Ruptured Abdominal Aortic Aneurysm

This manual is designed to serve as the standard for the management of patients with ruptured abdominal aortic aneurysm (AAA) by means of modern techniques. All aspects are covered, from pathogenesis, clinical presentation, and diagnosis through to initial management, operative strategies, postoperative complications, outcomes and quality of life issues. The book is based on the experience gained at a leading U.S. institution (Harborview Medical Center, University of Washington) that treats up to 40 patients with ruptured AAA annually and is highly respected for its expertise in this medical emergency. The team at Harborview Medical Center has recently shown that the implementation of a structured protocol for the management of ruptured AAA, with emphasis on an “endovascular-first” strategy, dramatically reduces mortality and complications. This has led to a sea change in the way in which patients are managed. There is an increasing hunger for information on these codified protocols and Ruptured Abdominal Aortic Aneurysm: The Definitive Manual will be invaluable for both surgeons and critical care physicians.

As the field of general surgery continues to expand, the diagnostic and therapeutic pathways are becoming more complex. The diagnostic modalities available to the clinician can be both very helpful but also overwhelming considering the findings can often determine the scope of treatment for a patient. This text will take the major pathologies of the systems commonly studied in general surgery and present them in a unique format based upon algorithms. The algorithms will begin with the clinical presentation of the patient, work its way through the various diagnostic modalities available to the surgeon, and finally allow the physician to make a decision regarding treatment options based upon various patterns in the algorithms. This text will become a very useful resources for surgeons as it allows complex clinical pathways to be conveniently organized in logical algorithms. It will become a concise yet comprehensive manual to assist in clinical decision making. All algorithms will be reviewed by experts in their field and include the most up-to-date clinical and evidence-based information. Clinical Algorithms in General Surgery provides a useful resource for surgeons in clinical practice as well as surgical residents, and surgical attendings who are preparing for board examinations. See sample algorithm in Attachments.

This book aims to familiarize readers with the most common acute surgery topics encountered in clinical practice and is unique in its use of infographics. It will be used in clinical rotations in surgery as a supplement to the knowledge gained, and will also provide instructors with a complementary tool, offering a wide-ranging guide to general aspects of acute surgery, with some hints on gynecologic and urologic emergencies. The book is intended to provide medical students and junior residents in medicine or surgery with a comprehensive and up-to-date overview of the most relevant operative techniques.

New updated edition first published with Cambridge University Press. This new edition includes 29 chapters on topics as diverse as pathophysiology of atherosclerosis, vascular haemodynamics, haemostasis, thrombophilia and post-amputation pain syndromes.

This book presents 100 challenging cases encountered in vascular surgery practice that were selected from the author’s vascular registry of 7,000 vascular reconstructions (endovascular and open). Chapters include difficult surgical problems of patients with aortic, visceral and peripheral arterial aneurysms, with expert management of mycotic, inflammatory and ruptured aneurysms and major complications like aorto-duodenal fistula, graft infection or inferior vena cava injury. These reconstructions are representative of the “real world” experience of vascular surgery in the United States, and the selection of cases were based on either difficulty with case selection, or complex operative or an endovascular technique. The natural history of vascular reconstructions often leads to secondary reconstructions, which are far more complex and therefore are included in significant numbers in this text. Both good and unsatisfactory results have been included and the lessons learned from the poor outcomes are emphasized. Invited commentaries from leading experts in the field have been added to a few chapters offering an alternate viewpoint in the management of patients with complex pathology. Challenging Arterial Reconstructions: 100 Clinical Cases serves as an invaluable resource to vascular surgeons that are learning or regularly performing open surgical or endovascular interventions.

The clinical practice of anesthesia has undergone many advances in the past few years, making this the perfect time for a new state-of-the-art anesthesia textbook for practitioners and trainees. The goal of this book is to provide a modern, clinically focused textbook giving rapid access to comprehensive, succinct knowledge from experts in the field. All clinical topics of relevance to anesthesiology are organized into 29 sections consisting of more than 180 chapters. The print version contains 166 chapters that cover all of the essential clinical topics, while an additional 17 chapters on subjects of interest to the more advanced practitioner can be freely accessed at www.cambridge.org/vacanti. Newer techniques such as ultrasound nerve blocks, robotic surgery and transesophageal echocardiography are included, and numerous illustrations and tables assist the reader in rapidly assimilating key information. This authoritative text is edited by distinguished Harvard Medical School faculty, with contributors from many of the leading academic anesthesiology departments in the United States and an introduction from Dr S. R. Mallampati. This book is your essential companion when preparing for board review and recertification exams and in your daily clinical practice.

This book considers mainly diagnosis, screening, surveillance and treatment of abdominal, thoracoabdominal and thoracic aortic aneurysms. It addresses vascular and cardiothoracic surgeons and interventional radiologists, but also anyone engaged in vascular medicine. The high mortality of ruptured aneurysms certainly favors the recommendation of prophylactic repair of asymptomatic aortic aneurysms (AA) and therewith a generous screening. However, the comorbidities of these patients and their age have to be kept in mind if the efficacy and cost effectiveness of screening and prophylactic surgery should not be overestimated. The treatment recommendations which will be outlined here, have to regard on the one hand the natural course of the disease, the risk of rupture, and the life expectancy of the patient, and on the other hand the morbidity and mortality of the prophylactic surgical intervention. The book describes perioperative mortality after endovascular and open repair of AA, long-term outcome after repair, and the cost-effectiveness of treatment.

This book, intended for all physicians who are facing patients with abdominal aortic aneurysms, has been assembled by interested, invited authors and contains important topics from basic research to clinical practice. Experimental studies focus on biomechanical and biochemical factors. In clinical practice, the decision to treat, based on risk-benefit ratio, is very delicate in patients with concomitant malignant diseases. Periprocedural risk is determined by anatomy, while aneurysms causing neck pain are one of the most frequent challenges for both open and endovascular methods. Finally, careful planning is crucial. Postoperative complications are different from post-implantation syndrome, which is still an underestimated problem, toward detection and treatment of endoleaks and eventual conversion.