Practical Carotid Artery Stenting (eBook)

Sumaira Macdonald, Gerald Stansby (Herausgeber)

eBook Download: PDF

2010 | 2009
XIV, 208 Seiten
Springer London (Verlag)
978-1-84800-299-9 (ISBN)

Infos

In the management of vascular disease, there has been an inexorable drive towards less invasive endovascular treatment options. Endovascular treatment of carotid stenosis for stroke is no exception. Several sizeable multicentre trials are running concurrently, which are comparing carotid endarterectomy (CEA), the 'gold standard,' with the less invasive alternative, carotid stenting (CAS) for low-risk patients with symptomatic carotid stenoses who are considered to be surgical candidates. The endovascular option is in itself a newcomer but state-of-the-art CAS with regards use of all the available technical refinements, to include low-profile monorail dedicated systems with contemporary pharmacological support, is perhaps all but five years old. There is considerable interest from clinicians from a variety of clinical backgrounds and from industry in this technique and, therefore, scope for a contemporary practical guide.

Gerard P Stansby, BA, MBBChir, MA, FRCS, MChir, is a Professor of Vascular Surgery, Freeman Hospital and University of Newcastle upon Tyne, UK. He is an experienced editor of several books and journals and has published books on surgery and venous diseases (Goldberg & Stansby, Surgical Talk; Surgery for Finals, World Scientific Book Publishing, 1999 ISBN 1-86094-077-3 '2nd edition 2005; Belcaro, Nicolaides, & Stansby, The Venous Clinic, Imperial College Press.1997, ISBN 1-86094-051-X; Labropoulos & Stansby, Venous and Lymphatic Diseases, Marcel Dekker ltd. 2006, ISBN 0824729234). He is a consultant vascular surgeon, experienced in carotid surgery and patient selection. He has published research on carotid surgery and is the author of the Royal College of Surgeons STEP course section on carotid disease.

Sumaira Macdonald, MBChB, MRCP, FRCR, PhD, is a Consultant Vascular Radiologist & Honorary Clinical Senior Lecturer, The Freeman Hospital, Newcastle upon Tyne, UK, who has been responsible for setting up the carotid stenting program in Newcastle. She is also involved with several trials of carotid stenting, and regularly proctors and teaches the technique nationally and internationally.

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In the management of vascular disease, there has been an inexorable drive towards less invasive endovascular treatments. This has substantially altered the attitudes of patients, clinicians and health care providers.Endovascular treatment of carotid stenosis for stroke is no exception. Several trials are running concurrently; these are comparing carotid endarterectomy (CEA) with the less invasive alternative, carotid stenting (CAS). There is already evidence that CAS may be preferable in certain patient populations i.e. those deemed to be at high surgical risk. Furthermore both procedures have comparable benefits in terms of survival free of ipsilateral stroke between three to five years post-procedure.State-of-the-art CAS (with regards use of all available technical refinements) is all but five years old. There is considerable interest from clinicians from a variety of clinical backgrounds and from industry in this technique and, therefore, scope for a contemporary practical guide.

Inhalt

Dedication 5
Preface 6
Editor's Biographies 7
Contents 8
Contributors 10
Carotid Stenting: The Evidence Base 12
Patient Selection for Carotid Stenting 20
What Is the Evidence for Intervening in Asymptomatic Patients? 27
Carotid Artery Stenting. First Steps: Training, Support, and Proctorship 40
Preprocedure Imaging 49
Cerebral Arterial Anatomy 71
Patient Selection: Anatomical 83
Plaque Stability and Carotid Stenting 89
Pharmacological Support 101
Equipment, Basic and Advanced: An Overview 118
Difficult Access: Tips and Tricks 123
Procedural Tips and Tricks 138
Embolic Containment Devices and How to Avoid Disaster 148
Relevance of Periprocedural Hemodynamics 164
Dealing with Complications: Neurorescue 172
Surveillance: Diagnosis and Management of In- Stent Restenosis 183
Optimizing Outcomes 193
Index 204

Produkt-Details

• Erscheint lt. Verlag: 11.3.2010
• Zusatzinfo: XIV, 208 p. 76 illus., 19 illus. in color.
• Verlagsort: London
• Sprache: englisch
• Themenwelt: Medizinische Fachgebiete ► Chirurgie ► Herz- / Thorax- / Gefäßchirurgie
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► HNO-Heilkunde
• Themenwelt: Medizinische Fachgebiete ► Innere Medizin ► Kardiologie / Angiologie
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Neurologie
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Orthopädie
• Themenwelt: Medizinische Fachgebiete ► Radiologie / Bildgebende Verfahren ► Radiologie
• Themenwelt: Studium ► 1. Studienabschnitt (Vorklinik) ► Biochemie / Molekularbiologie
• Schlagworte: anatomy • Diagnosis • Head and Neck Surgery • hemodynamics • Neuroanatomy • Outcome • Stent • stroke • vascular disease
• ISBN-10: 1-84800-299-8 / 1848002998
• ISBN-13: 978-1-84800-299-9 / 9781848002999