By Wesley S. Moore MD
Within the 4th version of Endovascular surgical procedure, Drs. Wesley S. Moore, Samuel S. Ahn, and a number of specialists advisor you thru the newest advancements during this leading edge box. New techniques and particular gains, corresponding to key issues and case reports, support illustrate powerful sufferer care, and new subject matters similar to endoscopic administration of aneurismal illness and irritating accidents overview with you the newest endovascular surgical innovations. Full-text on-line entry at www.expertconsult.com permits you to quickly seek this reference each time, at any place. assessment uncomplicated ideas and new ideas, and stick to a pragmatic, problem-solving method of support handle difficult components. achieve larger aspect and intensity than different present texts, in addition to clean views with contributions from new authors. develop your surgical talents with new chapters on endoscopic administration of aneurismal disorder and hectic accidents, and evaluate a invaluable new part protecting the ideas process for Portal high blood pressure, Anesthetic administration for Endovascular approaches, using Coil Embolization in Endovascular surgical procedure, and extra. See case displays from the author's personal evaluation direction that can assist you observe key details to actual medical occasions. Reference the full textual content and video clips on-line at www.expertconsult.com. maintain your surgical perform present due to accomplished updates all through. An in-depth, middle reference at the most sensible practices and methods in endovascular surgical procedure. ideal for either the educational vascular health practitioner who wishes a accomplished view of endovascular surgical procedure in addition to a refresher on present strategies and optimum results for the practitioner.
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Extra resources for Endovascular Surgery: Expert Consult - Online and Print 4th Edition
Although aortic endografting is most commonly performed, at least in our practice, with the patient under local anesthesia (for the femoral cutdowns) and anesthesia-provided deep intravenous sedation, many vascular surgeons prefer epidural or general anesthesia for these procedures. The only benefit we can see for these latter forms of anesthesia would be the ability to suspend respiration during angiographic runs to improve image clarity by elimination of respiratory motion artifacts, something that is rarely necessary and does not, in our opinion, justify these more invasive forms of anesthesia.
13. 14. 15. 16. 2. PREPARING THE ENDOVASCULAR OPERATING ROOM SUITE Zhou W, Reardon ME, Peden EK, et al: Endovascular repair of a supra-aortic debranching with antegrade endograft deployment via an anterior thoracotomy approach, J Vasc Surg 43:1045e1048, 2006. Hodgson KJ, Mattos MA, Sumner DS: Angiography in the operating room: equipment, catheter skills and safety issues. In: Yao JST, Pearce WH, editors: Techniques in Vascular Surgery, Stamford, CT, 1997, Appleton & Lange. Mansour MA: The new operating room environment, Surg Clin North Am 79:477e487, 1999.
Contrast agents with higher osmolality can induce significant discomfort when injected into the patient. This can be particularly problematic when evaluating patients with ischemic rest pain because these patients are likely to develop muscle spasms when exposed to the increased osmolality of any contrast agent. The resulting involuntary patient movement can severely compromise the image quality obtained. Traditional ionic contrast agents dissociate in blood, effectively doubling their osmolality, whereas newer nonionic agents are lower in osmolality and maintain that characteristic when injected, minimizing contrast-associated patient discomfort.