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Vascular / Endovascular Surgery Vascular / Endovascular Surgery Combat Manual Combat Manual

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Vascular / Endovascular Surgery Vascular / Endovascular Surgery Combat Manual Combat Manual Vascular / Endovascular Surgery / Endovascular Vascular Vascular / Endovascular Surgery Combat Manual Combat Manual Combat W. L. Gore & Associates, Inc. Flagstaff, AZ 86004 +65.67332882 (Asia Pacific) 800.437.8181 (United States) 00800.6334.4673 (Europe) 928.779.2771 (United States) goremedical.com Stone Stone AbuRahma Campbell GORE®, EXCLUDER®, TAG®, VIABAHN®, and designs are trademarks of W. L. Gore & Associates. AbuRahma © 2012, 2013 W. L. Gore & Associates, Inc. AS0315-EN1 JULY 2013 Campbell Compliments of W. L. Gore & Associates, Inc. This publication, compliments of W. L. Gore & Associates, Inc. (Gore), is intended to serve as an educational resource for medical students, residents, and fellows pursuing training in vascular and endovascular surgery. Readers are reminded to consult appropriate references before engaging in any patient diagnosis, treatment, or surgery, including Prescribing Information (including boxed warnings and medication guides), Instructions for Use, and other applicable current information available from manufacturers. Gore products referenced within are used within their FDA approved / cleared indications. Gore does not have knowledge of the indications and FDA approval / clearance status of non-Gore products, and Gore does not advise or recommend any surgical methods or techniques other than those described in the Instructions for Use for its devices. Gore makes no representations or warranties as to the PERCLOSE®, PROSTAR®, SPARTACORE®, STARCLOSE®, and SUPRACORE® are trademarks of Abbott Laboratories. surgical techniques, medical conditions, or other factors that OMNI FLUSH and SIMMONS SIDEWINDER are trademarks of AngioDynamics. ICAST is a trademark of Atrium Medical Corporation. ASPIRIN® is a trademark of Bayer HealthCare, LLC. MORPH® is a trademark of BioCardia, may be described in this publication. Inc. AGGRENOX® and PRADAXA® are trademarks of Boehringer Ingelheim Pharma GmbH & Co. KG. AMPLATZ, GREENFIELD®, and WALLSTENT® are trademarks of Boston Scientific Corporation or its affiliates. COUMADIN® and GLUCOPHAGE® are trademarks of Bristol-Myers Squibb. CARDIVA CATALYST is a trademark of Cardiva Medical, Inc. BIRD’S NEST®, COOK®, CELECT, LUNDERQUIST®, PTX®, TX2®, ZENITH®, and ZILVER® are trademarks The opinions and advice expressed herein are those of the of COOK® Medical. GENESIS, OPTEASE®, PALMAZ®, and TRAPEASE® are trademarks of Cordis Corporation. FLAIR®, authors alone, and do not reflect the opinions or advice of FLUENCY®, and VECTRA® are trademarks of C. R. Bard, Inc. EFFIENT® is a trademark of Eli Lilly and Company. POWERLINK® is a trademark of Endologix, Inc. ANCEF® is a registered trademark of GlaxoSmithKline. ANCURE® Gore or the West Virginia University. is a trademark of Guidant Corporation. DACRON® is a trademark of INVISTA. SYVEK® is a trademark of Marine Polymer Technologies, Inc. SAFEGUARD® is a trademark of MAQUET. BENADRYL® is a trademark of McNEIL-PPC. ANEURX®, ENDURANT®, EVS, PIONEER®, and TALENT are trademarks of Medtronic, Inc. HIBICLENS® is a trademark of Mölnlycke® Healthcare US, LLC. NOVOSEVEN® is a trademark of Novo Nordisk A/S. PLETAL® is a trademark of Otsuka America Pharmaceutical, Inc. SOLU-MEDROL® and SOLU-CORTEF® are trademarks of Pfizer. LOVENOX® is a trademark of sanofi-aventis U.S. LLC. PLAVIX® is a trademark of Sanofi. CLO-SUR PLUS P.A.D is a trademark of Scion Cardio Vascular, Inc. ANGIO-SEAL, FEMOSTOP, and VASOSEAL are trademarks of St. Jude Medical, Inc. GLIDECATH® and GLIDEWIRE® are trademarks of Terumo Medical Corporation. ANGIOMAX® is a trademark of The Medicines Company. VECTRA® is a trademark of Thoratec Corporation. D-STAT® and DUETT are trademarks of Vascular Solutions, Inc. VANCOCIN® is a trademark of ViroPharma Incorporated. ZOSYN® is a trademark of Wyeth Pharmaceuticals Inc. This publication, compliments of W. L. Gore & Associates, Inc. (Gore), is intended to serve as an educational resource for medical students, residents, and fellows pursuing training in vascular and endovascular surgery. Readers are reminded to consult appropriate references before engaging in any patient diagnosis, treatment, or surgery, including Prescribing Information (including boxed warnings and medication guides), Instructions for Use, and other applicable current information available from manufacturers. Gore products referenced within are used within their FDA approved / cleared indications. Gore does not have knowledge of the indications and FDA approval / clearance status of non-Gore products, and Gore does not advise or recommend any surgical methods or techniques other than those described in the Instructions for Use for its devices. Gore makes no representations or warranties as to the PERCLOSE®, PROSTAR®, SPARTACORE®, STARCLOSE®, and SUPRACORE® are trademarks of Abbott Laboratories. surgical techniques, medical conditions, or other factors that OMNI FLUSH and SIMMONS SIDEWINDER are trademarks of AngioDynamics. ICAST is a trademark of Atrium Medical Corporation. ASPIRIN® is a trademark of Bayer HealthCare, LLC. MORPH® is a trademark of BioCardia, may be described in this publication. Inc. AGGRENOX® and PRADAXA® are trademarks of Boehringer Ingelheim Pharma GmbH & Co. KG. AMPLATZ, GREENFIELD®, and WALLSTENT® are trademarks of Boston Scientific Corporation or its affiliates. COUMADIN® and GLUCOPHAGE® are trademarks of Bristol-Myers Squibb. CARDIVA CATALYST is a trademark of Cardiva Medical, Inc. BIRD’S NEST®, COOK®, CELECT, LUNDERQUIST®, PTX®, TX2®, ZENITH®, and ZILVER® are trademarks The opinions and advice expressed herein are those of the of COOK® Medical. GENESIS, OPTEASE®, PALMAZ®, and TRAPEASE® are trademarks of Cordis Corporation. FLAIR®, authors alone, and do not reflect the opinions or advice of FLUENCY®, and VECTRA® are trademarks of C. R. Bard, Inc. EFFIENT® is a trademark of Eli Lilly and Company. POWERLINK® is a trademark of Endologix, Inc. ANCEF® is a registered trademark of GlaxoSmithKline. ANCURE® Gore or the West Virginia University. is a trademark of Guidant Corporation. DACRON® is a trademark of INVISTA. SYVEK® is a trademark of Marine Polymer Technologies, Inc. SAFEGUARD® is a trademark of MAQUET. BENADRYL® is a trademark of McNEIL-PPC. ANEURX®, ENDURANT®, EVS, PIONEER®, and TALENT are trademarks of Medtronic, Inc. HIBICLENS® is a trademark of Mölnlycke® Healthcare US, LLC. NOVOSEVEN® is a trademark of Novo Nordisk A/S. PLETAL® is a trademark of Otsuka America Pharmaceutical, Inc. SOLU-MEDROL® and SOLU-CORTEF® are trademarks of Pfizer. LOVENOX® is a trademark of sanofi-aventis U.S. LLC. PLAVIX® is a trademark of Sanofi. CLO-SUR PLUS P.A.D is a trademark of Scion Cardio Vascular, Inc. ANGIO-SEAL, FEMOSTOP, and VASOSEAL are trademarks of St. Jude Medical, Inc. GLIDECATH® and GLIDEWIRE® are trademarks of Terumo Medical Corporation. ANGIOMAX® is a trademark of The Medicines Company. VECTRA® is a trademark of Thoratec Corporation. D-STAT® and DUETT are trademarks of Vascular Solutions, Inc. VANCOCIN® is a trademark of ViroPharma Incorporated. ZOSYN® is a trademark of Wyeth Pharmaceuticals Inc. TAFF VASCULAR/ENDOVASCULAR SURGERY S COMBAT MANUAL ISION ISION V Patrick A. Stone, MD, FACS Editor and Chief Associate Professor of Surgery Ali F. AbuRahma, MD, FACS Section Editor Open Vascular Reconstructions Professor of Surgery John E. Campbell, MD DI CHARLESTON ERSITY: Section Editor Vascular Medicine and Endovascular Surgery V Assistant Professor of Medicine and Surgery Contributing Authors Saadi Alhalbouni, MD Vascular Surgery Fellow WEST VIRGINIA UNI VIRGINIA WEST Mark C. Bates MD, FACC, FSCAI, FSVM Professor of Medicine and Surgery James R. Campbell II, MD Assistant Professor of Surgery and Medicine D. Daniel Dearing, MD Vascular Surgery Fellow Stephen M. Hass, MD, JD Assistant Professor of Surgery Albeir Y. Mousa, MD Associate Professor of Surgery Aravinda Nanjundappa, MD, FACC Associate Professor of Medicine and Surgery Mohit Srivastava, MD Assistant Professor of Surgery West Virginia University: Charleston Division Department of Surgery: Division of Vascular and Endovascular Surgery a DEDICATION This book is dedicated to James P. Boland, MD. No single individual has had such a significant impact on surgical education and retention of general surgeons in West Virginia. His devotion to patient care extended from university practice to the private practice community without reservation. His ability to bring chaos to order in the operating room was felt by hospital staff and physicians alike. His teachings and patience will not be forgotten, but preserved through generations of surgeons trained under his watch. “It feels good to be under the bright lights….” James P. Boland, MD Chairman Dept. of Surgery West Virginia University Charleston Division 1976–2011 VASCULAR SURGERY RULES OF ENGAGEMENT When talking to families postoperatively, explain your biggest 1. NGAGEMENT concerns about the case — no one likes surprises. E 2. When you talk to patients, always do it sitting down. 3. If you do it perfect it might work. OF LES RU Make claudicators beg for intervention. 4. RGERY RGERY Arterial access appears simple but can be deadly. 5. SU If you have not seen it done before, there is a reason why. 6. LAR LAR Amputation survival is equivalent to metastatic cancer. 7. CU 8. Close the skin like it is your baby’s face. Patients judge you more on the outside appearance than what you did on the inside. VAS 9. If it can get infected, it will. 10. Statistics apply to everything — the numbers always catch up to you eventually. 11. If you don’t like what it looks
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