Vascular Complications of Surgery and Intervention: A Practical Guide

Description

The concept for this book evolved over many years of intense clinical practice during which a wide variety of vascular complications were encountered as a result of other surgical or interventional procedures. In this book, the authors describe cohesive efforts by experts in the field as they commit to advancing health care quality by all professionals. It should be noted at the outset that the book does not discuss various non-vascular or systemic complications of patients undergoing vascular interventions such as myocardial infarction, renal or respiratory failure. Instead, the content is divided into four separate sections. The material begins with an introduction to vascular anatomy and function. There follows a section addressing specific complications of the vascular system that can occur in any patient, sometimes even without intervention. The third section addresses complications specific to interventions and surgical procedures. The final section is dedicated to the delayed and long-term sequelae attributable to the most commonly encountered vascular complications. Vascular Complications of Surgery and Intervention: A Practical Guide is targeted towards dedicated health care professionals managing patients affected by inadvertent but potentially disastrous vascular complications and for those practitioners performing interventions either directly upon the vascular system or procedures that have potential for collateral impact. Introduction Contents Contributors Part I: General Principles 1: Regional Vascular Anatomy Embryologic Development of Vascular Tree Head and Neck Intracranial Arteries Veins/Sinuses Extracranial Arteries Veins Normal Variants Chest Veins Normal Variants Abdomen and Pelvis Abdominal Aorta Veins Normal Variants Upper Extremities Arteries Veins Normal Variants Lower Extremities Arteries Veins Normal Variants References 2: Impact of Hemorrhage, Thrombosis, and Ischemia Introduction Hemorrhage Thromboembolic Disease Ischemic Injury Conclusion References 3: Principles of Vascular Imaging Introduction Imaging Modalities and Protocols CT Angiography (CTA) Magnetic Resonance Angiography (MRA) Conventional Angiography Noninvasive Hemodynamic Testing Ultrasonography Radiograph Nuclear Medicine Summary of Recommendations References Part II: Perioperative 4: Perioperative Venous Thromboembolism Introduction Risk Factors and Epidemiology of VTE Pathophysiology Deep Vein Thrombosis Lower Extremity Upper Extremity Pulmonary Embolism Prophylaxis Treatment Future Investigation Summary References 5: Postoperative Spinal Cord Ischemia and Stroke Introduction Spinal Cord Ischemia Intraoperative Prevention Postoperative Management SCI Treatment Protocol Modified SCI Prevention Protocol Recovery Stroke Cerebral Protection Strategies Intraoperative Monitoring Strategies Intraoperative Stroke Postoperative Stroke Conclusion References 6: Arterial Thromboembolic Complications Scope Regions Presentations Imaging Treatment Surveillance Summary References 7: Vascular Injuries in Children Introduction Differences in Adult and Pediatric Trauma Epidemiology Extremity Injury Carotid Injury Aortic Injury Anticoagulation Outcomes Conclusion References Part III: Operation and Intervention 8: Principles of Vascular Access and Complications Introduction General Principles Ultrasound Technique Equipment Scanning Access Technique Access Site Selection Preparation Cannulation Summary Vascular Access Types Arterial Access Venous Access Peripheral Venous Access Central Venous Access Peripherally Inserted Central Catheter (PICC) Central Venous Catheters Decannulation Mitigating Complications Conclusion References 9: Procedural Checklist/Situational Awareness Procedural Checklist/Situational Awareness My First Checklist. Why I Made My Checklist and Why Every Surgeon Should Too! Successful Checklist Implementation Cultural Shift Planning, Staffing, and Checklist Entering the Operating Room Case Scenarios Did you Give the Heparin? Where’s the Shunt? Conclusion References 10: Management of Iatrogenic Abdominal Vascular Injuries Introduction Incidence Injury Recognition Risk Factors Management Exploratory Laparotomy for Vascular Control and Repair Vascular Exposures During Damage Control Laparotomies Special Considerations for Injuries to Specific Vessels Aortoiliac Injuries Iliocaval Venous Injuries Mesenteric Arterial Injuries Renal Vascular Injuries Summary References 11: Inadvertent Ischemia Occurring with Abdominal Surgery Introduction Chapter Overview Common Operations Prone to Vascular Injury Case 1: The Unassuming Cholecystectomy Case 2: The Right Colectomy Case 3: This Is Not Looking So Good…5–6 Days Later Summary References 12: Vascular Injury During Spine Surgery Preoperative Considerations Potential Complications Special Circumstances Technical Considerations Instrumentation Exposure Repair References 13: Vascular Complications Associated with the Cardiac Patient Introduction Preoperative Evaluation Postoperative Vascular Complications After Common Cardiac Operations Vascular Complications Related to Vascular Access and Invasive Hemodynamic Monitoring Stroke Acute Mesenteric Ischemia Lower Extremity Ischemia Vascular Complications Related to Mechanical Circulatory Support Vascular Complications Related to Transcatheter Valves References 14: Vascular Insult of the Operated Extremity Patterns of Vascular Insults with Blunt Orthopedic Injuries Introduction Injury Patterns Axillary Artery Injury with Humeral Neck Fractures and Anterior Shoulder Dislocation Brachial Artery Injury with Humeral Diaphysis Fracture and Elbow Dislocation Femoral Artery Injury with Femoral Neck Fracture and Hip Dislocation Popliteal and Tibial Arterial Injuries with Supracondylar Femur Fractures, Proximal Tibial Fractures, and Posterior Knee Dislocations Who Should Operate First, Vascular or Orthopedic Surgery? Common Elective Surgical Procedures with a Higher Risk for Vascular Insult Resuscitative Endovascular Balloon Occlusion of Aorta Acute Compartment Syndrome (ACS) Lower Leg Compartment Syndrome Forearm Compartment Syndrome Conclusion References 15: Interventional Alternatives for Vascular Injury Introduction Technologies Access Catheters/Wires Sheaths Balloons/Stents/Coils Applications Techniques Summary Access Vessel Selection Sheath Insertion Balloon Delivery and Inflation Device Removal Organizational Framework Patient Needs Provider Strengths Institutional Resources The Ideal Horizon Technologies Summary References Part IV: Delayed 16: Dreaded Late Complications: Infection, Blowout, Pseudoaneurysm, Fistula Introduction Infection (Surgical Site Infection, Prosthetic Graft Infection) Incidence Pathophysiology Microbiology Clinical Presentation Diagnosis Treatment Prevention Conclusion Late Anastomotic Complication: Pseudoaneurysm, Anastomotic Aneurysm, and Blowout Pathophysiology Diagnosis Treatment Conclusion Aortoenteric Fistula Incidence Pathophysiology Diagnosis Treatment Conclusions Lymphocele/Lymphatic Fistula/Chylous Ascites Etiology Incidence Diagnosis Treatment Conclusion Conclusion References Reference A 17: Considerations for Surgery in Hostile Zones Introduction Case Example General Considerations Oncologic Considerations Sarcoma RCC Pancreatic Adenocarcinoma Other Considerations/Benefits References 18: Medical and Legal Implications of Failure to Rescue Crew Resource Management Resilience High Reliable Organizations (HRO) Implementation of the OODA Loop Closing the Loop Conclusion References Index