Samuel Wilson – Vascular Surgery (2017)

Описание

When the first edition of Vascular Surgery: Principles and Practice was planned three decades ago, we could not have anticipated the revolution that was about to occur in vascular surgery. On reflection, the changes brought by endovascular methods evolved progressively from ‘Jeffersonian research’ – the application of innovation to solve practical problems. Beginning with Dotter’s recanalization experiments in dilation of obstructed arteries and his human application, leading to Gruentzig’s critical balloon catheter modifications, the stage was set for rapid advancement. Peripheral arterial stents were made from stainless steel and nitinol, and percutaneous angioplasty began to replace bypass operations for arterial occlusive disease. Endovascular repair of aortic aneurysms was the most dramatic advance reducing operative mortality to one quarter of open repair and reducing hospitalization to 1 or 2 days.
Throughout all of this change, vascular surgeons, more than any other surgical specialty, have supported their practice with rigorous clinical trials. For example, in occlusive disease percutaneous angioplasty was compared to bypass operation and carotid endarterectomy to medical management. In aneurysmal disease, repair was randomized to observation for small aortic aneurysms and endovascular to open repair. Some specialties having major changes to less invasive technology have seen numbers of procedures multiply, whereas having well-defined indications for intervention, as in aneurysm repair and carotid endarterectomy, has not led to proliferation in these procedures. More than anything, this signifies the need for vascular surgeons to remain involved in research – both basic and clinical – ultimately ensuring the public health. Vascular surgery continues to evolve. No doubt questions such as the role of carotid stenting, repair of type II endoleaks, prevention of myointimal hyperplasia or designing a better arterial replacement will be answered in the next decade.
The goal of this text is to set out current standards in practice. We recognize these may change in the years ahead, but the methods we describe have been selected to last for the remainder of this decade. Proven patient management is emphasized, relying heavily on clinical trial research. Procedures are described and an atlas of open procedures included, but it is not a text of personal operative descriptions. Rather the discussions are directed at diagnosis, indications, methods of intervention and expected outcomes. We hope this work will be useful for the practicing vascular surgeon, resident in training or anyone inquiring into our field.
Indeed, the reader will find vascular surgery has evolved dramatically since the first edition of this text was published in 1987. Vascular surgery has seen a remarkable transformation from a specialty which dealt with the natural history of vascular disease and its treatment primarily by open procedures to a specialty which has kept the focus it had while mastering the major components of improved imaging and endovascular treatments.
This fourth edition of Vascular Surgery: Principles and Practice has incorporated these advances while maintaining the specialty’s past assets. Since natural history and open surgery will always be a component of optimal care for patients with vascular diseases, this mix of the old and the new will make this edition a valuable resource for all vascular surgeons and others interested in the optimal care of vascular patients. Lastly, we thank the authors who have given so generously of their time, knowledge and experience, which made this book possible.