319-29285-4
A
Abdominal aortic aneurysms (AAA) repair,
10–12, 59, 60, 62, 63, 127,
129–131, 133–139
anxiety/depression, 9
beneficial effects, 5
complications, 9
controversy, 10
COPD, 8
cost-effectiveness, 8
definition, 1
effectiveness, 7
endograft, 132
endovascular repair, 59–60
identification, 1
imaging modalities, 5
LaPlace’s law, 4
MASS trial, 5
meta-analysis, 5
open AAA repair, 60–63, 132
operative management, 9
population-based screening RCTs, 8
prevalence, 6, 7
RCTs, 5
reduction, 5
repair, 1, 4
risk factors, 4
SAAAVE Act (see SAAAVE Act)
screening guidelines, 2–3
smoking, 8
statistical analysis plans, 6
surgical and surveillance planning,
4, 6
systematic review, 4
ultrasound, 5, 10
US Veterans Affairs screening study, 59
vascular health problem, 1
vessel wall weakens, 1
Viborg trials, 6
wall tension, 4
women, 7
Action in Diabetes and Vascular diseases
(ADVANCE), 114
Action to Control Cardiovascular Risk in
Diabetes (ACCORD), 114
Activated clotting time (ACT), 48
Advance directives, 182
Age-related venous thromboembolism
changes, anatomy of vein walls, 81
gender difference, 80
genetic risk factors, 80
malignancy, 80
medical comorbidities, 80
physiology, 81
Aging
pathophysiology and pharmacology, 46–47
Air plethysmography (APG), 96, 97, 99
American College of Cardiology (ACC), 54
American College of Surgeons National
Surgical Quality Improvement
Program (NSQIP), 54
American College of Surgeons NSQIP
Surgical Risk Calculator, 54
American Society of Anesthesiologists
classification (ASA), 102
The 2010 American Society of Regional
Anesthesia, 51
Anesthesiology, 48
Aneurysm repair, 128
Angiotensin-converting enzyme (ACE)
inhibitors, 45
Anticoagulants, 51, 53
Aorta
arch of, 63
Aortic aneurysm disease in elderly
AAA, DTAA and TAAA repair, 129
abdominal aortic aneurysm, 131–134
age influences decision-making, 130
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Aortic aneurysm disease in elderly (cont.)
aortic endografting, 139
candidacy, 139
descending TAA and TAAA repair, 134–135
EVAR, 127
F/B-EVAR for Juxtarenal and TAAA,
136–138
frailty scores, 130–131
functional recovery, 138
long-term EVAR, 139
men vs. women, 128
nonagenarians, 134
octogenarians, 133–134
patients, 127
preoperative evaluation, 130
quality of life, 138
risk, 128
short-term mortality, 139
surveillance protocols, 139
thoracic aortic, 134–139
thoracic endovascular aneurysm repair,
135–136
thoracoabdominal aortic aneurysms,
134–139
untreated aneurysm, 127–128
ARBITER trial, 115
ASRA guidelines, 52
Asymptomatic Carotid Atherosclerosis Study
(ACAS), 114, 115
Asymptomatic Carotid Stenosis and Cognitive
Function (ACCOF) study, 118, 121
Asymptomatic Carotid Surgery Trial
(ACST), 115
Asymptomatic, Carotid Artery Occlusive
Disease, 166–167
Asymptomatic, Intact Abdominal Aortic
Aneurysms, 165, 166
Atherosclerosis Risk in Communities (ARIC)
study, 114, 120
Automatic rapid inflation/deflation, 97
AVF access surgery, 47
B
Breath holding index (BHI), 121
C
Cardiopulmonary dysfunction, 96
Carotid
endarterectomy, 115
intima-media thickness (IMT), 115
Carotid artery stenosis (CAS), 13, 14, 117–121
Carotid atherosclerotic occlusive disease, 113
Carotid endarterectomy (CEA), 66–70,
115–121
Carotid Revascularization Endarterectomy
versus Stent Trial (CREST), 116
Carotid stenosis, 16–18
American Heart Association, 19–20
asymptomatic, 15–16
carotid bruits, 15
cause of strokes, 13–14
DUS, 15
impact, stroke, 13
myocardial infarction, 15
non-invasive imaging techniques, 15
physical exam, 14
prevalence and risk factors, 13, 14
screening
asymptomatic adults, 17–18
high-risk asymptomatic adults, 18
identifying disease process, 16
medical therapy, 17
Society for Vascular Surgery, 18–19
USPSTF, 18
Carotid stent placement, 47–48
Cautious fluid administration, 48
Cerebral metabolic oxygen consumption
(CMRO2), 69
Cerebrovascular disease, elderly, 113–121
catastrophic deficits, 113
chronological age, 121
risk factors, 113
stroke
ACCOF study, 121
asymptomatic carotid stenosis, 115–116
carotid artery stenosis, 117–121
carotid endarterectomy, 115
cerebral hypoperfusion, 120
cognitive decline, 118–120
epidemiology and rehabilitation,
113–114
risk factors, 114–115
silent micro-embolization, 120
symptomatic carotid stenosis, 116–117
Cerebrovascular hemodynamic, 121
Chronic kidney disease (CKD), 159
Chronic venous insufficiency (CVI), 95–99
calf muscle pump dysfunction, 100
in CEAP classification, 100
compliance of, 99
deep venous obstruction, 100
dysfunction, 100
elderly, 102–103, 105–106, 109–110
leg edema
air plethysmography, 97
CT venogram, 98
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197
duplex ultrasound, 96–97
elderly, 96, 99
MR venogram, 98
phlebography, 98
workup, 95
leg muscles, 99
patients, 95
symptomatic, 100
telangiectasias and reticular veins, 103
therapeutic interventions, 106–110
varicose veins, 95, 103–106
VCSS, 100
venous stasis ulceration, 106–109
Clopidogrel, 52
Cochrane database, 62
Cognitive function, 118–121
Compression therapy, 108
Computed tomography (CTA), 139
Contrast nephropathy
CI-AKI, 168
guidelines, KDIGO, 168
intermittent hemodialysis, 169
N-acetylcysteine (NAC), 168
percutaneous coronary interventions, 168
RCT, 169
risk factor, 168
Contrast-induced acute kidney injury
(CI-AKI), 168
Critical limb ischemia (CLI)
age, 153
amputation over revascularization, 155
aortoiliac disease, 150
dementia, 150
endovascular therapy, 153
high-risk or nonambulatory patient, 153
impacts, 150
limb salvage, 150
lower extremity revascularization,
151–152
management, 150
operative living status and ambulatory
ability, 150
palliative, 153
prediction models, 153, 154
PREVENT III cohort, 150
QOL, 153
surgery, 150
syndrome of PAD, 150
D
Dalteparin, 84
Deep venous thrombosis (DVT), 108. See also
Venous thromboembolism (VTE)
Deficit accumulation index (DAI), 37
Descending TAA (DTAA), 129, 134, 135, 138
Diastolic dysfunction, 72
Dobutamine stress echocardiogram (DSE), 56
Dual antiplatelet therapy (DAPT), 56
Dutch Randomized Endovascular Aneurysm
Management (DREAM) trial, 131
E
EEG waveform flattening, 120
Elderly, 83, 143
PAD (see Peripheral arterial disease (PAD))
VTE (see Venous thromboembolism (VTE))
Endarterectomy, carotid, 115
Endovascular aortic aneurysm repair (EVAR),
127, 130, 131, 133–134, 136–139
Endovascular repair (EVAR), 59
Endovenous heat-induced thrombosis
(EHIT), 106
Endovenous laser treatment (EVLT), 105
End-stage renal disease (ESRD), 159
AAA repair, 165, 166
CEA and CAS, 166
extracranial carotid artery, 165
guidelines, 171
lower extremity peripheral arterial
occlusive disease, 167
perioperative risk, 165
risk factors, 164
Enoxaparin, VTE, 83
Epidural opioids, 63
European Carotid Surgery Trial (ECST),
116, 117
Exercise therapy, PAD, 148
F
Fondaparinux, 52
Fusiform aneurysms, 129
G
General anesthesia (GA), 49
preoperative assessment, 53–56
General Anesthetic Versus Local Anesthetic
(GALA), 70
Geriatric pharmacology, 58–59
Geriatric physiology
cardiac, 56–57
nervous system, 58
renal and hepatic, 58
respiratory, 57
Glomerulonephritis, 96
Index
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198
H
Hemodialysis (HD), 47, 160, 162–167
AVF vs. AV G vs. TDC
KDOQI guidelines, 162, 163
lower extremity peripheral arterial
occlusive disease, 167
vascular access, 164
vascular interventions, 164–167
CI-AKI, 169
vs. PD, 161, 162
I
Inferior vena cava (IVC), 65
Infraclavicular brachial plexus block, 47
Intermittent claudication, 145
J
Journal of Vascular Surgery in 2011, 67
K
Kidney Diseases Improving Global Outcomes
(KDIGO), 168, 170
L
Left heart bypass (LHB), 64, 65
Lower extremity peripheral arterial occlusive
disease, 167
Lower extremity vascular, 48–53
Low-molecular-weight heparin (LMWH), 52
M
Magnetic resonance venography (MRV), 96
Major adverse cardiac event (MACE), 54
Medical decision making, 180
Medical therapy, PAD, 146, 147
Middle cerebral artery (MCA), 120
Minimally invasive vascular surgery, 47–48
Modified mini-mental state examination
(MMSE), 119
Myocardial Infarction and Cardiac Arrest
(MICA), 54
N
National Institute of Neurologic Disorders
(NINDS), 119
National Surgical Quality Improvement
Program (NSQIP), 50
Near infrared spectroscopy (NIRS), 69
Neuraxial needle placement, 51
Noncardiac surgery, preoperative assessment, 56
North Atlantic Symptomatic Carotid
Endarterectomy Trial (NASCET),
116, 117
O
Open and endovascular revascularization
claudication, 148, 149
CLI, 150–153
P
Pain Medicine Evidence-Based Guidelines, 51
Partial thromboplastin time (PTT), 55
Perforator ligation, 48–53
Perioperative Ischemia Randomized
Anesthesia Trial (PIRAT), 49
Peripheral arterial disease (PAD), 144, 145,
150–153
ABIs, 146
ACC/AHA 2005 and 2011 Practice
Guidelines, 20–22, 24
age- and gender-adjusted logistic
regression analyses, 45
ankle brachial index, 22
arteriography, 22
asymptomatic, 143
atherosclerosis, 145
clinical implications, 145
coronary artery disease, 45
cost, 25, 144
depression, 146
detection and management, asymptomatic
PAD, 21, 23–24
diagnosis, 20, 145
Duplex ultrasound, 22
elderly patient
asymptomatic, 144
intermittent claudication, 145
estimation, 20
exercise therapy, 148
functional status and QOL, amputation, 155
geriatric syndrome frailty, 143
harms of detection and early treatment, 25
interventions, 146
limb-threatening disease, 145
lower extremity, 45
management, symptomatic PAD, 23
medical therapy, 146–147
open and endovascular revascularization,
148–149
CLI, 150–153
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outcomes, revascularization, 153
percutaneous vascular intervention
(PVI), 144
physical activity, 146
pre- and post-exercise ABIs, 22
preoperative assessment, 46
prevalence, 20, 21, 143
primary amputation, 153–155
prognosis, 145
recommendation, US Preventative Services
Task Force, 21, 24
revascularization procedures, 144
risk factors, 45
symptoms, 143
systolic blood pressures, 22
treadmill testing, 22
USPSTF guidelines, 25–26
vascular intervention, 144
vascular review of systems, 21
the Walking Impairment Questionnaire
(WIQ), 22
Peripheral arterial stent placement, 47–48
Peripheral subcutaneous AV fistula, 47
Peripheral vascular disease, 45, 54
Peritoneal dialysis (PD), 162
Permanent vascular access, 47
Phantom limb pain (PLP), 53
PIRAT study, 49
Plasminogen activator inhibitor-1 levels, 50
Postoperative cognitive dysfunction
in adult patients, 71
delirium, 71–72
diagnosis of, 71
findings of, 71
ISPOCD1, 71
Practical wisdom, 185
Prothrombin time (PT), 55
Q
Quality of life (QOL)
CHEQ, 171
dialysis dependence, 169
ESRD, 171
hemodialysis patients, 170
PD, 170
peritoneal dialysis patients, 170
SF-VAQ, 171
R
Radiofrequency ablation (RFA), 105
Regional anesthesia
after surgery, 49
efficacy of, 70
in elderly patients, 71
neuraxial, 51
older patients, 50
and peripheral nerve blocks, 72
spinal and epidural anesthesia, 52
Regional anesthesia (RA), 102
Regional cerebral blood flow (rCBF), 69
Renal failure, elderly, 160
acute kidney injury management, 170
CKD, 159
dialysis, 159
ESRD, 159
HD vs. PD, 161–162
RRT (see Renal replacement therapy (RRT))
Renal replacement therapy (RRT)
AKI, 161
assesment, kidney function, 161
causes of ESRD, 160
congestive heart failure, 161
dialysis, 161
eGFR, 160
ESRD, 161
guidelines, 161, 171
hemodialysis (HD), 160
HRQoL, 169, 171
initiation, 160
KDIGO, 169
prevention, contrast nephropathy, 168–172
vascular intervention, 167
Residual volume fraction (RVF), 97
Revised Cardiac Risk Index (RCRI), 54
Risk assessment and counseling, vascular
surgery
cognitive dysfunction, 38
comorbidities, 37
DAI tools, 37
decision-making, 37
diagnosis, 38
frailty, 37
geriatric, 38
history and physical examination, 37
palliative care, 38
RAI and mFI, 37
Rocuronium, 58
S
SAAAVE Act
abdominal ultrasounds, 10
aggressive screening measures, 11
cost-effective, 12
drawbacks, 12
implementation, 11
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SAAAVE Act (cont.)
mortality benefit, 10
one-time AAA screening ultrasound, 10
reduction, 11
reimbursement, 12
risk factors, 10
screening recommendations, 11
Sarcopenia, 35
Screening and prevention, 1, 13–18, 20
AAAs (see Abdominal Aortic Aneurysms
(AAAs))
American Heart Association, 19–20
carotid stenosis (see Carotid stenosis)
PAD (see Peripheral artery disease (PAD))
Society for Vascular Surgery, 18–19
USPSTF, 18
Shared decision making (SDM), 180, 184–186
The Society for Vascular Surgery (SVS), 145
Spinal anesthesia, 48
Spinal cord CVs decline, 46
Stenting and Angioplasty with Protection in
Patients at High Risk for
Endarterectomy (SAPPHIRE), 117
Superficial venous thrombosis (SVT), 106
Surgical anesthesia, 48
Surgical decision making, 184
SVS/AVF guidelines, 104, 109, 110
Symptomatic carotid disease, 116
T
T10 dermatome, 59
Thoracic aortic abdominal aneurysm, 63–66
Thoracic aortic aneurysms (TEVAR), 127,
129, 134–136, 139
Thoracic aortic surgery, 66
Thoracoabdominal aneurysm (TAA)
repair, 64
Thoracoabdominal aortic aneurysms (TAAA),
127, 129, 134–138
Tinzaparin, 84
Transcranial Doppler (TCD), 68, 120
Transesophageal echocardiography (TEE),
61, 72
Transient ischemic attacks (TIAs), 66, 118
Transilluminated powered phlebectomy
(TIPP), 105
Trauma bay, 180
U
Unfractionated Heparin, 83
United Kingdom Prospective Diabetes Study
(UKPDS), 114
Urinary cortisol excretion, 49
US Preventive Services Task Force, 115
V
Valsalva maneuver, 97
Vascular surgery, 35–40
aging
cardiac changes, 36
cardiopulmonary perspective, 35
dysphagia, 36
homeostasis, 35
mortality and morbidity, 35
muscle breakdown and anorexia, 35
nonsarcopenic patient, 35
renal dysfunction, 36
sarcopenia, 35
ethics
ACS NSQIP risk calculator, 189
capacity, 181–182
clinical decisions, 179
decision-making capacity, 190
emergencies, 190
ethical practice strives, 189
goals of care, 186–187, 190
informed consent, 183–184
patient, 179
postoperative care, 187–188
SDM, 184, 185
shared decision making, 190
support, 188–189
surrogate decision-making, 182–183,
190
time-limited trial, 187–190
urgency, 180
optimization, preoperative patient
abdominal aortic aneurysm repair, 39
CGA service, 40
comorbidities, 39
data, 39
frailty perspective, 39
geriatric/palliative care, 40
higher risk, 39
laparotomy, 40
symptomatic carotid disease, 39
risk assessment and counseling
(see Risk assessment and
counseling, Vascular surgery)
Vasoconstrictors, 48
Vecuronium, 58
Vein stripping, 48–53
Venous Clinical Severity Score (VCSS), 100
Venous filling index (VFI), 97
Venous leg ulcers (VLUs), 106–109
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Venous reflux, 97
Venous thromboembolism (VTE), 80–87
aging, 79
anticoagulants
dalteparin, 84
DOACs, 86, 87
enoxaparin, 83–84
tinzaparin, 84
unfractionated heparin, 83
VKAs, 85
bleeding on vitamin K antagonists, 86
bleeding vs. physical activity in elderly
patients, 81
catheter-directed, 91
elderly patients, 82, 83
estimation, 79
pulmonary embolism, 79, 90
risk factors (see Age-related venous
thromboembolism)
risk of fatal bleeding in elderly, 88
risk of intracranial bleeding in
elderly, 89
risk of recurrent, 87
systemic, 90
testing, 82
Vitamin K antagonists (VKA)
age-related bleeding, 85, 86
comorbidities, 85
ICH, 85, 86
intracranial bleeds, 85
risk of bleeding, 85
risk of hemorrhage, 85
systematic review, 85
W
Warfarin therapy, 52
Wound care, 107
Index
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