The Vertebral Artery


Book Description

Our common interest in surgery of the vertebral artery was born in 1976, when as residents in the same hospital, we attended an attempt by two senior surgeons to treat an aneurysm of the vertebral artery at the C 3 level. Long discussions had preceded this unsuccessful trial, to decide if surgery was indicated and to choose the surgical route. Finally a direct lateral approach was performed, but access was difficult and correct treatment was impossible, resulting in only partial reduction of the aneurysmal pouch. Following this experience, we decided to seek a regular and well defined approach for exposition of the vertebral artery. Review of the literature indicated some surgical attempts, but the descriptions did not give the impression of safety and reproducibility. No landmark on the described surgical route appeared sufficiently reliable. Henry's anatomical work (1917) gave the only accurate description on vertebral artery anatomy, and it became the basis for our work. When the same patient was referred again one year later, after a new stroke in the vertebro-basilar system, we had behind us repetitive experience on cadavers of an original approach to the distal vertebral artery.




Vertebrobasilar Ischemia and Hemorrhage


Book Description

A comprehensive review of vascular disease in the vertebrobasilar circulation by one of the world's leading authorities, fully updated throughout.




Carotid and Vertebral Artery Dissection


Book Description

Carotid and vertebral artery dissections are responsible for one-quarter of strokes in young adults. Despite this fact, there is very little awareness and understanding of these vascular injuries by the public, and even by healthcare providers. This book answers the common questions that patients with carotid and vertebral artery dissections have with easy-to-understand explanations. Also included are stories from patients who have persevered after their dissections. Their tales personalize dissection and stroke in young adults in an undeniable way, and illustrate the existence of the lingering effects dissections can have on patients for years. Jodi A. Dodds, MD, a vascular neurologist at Duke University, and Amanda P. Anderson, MS, CCC-SLP, a speech-language pathologist and a survivor of a severe carotid artery dissection, have created an important and needed resource for patients and their families as they navigate through the aftermath of this life-changing event.




Pathology and surgery around the vertebral artery


Book Description

This is the first comprehensive book about surgery on and around the vertebral artery all along its cervical and intracranial course. This vessel has been considered for long as out of surgical reach leaving many different pathologies not or incompletely treated. The surgical exposure and control of the vertebral artery not only permit to treat lesions of the vertebral artery wall or developed in contact to it but also to improve the access to the intervertebral foramen (tumors, osteophytes), to the anterior aspect of the spinal cord (tumors, spondylotic spurs), to the foramen magnum and to the jugular foramen. This book written by leading experts includes all aspects of vertebral artery surgery from anatomy to imaging, surgical techniques and pathologies; it is illustrated by many figures especially operative views and schematic drawings so that the beginner as well as the experienced surgeon find useful information. One of the editors of this book (B. GEORGE) was recently awarded the Olivecrona award for his work on the surgery of the vertebral artery.




Manual of Neurosonology


Book Description

Neurosonology is non-invasive, portable, and has excellent temporal resolution, making it a valuable and increasingly popular tool for the diagnosis and monitoring of neurological conditions when compared to other imaging techniques. This guide looks beyond the use of neurovascular ultrasound in stroke to encompass a wide range of other neurological diseases and emergencies. It offers a practical approach to the examination of patients, interpretation of ultrasound studies, and the application of neurosonology to the development of management and treatment strategies. Each chapter incorporates a thorough and clear procedural methodology alongside scanning tips for trainees; this step-by-step approach is further enhanced by example images and focused diagnostic questions. Authored and edited by international experts, this practical manual of neurosonology is an invaluable resource for neurologists, neurosurgeons, intensivists, radiologists, and ultrasonographers.




Neurovascular Imaging


Book Description

Vascular Neurology, Vascular Neurosurgery and Interventional Neuroradiology are independent fields with dedicated Training Programs. Neuroimaging, and in particular what we call "Neurovascular Imaging" is a unifying factor which can be considered the intersection of these three medical specialties. With this book we aim to cover thoroughly the imaging techniques, potentialities, and present and future applications as applied to all the vascular diseases of the central nervous system from the imaging point of view. This book will comprise eight main sections: (1) The Basics, (2) Arteries of the Head and Neck (3) The basics of Intracranial Arteries (4) Diseases of the vessels (5) Stroke Imaging (6) Veins Imaging (7) Spine Imaging (8) Pediatrics.




Peripheral and Cerebrovascular Intervention


Book Description

Peripheral and Cerebrovascular Intervention draws upon experts from diverse fields to provide readers with a comprehensive foundation for understanding and performing endovascular procedures—from the basic steps to the most current and advanced techniques. Individual chapters focus on primary intervention sites, including lower extremity, renal/mesenteric, subclavian/upper extremity, carotid/vertebral, intracranial and venous interventions. Additionally, chapters covering critical limb ischemia and abdominal and thoracic aortic aneurysms are included. By incorporating valuable clinical information, such as indications, contraindications, complications and discussions of surgical techniques and procedures, this book is a valuable resource for the busy practitioner and will be of interest to all interventional and general cardiologists, radiologists and neurologists; vascular surgeons; internists and residents and fellows.




Surgery of Vertebrobasilar Aneurysms


Book Description

It is a great privilege to write the foreword for this classical work of Professor Charles Drake. There is no doubt that intracranial aneurysms have existed since the beginning of time. This terrifying disease of the brain arteries, with its dramatic consequences for the patient, has surely been observed in all human collectives, although clear definition and description in the literature began only 300 years ago. During the last century, clinical signs and symptoms have been carefully observed and analyzed, and 100 years ago, the first attempts were made for surgical treatment, such as the ligature of external and internal carotid and vertebral arteries. With the introduction of angiography, an entirely new dimension of diagnosis and differential diagnosis of the vascular diseases of CNS, was accomplished. In the years between 1945 and 1970, the neurosurgeon was increasingly stimulated to directly eliminate intracranial aneurysms. The most respected and avoided location, the aneurysms at the bifurcation of the basilar artery, remained as a "dark corner. " Several pioneers of neurosurgery attempted to explore the interpeduncular fossa, but finally retreated. Not so Charles Drake. His vision must have been stronger than his anxiety, after experiences of initial fatalities, to persevere more decisively in this desperate fight instead of to yield. Such steadfastness requires enormous courage. But what distin guishes courage! Surgical courage is not just a fearless or unscrupulous action.




The Cerebral Circulation


Book Description

This e-book will review special features of the cerebral circulation and how they contribute to the physiology of the brain. It describes structural and functional properties of the cerebral circulation that are unique to the brain, an organ with high metabolic demands and the need for tight water and ion homeostasis. Autoregulation is pronounced in the brain, with myogenic, metabolic and neurogenic mechanisms contributing to maintain relatively constant blood flow during both increases and decreases in pressure. In addition, unlike peripheral organs where the majority of vascular resistance resides in small arteries and arterioles, large extracranial and intracranial arteries contribute significantly to vascular resistance in the brain. The prominent role of large arteries in cerebrovascular resistance helps maintain blood flow and protect downstream vessels during changes in perfusion pressure. The cerebral endothelium is also unique in that its barrier properties are in some way more like epithelium than endothelium in the periphery. The cerebral endothelium, known as the blood-brain barrier, has specialized tight junctions that do not allow ions to pass freely and has very low hydraulic conductivity and transcellular transport. This special configuration modifies Starling's forces in the brain microcirculation such that ions retained in the vascular lumen oppose water movement due to hydrostatic pressure. Tight water regulation is necessary in the brain because it has limited capacity for expansion within the skull. Increased intracranial pressure due to vasogenic edema can cause severe neurologic complications and death.




Vascular Medicine: A Companion to Braunwald's Heart Disease E-Book


Book Description

With authoritative coverage of everything from recent discoveries in the field of vascular biology to recent clinical trials and evidence-based treatment strategies, Vascular Medicine, 3rd Edition, is your go-to resource for improving your patients' cardiovascular health. Part of the Braunwald family of renowned cardiology references, this updated volume integrates a contemporary understanding of vascular biology with a thorough review of clinical vascular diseases, making it an ideal reference for vascular medicine specialists, general cardiologists, interventional cardiologists, vascular surgeons, and interventional radiologists. - Incorporates technologic advances in vascular imaging – including ultrasound, MRI, CTA, and catheter-based angiography – along with more than 230 new figures, providing an up-to-date and complete view of the vascular system and vascular diseases. - Covers novel antithrombotic therapies for peripheral artery disease and venous thromboemboism, advances in endovascular interventions for aortic aneurysms, and today's best surgical treatments for vascular diseases. - Includes seven new chapters: Pathobiology of Aortic Aneurysms; Pathobiology and Assessment of Cardiovascular Fibrosis; Large Vessel Vasculitis; Medium and Small Vessel Vasculitis; Epidemiology and Prognosis of Venous Thromboembolic Disease; Fibromuscular Dysplasia; and Dermatologic Manifestations of Vascular Disease. - Discusses methods for aggressive patient management and disease prevention to ensure minimal risk of further cardiovascular problems. - Keeps you current with ACC/AHA and ECC guidelines and the best ways to implement them in clinical practice. - Enhanced eBook version included with purchase, which allows you to access all of the text, figures, and references from the book on a variety of devices