Photographic Atlas of Reconstructive Arterial Surgery

The Segmental Nature of Peripheral Obliterative Arterial Disease.- I — Reconstructive Surgery in Chronic Obliterative Disease of the Superficial Femoral Artery.- 1. Extensive occlusion of the superficial femoral artery.- 1.1. Discarded femoral bypass procedures.- 1.2. Autogenous saphenous vein bypass graft.- 1.3. Composite saphenous vein graft. Combination of saphenous vein bypass graft and disobliteration with venous patch graft angioplasty.- 1.4. Composite saphenous vein bypass graft. Combination of ipsilateral and contralateral saphenous vein.- 1.5. Thromboendarterectomy with venous patch graft angioplasty.- 1.6. Closed-loop endarterectomy.- 2. Segmental obstruction of the superficial femoral artery.- 2.1. Thromboendarterectomy and limited intimectomy with autogenous vein patch graft angioplasty.- 2.2. Autogenous vein graft. Bypass operation and exclusion arterioplasty with proximal end-to-end anastomosis.- 2.3. Reconstruction using a prosthesis.- 2.4. Autogenous vein bypass graft in combination with proximal endarterectomy.- 2.5. Treatment of stenosis at the origin of the superficial femoral or the profunda femoris artery.- II — Reconstructive Surgery in Popliteal Occlusive Disease.- 1.1. Endarterectomy with vein patch graft angioplasty.- 1.2. Closed-loop endarterectomy.- 1.3. Autogenous saphenous vein bypass graft.- 1.4. Exclusion arterioplasty with autogenous vein graft.- 1.5. Resection and replacement by venous autograft.- III — Reconstructive Surgery in Extensive Occlusion of the Femoro-Popliteal Artery.- 1.1. Autogenous saphenous vein bypass graft.- 1.2. Bilateral autogenous saphenous vein bypass graft.- 1.3. Composite saphenous vein bypass graft. Combination of ipsilateral and contralateral saphenous vein.- 1.4. Combination of proximal endarterectomy with venous patch graft angioplasty and distal saphenous vein bypass graft.- IV — Reconstructive Surgery in Common Femoral Occlusive Disease.- 1. Bilateral stenosis of the common femoral artery bifurcation treated by disobliteration and vein patch graft angioplasty.- 2. Bilateral obstruction of the common femoral artery treated by thromboendarterectomy and vein patch graft angioplasty.- 3. Occlusion of the common femoral artery and stenosis of the external iliac artery.- 3.1. Open and closed-loop endarterectomy with synthetic patch graft angioplasty.- 3.2. Endarterectomy and vein patch graft angioplasty.- 4.Occlusion of the common femoral artery and its bifurcation; treatment by disobstruction and Y-shaped vein patch graft angioplasty.- 5. Occlusion of the common femoral artery and inoperable occlusive disease of the femoropopliteal artery; reconstruction of the inflow tract of the profunda femoris artery.- V — Reconstructive Surgery in External Iliac Occlusive Disease/.- 1. Stenosis of the external iliac artery.- 1.1. Endarterectomy and patch graft angioplasty.- 1.2. Side-to-side anastomosis between hypogastric artery and external iliac artery.- 2. Extensive occlusion of the external iliac (and common femoral) artery.- 2.1. Prosthetic bypass graft.- 2.2. Prosthetic bypass graft through the obturator foramen.- 2.3. Combination of proximal prosthetic bypass graft and distal endarterectomy with venous patch graft angioplasty.- 2.4. Endarterectomy with proximal synthetic and distal autogenous venous patch graft angioplasty.- 2.5. Autogenous saphenous vein graft.- 2.6. Closed-loop endarterectomy.- VI — Reconstructive Surgery in Unilateral Common Iliac Occlusive Disease/.- 1.1. Disobliteration and prosthetic patch graft angioplasty.- 1.2. Resection and replacement by prosthetic graft.- 1.3. Partial resection and exclusion arterioplasty with prosthesis.- 1.4. Bypass reconstruction.- VII — Reconstructive Surgery in Extensive Thrombosis of the Common and External Iliac Arteries/.- 1.1. Prosthetic exclusion arterioplasty.- 1.2. Combination of proximal prosthetic substitution and distal endarterectomy with synthetic patch graft angioplasty.- 1.3. Combination of proximal prosthetic replacement and distal endarterectomy with venous patch graft angioplasty.- 1.4. Crossover bypass with prosthetic graft.- 1.5. Crossover bypass with venous autograft.- VIII — Reconstructive Surgery in Aortoiliac Occlusive Disease.- 1. Stenosis of the aortic bifurcation treated by endarterectomy and patch graft angioplasty.- 2. Stenosis of aortoiliac arteries.- 2.1. Disobliteration and synthetic patch graft angioplasty on both sides.- 2.2. Disobliteration and synthetic patch graft angioplasty on both sides (continued).- 2.3. Endarterectomy in combination with synthetic patch graft angioplasty on one side and venous patch graft angioplasty on the other side.- 2.4. Disobliteration and Y-shaped patch graft angioplasty.- 2.5. Disobliteration with patch graft angioplasty on one side and bypass graft on the other.- 2.6. Bypass reconstruction with bifurcated tube.- 2.7. Resection and replacement by prosthetic bifurcation.- 3. Occlusion of aortoiliac arteries.- 3.1. Resection and replacement by prosthetic bifurcation.- 3.2. Resection and prosthetic replacement with distal end-to-side anastomosis.- 3.3. Bypass operation.- 4. Coarctation of the aortic bifurcation treated by resection and replacement.- IX — Reconstructive Surgery in Iliofemoral Occlusive Disease.- 1. Elective revascularizing procedures of the profunda femoris artery.- 1.1. Prosthetic aortoprofunda bypass graft.- 1.2. Combination of proximal prosthetic replacement and distal endarterectomy with venous patch graft angioplasty.- 1.3. Endarterectomy with proximal synthetic and distal venous patch graft angioplasty.- 1.4. Autogenous saphenous vein graft.- 1.5. Crossover bypass with venous autograft.- 1.6. Closed-loop endarterectomy.- 2. (Aorto-) iliopopliteal bypass procedure.- 2.1. Resection and replacement of the aortic bifurcation; bypass of the iliofemoral artery and endarterectomy of the common femoral artery.- 2.2. Iliopopliteal composite saphenous vein bypass graft.- X — Reconstructive Surgery for Ascending Thrombosis of Aortoiliac Arteries/.- 1. Ascending thrombosis of the aortoiliac arteries with partial patency of the subrenal aortic segment (Types A and B).- 1.1. Resection and replacement of the obstructed aortic bifurcation; endarterectomy of the infrarenal part of the aorta combined with patch graft angioplasty.- 1.2. Resection and replacement of the obstructed aortoiliac arteries; endarterectomy of the infrarenal aortic segment and left common femoral artery combined with patch graft angioplasty.- 1.3. Aortoiliac bypass operation; treatment of the common femoral arteries by endarterectomy and vein patch graft angioplasty.- 2. Ascending occlusion of the aortoiliac arteries to immediately below the level of the renal arteries (Type C); treatment by resection and prosthetic replacement using an infrarenal aortic anastomosis.- 3. Ascending occlusion of the aortoiliac arteries with associated stenosis of one renal artery (Type D).- 3.1. Resection and prosthetic replacement of the aortoiliac arteries; left-sided nephrectomy.- 3.2. Resection and prosthetic replacement of the aortoiliac arteries; revascularization of the left kidney by means of splenorenal anastomosis.- 3.3. Resection and prosthetic replacement of the infrarenal aorta and aortic bifurcation; re-implantation of the post-stenotic renal artery into the prosthesis with interposition of a synthetic graft.- 3.4. Resection and prosthetic replacement of the infrarenal aorta and aortic bifurcation; re-implantation of the post-stenotic renal artery into the prosthesis with interposition of a splenic artery segment.- 3.5. Resection and prosthetic replacement of the aortoiliac arteries; autogenous vein bypass graft between endarterectomized subrenal part of the aorta and post-stenotic renal artery.- 3.6. Resection and prosthetic replacement of the aortoiliac arteries; re-implantation of the post-stenotic renal artery into the endarterectomized subrenal part of the aorta with interposition of an autogenous vein graft.- 4. Ascending occlusion of the aortoiliac arteries with associated stenosis of both renal arteries (Type E).- 4.1. Aortoiliac bypass operation using parts of the autogenous splenic artery as renal branches.- 4.2. Resection and prosthetic replacement of the aortoiliac arteries; insertion of two autogenous vein bypass grafts between endarterectomized subrenal part of the aorta and post-stenotic renal arteries.- XI — Reconstructive Surgery of Arterial an Eu Rysms.- 1. Aneurysm of the femoropopliteal artery.- 2. Aneurysm of the common femoral artery.- 3. Aneurysm of the infrarenal aorta.- 3.1. Resection and replacement by prosthetic bifurcation.- 3.2. Resection and replacement by prosthetic bifurcation with suprarenal aortic clamping.- 4. Multiple aortic aneurysms with kinking of the pre-aneurysmal portion of the aorta.- 5. Ruptured aneurysm of the infrarenal aorta.- 6. Aneurysm of the infrarenal aorta and aortic bifurcation.- 7. Aneurysm of the aortic bifurcation.- 8. Aneurysm of the infrarenal aorta with associated stenosis of one renal artery.- 8.1. Resection of the aneurysm and prosthetic replacement; transaortic endarterectomy of the stenotic renal artery.- 8.2. Resection of the aneurysm and prosthetic replacement; insertion of autogenous vein bypass graft between subrenal part of aorta and post-stenotic renal artery.- 9. Aneurysm of the midportion of the abdominal aorta with associated occlusion of one renal artery.- 10. Aneurysm of the thoracoabdominal aorta.- 10.1. Resection of the aneurysm and prosthetic replacement using a temporary external bypass shunt.- 14.2. Resection of the aneurysm and prosthetic replacement using a temporary internal bypass shunt.- 11. Aortic aneurysm combined with iliac occlusive disease.- 11.1. Stenosis of the aortic bifurcation and aneurysm of the abdominal aorta. Resection and prosthetic replacement.- 11.2. Aneurysm of the abdominal aorta combined with iliac occlusive disease. Treatment by resection and prosthetic replacement.- XII — Reconstructive Surgery in Renal Artery Stenosis and Occlusion/.- 1. Unilateral renal artery stenosis.- 1.1. Excision of the stenotic part of the renal artery with end-to-end anastomosis.- 1.1.1. Straight end-to-end anastomosis.- 1.1.2. Oblique end-to-end anastomosis.- 1.2. Endarterectomy with patch graft angioplasty.- 1.2.1. Endarterectomy with autogenous venous patch graft angioplasty.- 1.2.2. Disobliteration with autogenous venous patch graft angioplasty.- 1.2.3. Endarterectomy with aortorenal synthetic patch graft angioplasty.- 1.2.4. Endarterectomy and aortorenal autogenous arterial patch graft angioplasty.- 1.3. Splenorenal anastomosis.- 1.3.1. Resection of the stenotic part of the renal artery; end-to-end splenorenal anastomosis.- 1.3.2. End-to-side splenorenal anastomosis.- 1.3.3. End-to-end anastomosis between the splenic artery and the right renal artery.- 1.4. Resection and replacement by autogenous vein graft.- 1.5. Aortorenal bypass reconstruction.- 1.5.1. Aortorenal prosthetic bypass graft.- 1.5.2.Aortorenal bypass with autogenous splenic artery graft.- 1.5.3. Aortorenal bypass with autogenous vein graft.- 1.5.4. Aortorenal bypass with autogenous vein graft (continued).- 1.6. Re-implantation with graft interposition.- 1.6.1. Re-implantation with interposition of splenic artery graft.- 1.6.2. Re-implantation with interposition of venous graft.- 1.6.3. Re-implantation with interposition of prosthetic graft.- 1.7. Iliac-renal reconstructive procedures.- 1.7.1. Iliac-renal prosthetic bypass.- 1.7.2. Re-implantation of the renal artery into the common iliac artery with interposition of venous graft.- 2. Unilateral renal artery occlusion.- 2.1. Re-implantation with interposition of venous graft.- 22. End-to-end splenorenal anastomosis.- 3. Bilateral renal artery stenosis.- 3.1. Endarterectomy and bilateral aortorenal patch graft angioplasty.- 3.2. Endarterectomy with aortorenal patch graft angioplasty on the right side; splenorenal anastomosis on the left side.- 3.3. Bilateral aortorenal bypass with splenic artery grafts.- 3.4. Bilateral re-implantation with interposition of one continuous venous graft.- XIII — Reconstructive Surgery in Celiac and Superior Mesenteric Artery Occlusive Disease.- 1. Stenosis of the superior mesenteric artery.- 1.1. Endarterectomy with synthetic patch graft angioplasty.- 1.2. Aortomesenteric bypass procedure.- 1.2.1. Aortomesenteric prosthetic bypass graft.- 1.2.2. Aortomesenteric venous bypass graft.- 1.3. Re-implantation of the superior mesenteric artery into the aorta.- 2. Compression and stenosis of the celiac trunk.- XIV — Reconstructive Surgery in Occlusive Disease of the Branches of the Aortic Arch.- 1. Stenosis of the carotid bifurcation.- 1.1. Endarterectomy with synthetic patch graft angioplasty.- 1.2. Endarterectomy with venous patch graft angioplasty.- 2. Extensive stenosis of the internal carotid artery, treated by endarterectomy and venous patch graft angioplasty.- 3. Kinking of the internal carotid artery treated by transection and re-implantation of the internal carotid artery into the common carotid artery.- 4. Obstruction of the proximal part of the left common carotid artery.- 4.1. Endarterectomy with synthetic patch graft angioplasty.- 4.2. Re-implantation into the aortic arch with interposition of prosthetic graft.- 5. Stenosis of the proximal part of the vertebral artery, treated by disobliteration and venous patch graft angioplasty.- 6. Total occlusion of the left subclavian artery, treated by endarterectomy and venous patch graft angioplasty.- 7. Stenosis of the proximal part and occlusion of the distal half of the left subclavian artery; stenosis of the proximal vertebral artery. Reconstruction by disobliteration and patch graft angioplasties.- 8. Subclavian steal syndrome in left subclavian artery obstruction.- 8.1. Resection and prosthetic replacement.- 8.2. Prosthetic bypass graft.- 8.3. Endarterectomy and synthetic patch graft angioplasty.- 9. Subclavian steal syndrome in right subclavian artery occlusion, treated by disobliteration and synthetic patch graft angioplasty.- 10. Subclavian steal carotid recovery phenomenon in innominate artery occlusion. Reconstruction of the innominate artery by endarterectomy and synthetic patch graft angioplasty.- 11. Occlusive lesions of the innominate and right subclavian and common carotid arteries, treated with bifurcated bypass graft.- XV — Reconstructive Surgery in Traumatic and Iatrogenic Arterial Lesions.- 1. Traumatic arterial lesions of the upper and lower extremities.- 1.1. Acute traumatic lesion of the brachial artery; resection and replacement by an autogenous venous graft.- 1.2. Acute traumatic lesion and thrombosis of the superficial femoral artery; resection and venous graft replacement.- 1.3. Traumatic occlusion of the femoropopliteal artery; treatment with synthetic bypass graft.- 2. Traumatic arterial lesions of the shoulder and inguinal region.- 2.1. Traumatic occlusion of the left subclavian artery, treated by resection and venous graft replacement.- 2.2. Acute traumatic lesion and thrombosis of the common femoral artery bifurcation; treatment by resection and venous graft replacement.- 3. Traumatic arterial lesions of the trunk.- 3.1. Traumatic rupture of the descending aorta; treatment by resection of an aortic segment and prosthetic graft replacement.- 3.2. Acute traumatic lesion of the left iliac artery; treatment by crossover prosthetic bypass graft through the obturator foramen.- 4. Iatrogenic aneurysms and arteriovenous fistulas.- 4.1. Traumatic false aneurysm and arteriovenous fistula of the popliteal artery, treated by resection and replacement by an autogenous vein.- 4.2. False aneurysm due to disruption of a femoral bypass anastomosis, treated by resection and replacement.- 4.3. False aneurysm of the superficial femoral artery due to disruption of the suture of a synthetic patch; resection and replacement by an autogenous vein graft.