Vascular Imaging and Intervention
Vascular Imaging and Intervention
Second Edition
VOLUME 1 & 2
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Vascular Imaging and Intervention (Volume 1 & 2)
First Edition: 1992
Second Edition: 2020
9789385999024
Printed at
To my wonderful wife, Eunjoo, my lovely children, LeeAnn, SueAnn, and Andrew, and my son-in-law, Alexi Arango and SueAnn's fiancé, Roozbeh Alavi, for their unwavering support throughout the years of writing this book.
To our loving parents, Changgun Kim, Sunchom Kim, Howard Kangil Lee and Grace Kumsoon Cho Lee, with eternal gratitude for their everlasting support.
To my inspirational uncles, Bishop Paul Kim and Rev. Joseph Kim for their continuous prayers and blessings.
To my mentors: Profound appreciation for training me and showing me the wonders of cardiovascular and interventional radiology at Stanford University Medical Center: Professors Luis Wexler, William R Brody, Paul R Cipriano, Joseph F Walter, Diana Guthaner, and James F Silverman.
To my exemplary Chief, the late Dr Sven Paulin, Miriam H Stoneman, Professor of Radiology at Harvard Medical School, with whom I tremendously enjoyed working.
To my motivational professors, Professor Bong-Sop Sim, MD and Professor Byung Sok Min, MD at Catholic University College of Medicine.
To my friends and colleagues, Dr Jong Suk Hahn, Dr Yoon O Chang, Dr Kwang Woo Lee, Dr Kwang Soo Kim, Dr Jaechul Roh, and Dr Jae-Hyung Kim for their collegial encouragement, support, and heartfelt friendship.
To Dan E Orron for his immensely supportive friendship making this epic edition possible after our first co-edited book, Peripheral Vascular Imaging and Intervention.
Ducksoo Kim
There are so many people to thank for their support on this project, including my parents Julia and Abraham Orron, my brother David and his wife Dara, my children Zvika, Bar and Yonathan, my daughter-in-law Masha Tseitlin-Orron, my grandchildren Daniella, Avigail, and Daria, the Tseitlin, Karr, Cypis, Orren and Lachter families.
To Ducksoo Kim for his persistence since the first edition (Peripheral Vascular Imaging and Intervention) that this project can and should be done.
To the precious memory of two who left us prematurely; Yura Tseitlin and Moshe Graif.
Dan E Orron
To my wife Bharati and my sons Aayan and Darsh for their support, understanding and patience.
To my father Haribhai and mother Kumud for always believing in me and instilling in me strong work ethics, fairness and thirst for knowledge.
Nilesh H Patel
To my mother, Bella Farber, my brother Senia Farber who helped me to get to where I am today; and to my wife Carolyn, my daughter Elina and son Jake for providing me with daily support, love and inspiration.
Alik Farber
- Mohamad Abdalkader MD
- Fellow of Interventional Neuroradiology Boston Medical Center
- Boston, Massachusetts, USA
- Kush Agrawal MD
- Cardiovascular Consultant Central Arizona Heart Specialists
- Chandler, Arizona, USA
- Rafael Alvarez MD
- Resident of Surgery
- University of Michigan Health System Ann Arbor, Michigan, USA
- Vinit B Amin MD
- Staff Vascular and
- Interventional Radiologist
- Consulting Radiologists, Ltd.
- Edna and Plymouth
- Minnesota, USA
- Erin Angel PhD
- Senior Manager
- Clinical Collaborations
- Canon Medical Systems USA
- Tustin, California, USA
- Tetsuro Araki MD
- Research Fellow of Radiology
- Brigham and Women's Hospital
- Harvard Medical School
- Boston, Massachusetts, USA
- Lindsay M Arnold PharmD BCPS
- Clinical Specialist Lead
- Internal Medicine and Anticoagulation Department of Pharmacy
- Boston Medical Center
- Boston, Massachusetts, USA
- Rahul Arya MD
- Interventional Radiologist
- Department of Radiology
- Ingalls Memorial Hospital
- Harvey, Illinois and St James Franciscan Hospital
- Olympia Fields, Illinois, USA
- Galit Aviram MD
- Senior Lecturer
- Tel Aviv University Sackler School of Medicine
- Director
- Cardiothoracic Imaging Unit
- Tel-Aviv Sourasky Medical Center
- Tel Aviv, Israel
- Eyal Avraham MD
- Vascular Surgery Resident
- Carmel Medical Center
- Technion Medical School
- Haifa, Israel
- Sandeep Bagla MD
- Adjunct Associate Professor of Radiology
- University of North Carolina Chapel Hill
- Vascular Institute of Virginia
- Woodbridge, Virginia, USA
- Richard H Behrman PhD
- Adjunct Associate Professor of Radiology Boston University School of Medicine Chief Medical Physicist/Diagnostic Imaging
- Medical Physics and Radiation Safety
- Boston Medical Center
- Boston, Massachusetts, USA
- Alex Belenky MD PhD
- Director Vascular/Interventional Radiology
- Rabin Medical Center
- Affiliated to Sackler School of Medicine
- Tel Aviv, Israel
- James F Benenati MD FSIR
- Clinical Associate Professor of Radiology
- University of South Florida
- Medical Director
- Noninvasive Vascular Laboratory
- Miami Cardiac and Vascular Institute
- Miami, Florida, USA
- Marina C Bernal-Fernandez MD
- Resident of Radiology
- Boston Medical Center
- Boston University School of Medicine
- Boston, Massachusetts, USA
- Manav Bhalla MD
- Radiologist
- Department of Radiology
- Medical College of Wisconsin
- Milwaukee, Wisconsin, USA
- Tariq M Bhat MD FACC
- Associate Director Structural Heart Program
- Associate Director, Vascular Medicine
- Clinical Assistant Professor of Medicine
- Tufts University School of Medicine
- Steward St. Elizabeth's Medical Center
- Boston, Massachusetts, USA
- Shivank Bhatia MD
- Assistant Professor of Clinical Radiology and Urology
- Medical Director of VAH Vascular and Interventional Radiology
- University of Miami Miller School of Medicine
- Miami, Florida, USA
- R Furman Borst MD
- Radiologist, Affiliates in Imaging
- A Medical Group, Inc. Diagnostic
- Radiology, Vascular and Interventional Radiology
- San Francisco, California, USA
- Megan Bowen DO
- Staff General Surgeon
- San Antonio Military Medical Center
- San Antonio, Texas, USA
- Ian M Brennan MD
- Instructor of Radiology
- Beth Israel Deaconess Medical Center
- Harvard Medical School
- Boston, Massachusetts, USA
- Olga R Brook MD
- Assistant Professor of Radiology
- Beth Israel Deaconess Medical Center
- Harvard Medical School
- Boston, Massachusetts, USA
- Danielle E Casasso DO MPH
- Staff Vascular Surgeon
- Womack Army Medical Center
- Fort Bragg, North Carolina, USA
- Francisco Cesar Carnevale MD PhD
- Chief of Service
- Vascular and Interventional Radiology
- Hospital das Clinicas
- University of São Paulo Medical School
- Hospital Sirio-Libanês
- São Paolo, Brazil
- Thomas N Carruthers MD
- Assistant Professor of Surgery
- The Warren Alpert Medical School of Brown University
- Providence, Rhode Island, USA
- Jeanette Y Chun MD
- Assistant Professor of Radiology
- Tufts Medical School
- Senior Staff Radiologist
- Lahey Hospital and Medical Center
- Burlington, Massachusetts, USA
- Kyung J Cho MD FSIR
- William Martel Emeritus Professor of Radiology
- Department of Radiology
- Vascular and Interventional Radiology University of Michigan
- Ann Arbor, Michigan, USA
- Daniel Cornfield MD
- Associate Professor of Radiology
- Yale University School of Medicine
- New Haven, Connecticut, USA
- Jacob Cynamon MD
- Professor of Clinical Radiology Albert Einstein College of Medicine Department of Radiology
- Director of Vascular and Interventional Radiology
- Montefiore Medical Center
- New York City, New York, USA
- Sanjit Datta MS
- Case Western Reserve University
- School of Medicine
- Cleveland, Ohio, USA
- Winston Brooks Davis MD
- Assistant Professor of Clinical Radiology
- Indiana University School of Medicine
- Department of Radiology and Imaging Sciences
- Indiana University Health
- Indianapolis, Indiana, USA
- Steven Deso MD
- Interventional Radiologist
- University of Vermont Health Network— Champlain Valley Physicians Hospital
- Plattsburgh, New York, USA
- Jose A Diaz MD
- Assistant Professor of Surgery
- Section of Vascular Surgery
- Conrad Jobst Vascular Research Lab.
- University of Michigan School of Medicine
- Ann Arbor, Michigan, USA
- Mehul H Doshi MD
- Assistant Professor of Clinical Radiology
- University of Miami Leonard M Miller School of Medicine
- Department of Radiology
- University of Miami Health System Miami, Florida, USA
- Robert T Eberhardt MD
- Associate Professor of Medicine and Surgery
- Boston University School of Medicine
- Director of Vascular Medicine Services
- Boston Medical Center
- Boston, Massachusetts, USA
- Mohammad H Eslami
- MD MPH FACS FACC
- Professor of Surgery
- University of Pittsburgh School of Medicine
- UPMC Medical Center
- Pittsburgh, Pennsylvania, USA
- Alik Farber MD
- Professor of Surgery and Radiology
- Boston University School of Medicine
- Chief of Vascular Surgery
- Boston Medical Center
- Boston, Massachusetts, USA
- Roberto Ferraresi MD
- Peripheral Interventional Unit
- Diabetic Foot Clinic
- Istituto Clinico Città Studi
- Bergamo, Italy
- Aloke V Finn MD
- Medical Director
- CVPath Institute Inc.,
- 19 Firstfield Road
- Gaithersburg, Maryland, USA
- William D Foley MD FACR
- Professor of Radiology
- Medical College of Wisconsin
- Chief of Radiology
- Froedtert Hospital
- Milwaukee, Wisconsin, USA
- Brian Funaki MD
- Professor and Chief
- Vascular and Interventional Radiology
- University of Chicago Medicine Chicago, Illinois, USA
- Martin Funovics MD
- Associate Professor of Radiology
- The Medical University
- Vienna, Austria
- Ripal T Gandhi MD FSVM
- Miami Cardiac and Vascular Institute
- Associate Clinical Professor
- FIU Herbert Wertheim College of Medicine
- Assistant Clinical Professor
- University of South Florida College of Medicine
- Miami, Florida, USA
- Lawrence A Garcia MD
- Chief, Section Interventional Cardiology and Vascular Interventions
- Chief, Vascular Medicine
- Associate Professor of Medicine Tufts University School of Medicine
- Boston, Massachusetts, USA
- Yigal Gat MSc MD PhD
- Andrology and Interventional Radiology Unit
- Mayanei HaYeshua Medical Center
- Bnei Brak, Israel
- Condensed Matter Physics
- Weizmann Institute of Science
- Rehovot, Israel
- Jonathan D Gates MD MBA FACS
- Chief, Department of Surgery
- Vascular Surgery/Trauma Surgery
- Professor of Surgery
- Hartford Hospital
- University of Connecticut School of Medicine
- Farmington, Connecticut, USA
- Adam R Geronemus MD
- Vascular and Interventional Radiologist
- Miami Cardiac and Vascular Institute
- Miami, Florida, USA
- Associate Clinical Professor
- Department of Radiology
- University of South Florida College of Medicine
- Miami, Florida, USA
- Basavaraj Ghodke MD
- Director of Interventional
- Neuroradiology Harborview Medical Center
- Professor of Radiology and Neurological Surgery
- University of Washington
- Harborview Medical Center
- Seattle, Washington, USA
- Shanchita Ghosh MD
- Radiology Resident
- Jackson Memorial Hospital
- University of Miami Miller School of Medicine
- Miami, Florida, USA
- Gary W Gibbon MD FACS
- Professor of Surgery
- Boston University School of Medicine
- Medical Director
- South Shore Hospital Center for Wound Healing
- Weymouth, Massachusetts, USA
- Yosef S Golowa MD
- Associate Professor of Clinical Radiology
- Albert Einstein College of Medicine
- Department of Radiology
- Vascular and Interventional Radiology
- Montefiore Medical Center
- New York City, New York, USA
- Menachem Goren MD
- Assistant Chief of Radiology
- St James Mercy Hospital
- Hornell, New York, USA
- Carlos J Guevara MD
- Assistant Professor of Radiology and Surgery
- Washington University School of Medicine
- Interventional Radiology
- Mallinckrodt Institute of Radiology
- St Louis, Missouri, USA
- Naren Gupta MD PhD
- Southeastern Vascular Specialists
- Division of Vascular Surgery
- Hyannis, Massachusetts, USA
- Sanjay Gupta MD
- Professor of Radiology
- Department of Interventional Radiology
- The University of Texas
- MD Anderson Cancer Center
- Houston, Texas, USA
- Danial K Hallam MD MSc
- Professor of Radiology and Neurological Surgery
- University of Washington
- Harborview Medical Center
- Seattle, Washington, USA
- Praveen Hariharan MD MPH
- Associate Investigator
- Center for Vascular Emergencies
- Massachusetts General Hospital
- Physician, Boston VA Healthcare System
- Boston, Massachusetts, USA
- Hiroto Hatabu MD PhD
- Professor of Radiology
- Harvard Medical School
- Senior Radiologist
- Brigham and Women's Hospital
- Boston, Massachusetts, USA
- Eitan Heldenberg MD
- Chief
- Department of Vascular Surgery
- Assaf Harofeh Medical Center
- Tzrifin, Israel
- Affiliated to Sackler School of Medicine
- Tel Aviv University
- Tel Aviv, Israel
- Peter K Henke MD
- Leland Ira Doan Professor of Vascular Surgery
- Associate Chair of Research
- University of Michigan Health System
- Ann Arbor, Michigan, USA
- Dirk M Hentschel MD
- Assistant Professor of Medicine Harvard Medical School
- Director of Interventional Nephrology
- Division of Renal Medicine
- Brigham and Women's Hospital
- Boston, Massachusetts, USA
- Matthew Hoimes MD MS
- Assistant Clinical Professor of Radiology
- Tufts Medical School
- Adjunct Assistant Professor of Radiology
- University of Massachusetts Medical School
- Radiologist
- Newton-Wellesley Radiology Associates
- Newton, Massachusetts, USA
- Gabriel P Howles-Banerji MD PhD
- Interventional Radiologist
- Kaiser-Permanente East Bay Medical Center
- Oakland, California, USA
- Gloria Hwang MD
- Clinical Assistant
- Professor of Radiology
- Stanford University
- Division of Interventional Radiology Stanford University Medical Center Stanford, California, USA
- Ibrahim A Idakoji MD MPH
- Clinical Instructor
- Division of Interventional Radiology
- Stanford University Medical Center
- Stanford, California, USA
- Hernán J Jara PhD
- Professor of Radiology
- Boston University School of Medicine Director of Research
- Boston Medical Center
- Boston, Massachusetts, USA
- Matthew S Johnson MD
- Professor of Radiology and Surgery
- Indiana University School of Medicine
- Department of Radiology and Imaging Sciences
- Indiana University Health
- Indianapolis, Indiana, USA
- Issam I Kably MD
- Assistant Professor of Radiology
- University of Miami Miller School of Medicine
- Vascular and Interventional Radiology Jackson Memorial Hospital—Jackson Health System
- Miami, Florida, USA
- Christopher Kabrhel MD MPH
- Director
- Center for Vascular Emergencies
- Department of Emergency Medicine
- Massachusetts General Hospital
- Associate Professor Harvard Medical School
- Boston, Massachusetts, USA
- Nii-Kabu Kabutey MD
- Clinical Associate Professor of Surgery and Radiology
- Division of Vascular Surgery
- University of California
- Irvine, California, USA
- Jeffrey Kalish MD
- Associate Professor of Surgery and Radiology
- Boston University School of Medicine
- Director of Endovascular Surgery
- Boston Medical Center
- Boston, Massachusetts, USA
- Ron Karmeli MD
- Professor of Surgery
- Chief of Vascular Surgery
- Carmel Medical Center
- Technion Medical School
- Haifa, Israel
- Barry T Katzen MD FSIR
- Founder and Chief Medical Executive Miami Cardiac and Vascular Institute
- Associate Dean of Clinical Affairs
- Baptist Health
- Clinical Professor of Radiology and Surgery
- Herbert Wertheim College of Medicine Florida International University
- Miami, Florida, USA
- Claire S Kaufman MD
- Vascular and Interventional Radiologist University Hospital
- Assistant Professor of Radiology University of Utah
- Salt Lake City, Utah, USA
- John A Kaufman MD FSIR
- Professor of Radiology
- University of Oregon
- Director of Dotter Interventional Institute
- Portland, Oregon, USA
- Ashish Khandelwal MD
- Senior Associate Consultant and Assistant Professor
- Department of Radiology
- Mayo Clinic
- Rochester, Minnesota, USA
- Charles Y Kim MD FSIR
- Division Chief
- Vascular and Interventional Radiology
- Associate Professor of Radiology
- Duke University Medical Center
- Durham, North Carolina, USA
- Ducksoo Kim MD FSIR
- Professor of Radiology
- Boston University School of Medicine
- Chief of Vascular and Interventional Radiology
- Boston VA Healthcare System
- Boston, Massachusetts, USA
- Edward Kim MD
- Associate Professor of Radiology and Surgery
- Icahn School of Medicine at Mount Sinai
- Director of Interventional Oncology
- The Mount Sinai Hospital
- New York City, New York, USA
- Louis J Kim MD
- Professor of Neurological Surgery and Radiology
- University of Washington School of Medicine
- Seattle, Washington, USA
- Stanley Kim MD
- Interventional Radiologist
- Vascular Surgery and Interventional Radiology Partners
- Northwestern Medicine Regional Medical Group
- Central DuPage Hospital
- Winfield, Illinois, USA
- Young Kim MD
- Professor of Radiology
- University of Massachusetts School of Medicine
- Umass Memorial Healthcare
- Worcester, Massachusetts, USA
- Sirish Kishore MD
- Assistant Professor of Radiology
- Weill Cornell Medical College
- Department of Radiology
- Division of Interventional Radiology
- Memorial Sloan Kettering Cancer Center
- New York City, New York, USA
- Tilo Kölbel MD PhD
- Professor of Vascular Medicine
- University of Hamburg
- University Heart Center
- Hamburg, Germany
- Ralf R Kolvenbach MD
- Professor of Surgery
- University of Düsseldorf
- Director, Department of Vascular Surgery and Endovascular Therapy
- Augusta Hospital
- Catholic Hospital Group
- Düsseldorf, Germany ORf
- KMR Hospital and Augusta Clinics
- Düsseldorf, Germany
- Orhan Konez MD
- Longview Radiologists PS Inc
- Department of Radiology
- PeaceHealth St John Medical Center
- Longview, Washington, USA
- Juri Kopolovic MD
- Professor of Pathology
- Hebrew University
- Department of Pathology
- Hadassah Medical Center
- Jerusalem, Israel
- Nishita Kothary MD FSIR
- Professor
- Interventional Radiology
- Stanford University Medical Center Stanford, California, USA
- Venkataramu N Krishnamurthy MD
- Clinical Professor of Radiology and Vascular Surgery
- University of Michigan Hospitals
- Chief of Radiology Services
- VA Ann Arbor Health System
- Ann Arbor, Michigan, USA
- Paul Laeseke MD
- Assistant Professor of Radiology
- Department of Radiology
- University of Wisconsin
- Madison, Wisconsin, USA
- Cuong H Lam MD MBA
- Interventional Radiology Specialist Vascular and Interventional Radiology
- Kaiser Permanente Los Angeles Medical Center
- Los Angeles, California, USA
- Johannes Lammer MD
- Professor Emeritus of Radiology
- The Medical University of Vienna
- Vienna, Austria
- Jordan V Lao MD
- Diagnostic and Interventional Radiologist
- South Texas Radiology Group
- San Antonio Texas, USA
- Igor Latich MD
- Assistant Professor of Radiology and Biomedical Imaging
- Yale School of Medicine
- Vascular and Interventional Radiology
- New Haven, Connecticut, USA
- Byung-Boong Lee MD PhD FACS
- Professor of Surgery and Director
- Center for the Lymphedema and Vascular Malformations
- George Washington University Washington DC
- Adjunct Professor of Surgery
- Uniformed Services University of the Health Sciences
- Bethesda, Maryland, USA
- Jason T Lee MD
- Professor of Surgery
- Division of Vascular Surgery
- Stanford University School of Medicine Stanford University Medical Center
- Stanford, California, USA
- Jonathan Lorenz MD
- Professor of Radiology
- Vascular and Interventional Radiology
- University of Chicago Medicine Chicago, Illinois, USA
- John R McGrath MD
- Staff Interventional Radiologist
- Women and Children's Hospital
- The State University of New York at Buffalo
- Buffalo, New York, USA
- Francis MacNamara MBA
- Vice-president of Advanced Technology at Hansen Medical Inc.
- Mountain View, California, USA
- Justin P McWilliams MD
- Associate Professor of Radiology
- David Geffen School of Medicine at UCLA
- Co-Director, UCLA HHT Center of Excellence
- Division of Interventional Radiology
- Los Angeles, California, USA
- Marco Manzi MD
- Interventional Radiologist
- Interventional Radiology Unit
- Foot and Ankle Clinic
- Policlinico Abano Terme
- Padua, Italy
- Marco Molina MD
- Assistant Professor of Radiology
- Chief of Abdominal Imaging and Ultrasound
- UConn Health Radiology
- Farmington, Connecticut, USA
- Carla C Moreira MD
- University Surgical Associates
- Rhode Island Hospital
- Warren Alpert Medical School of Brown University
- Providence, Rhode Island, USA
- Kerstin Müller PhD
- Siemens Healthineers Product Manager CT Clinical Applications and Workflow
- Forchheim, Germany
- Daniel D Myers DVM
- Associate Professor of Surgery
- University of Michigan
- Section of Vascular Surgery
- Director
- Jobst Vascular Research Laboratories
- University of Michigan Health System
- Ann Arbor, Michigan, USA
- Govindarajan Narayanan MD
- Associate Professor of Clinical Radiology
- University of Miami Leonard M Miller
- School of Medicine
- Department of Radiology
- University of Miami Health System Miami, Florida, USA
- Andrea T Obi MD
- Assistant Professor of Surgery
- Department of Vascular Surgery
- University of Michigan Health System
- Ann Arbor, Michigan, USA
- Paul J O'Connor MD
- Resident of Radiology
- Icahn School of Medicine at Mount Sinai
- New York City, New York, USA
- Bruno C Odisio MD
- Assistant Professor of Radiology
- Department of Interventional Radiology
- The University of Texas
- MD Anderson Cancer Center
- Houston, Texas, USA
- Dan E Orron MD
- Director, Angiography/Interventional Radiology
- The Lady Davis Carmel Medical Center
- The Ruth and Bruce Rappaport Faculty of Medicine
- Technion—Israel Institute of Technology
- Haifa, Israel
- Johanna A Pallotta MD
- Associate Professor of Medicine
- Harvard Medical School
- Head of the Radioimmunoassay Laboratory and Director of the Endocrinology Clinic
- Beth Israel Deaconess Medical Center
- Boston, Massachusetts, USA
- Ashvin N Pande MD
- Assistant Professor of Medicine
- Boston University School of Medicine Director of Invasive Cardiology
- Boston Medical Center
- Boston, Massachusetts, USA
- Amish Patel MD
- Attending Radiologist
- Interventional Institute at Holy Name Medical Center
- Teaneck, New Jersey, USA
- Nilesh H Patel MD FSIR
- President
- Darshan, Inc.
- Reno, Nevada, USA
- Parag J Patel MD FSIR
- Associate Professor of Radiology and Surgery
- Medical College of Wisconsin
- Department of Radiology
- Froedtert Hospital
- Milwaukee, Wisconsin, USA
- Jeffrey S Pollak MD FSIR
- Professor of Radiology and Vascular Surgery
- Department of Radiology and Biomedical Imaging
- Yale School of Medicine
- New Haven, Connecticut, USA
- Keith B Quencer MD
- Vascular and Interventional Radiologist University Hospital
- Assistant Professor of Radiology
- University of Utah
- Salt Lake City, Utah, USA
- Dheeraj K Rajan MD
- Head and Professor
- Vascular and Interventional Radiology
- Department of Medical Imaging
- University Health Network
- University of Toronto
- Toronto, Ontario, Canada
- Sandeep Rao MD MBA
- Interventional Radiologist
- Department of Radiology
- Providence Memorial Hospital and Sierra Medical Center
- El Paso, Texas, USA
- Sekhar Rao MD
- Former Staff Interventional Radiologist
- VA Palo Alto Health Care System
- Medical Director of Xbiotech
- Austin, Texas, USA
- Neeraj Rastogi MD
- Former Vascular and Interventional Radiology Fellow
- Boston Medical Center
- Boston, Massachusetts, USA
- Charles E Ray MD PhD
- Professor and Chief of Radiology
- University of Illinois Hospital and Health Sciences Center
- Chicago, Illinois, USA
- Chet R Rees MD FSIR
- Clinical Professor of Radiology
- Baylor Scott and White Health Interventional Radiology
- TAMHSC-BUMC
- Dallas, Texas, USA
- Renato Ripamonti MD
- Interventional Radiology
- Vascular Surgery and Interventional Radiology Partners
- Northwestern Medicine Regional Medical Group
- Northwestern Medicine
- Central DuPage Hospital
- Winfield, Illinois, USA
- John R Ross MD
- Chief Surgeon
- Dialysis Access Institute
- The Regional Medical Center
- Orangeburg, South Carolina, USA
- Barry A Sacks MD
- Clinical Associate Professor of Radiology
- Harvard Medical School
- Attending Interventional Radiologist
- Department of Radiology
- Beth Israel Deaconess Medical Center
- Boston, Massachusetts, USA
- Umar Sadat MRCS MPhil PhD
- Specialist Registrar in Vascular Surgery Cambridge Vascular Unit
- Cambridge University Hospitals Foundation Trust, UK
- Jason T Salsamendi MD
- Assistant Professor of Clinical Radiology Medical Director
- JMH Interventional Radiology
- University of Miami Miller School of Medicine
- Miami, Florida, USA
- Andres Schanzer MD FACS
- Professor of Surgery and Quantitative Health Sciences
- University of Massachusetts Medical School
- Worcester, Massachusetts, USA
- Matthew J Scheidt MD
- Assistant Clinical Professor of Radiology
- University of Illinois College of Medicine
- Peoria Central Illinois Radiological Associates
- Peoria, Illinois, USA
- Mickey Scheinowitz PhD FACSM
- Director
- Sylvan Adams Sports Institute
- Tel Aviv University
- Tel Aviv, Israel
- Peter A Schneider MD
- Chief of Vascular Surgery
- Kaiser Permanente Moanalua Medical Center
- Honolulu, Hawaii, USA
- Joseph R Schneider MD PhD
- Professor of Surgery
- Northwestern University Feinberg School of Medicine
- Vascular Surgery and Interventional Radiology Partners
- Northwestern Medicine
- Winfield, Illinois, USA
- Leslie M Scoutt MD
- Professor of Radiology Vascular Surgery and Cardiology
- Vice Chair
- Department of Radiology and Biomedical Imaging
- Chief, Ultrasound Section
- Yale School of Medicine
- New Haven, Connecticut, USA
- Laligam N Sekhar MD FAANS FACS
- Professor and Vice Chairman
- Department of Neurosurgery
- University of Washington
- Harborview Medical Center
- Seattle, Washington, USA
- Seanthan Senthilnathan MD
- Radiology Resident
- Department of Medical Imaging University Health Network
- University of Toronto
- Toronto, Ontario, Canada
- Michael D Sgroi MD
- Assistant Professor of Surgery
- Division of Vascular Surgery
- Stanford University
- Stanford, California, USA
- Emerson E Sharpe III MD
- Vascular and Interventional Radiologist
- Colorado Permanente Medical Group
- Denver, Colorado, USA
- Palma M Shaw MD
- Associate Professor of Surgery
- SUNY Medical Center
- State University of New York
- Syracuse, New York, USA
- Naomi Shin MD
- Internist
- Umass Memorial Medical Center
- University of Massachusetts Medical School
- Worcester, Massachusetts, USA
- Jessica P Simons MD MPH
- Assistant Professor of Surgery
- University of Massachusetts Medical School
- Worcester, Massachusetts, USA
- Michael Singh MD
- Associate Professor of Surgery
- Chief, Vascular Surgery UPMC Shayside
- Co-Director Aortic Center
- UPMC Heart and Vascular Institute Pittsburgh, Pennsylvania, USA
- Jeffrey J Siracuse MD
- Assistant Professor of Surgery and Radiology
- Division of Vascular and Endovascular Surgery
- Boston University School of Medicine
- Boston Medical Center
- Boston, Massachusetts, USA
- Brian F Stainken MD FACR FSIR
- Chief
- Department of Radiology
- The Stamford Hospital
- Stamford, Connecticut, USA
- Michael L Steigner MD
- Assistant Professor of Radiology
- Harvard Medical School
- Director of Vascular CT/MR
- Heart and Vascular Center
- Brigham and Women's Hospital
- Boston, Massachusetts, USA
- Kevan Stewart MD
- Interventional Radiologist
- Department of Radiology
- Texas Tech University Health Sciences Center
- El Paso, Texas, USA
- Charles S Sutton MD
- Volunteer Clinical Faculty
- The Commonwealth Medical College Scranton, Pennsylvania, USA
- Tze-Woei Tan MD
- Assistant Professor
- Division of Vascular Surgery and Southern Arizona Limb Salvage Alliance (SALSA)
- Banner University Medical Center/University of Arizona
- Tucson, Arizona, USA
- Elizabeth Tang MD
- Assistant Professor of Radiology
- Seattle Childrens Hospital
- University of Washington
- Seattle, WA, USA
- Tjun Y Tang MD FRCS (Gen) FAMS
- Adjunct Assistant Professor
- Consultant Vascular and Endovascular Surgeon
- Department of Vascular Surgery
- Singapore General Hospital, Singapore
- Farzana Tariq MD
- Neurosurgery Resident
- Wayne State University School of Medicine, Detroit Medical Center
- Detroit, Michigan, USA
- Parag P Tolat MD
- Assistant Professor of Radiology
- Medical College of Wisconsin
- Chief of Abdominal/body Imaging
- Froedtert Hospital
- Milwaukee, Wisconsin, USA
- Roger T Tomihama MD
- Assistant Professor of Radiology
- Vascular and Interventional Radiology
- Loma Linda University Medical Center
- Loma Linda, California, USA
- Sho Torii MD PhD
- Research Fellow
- CV Path Institute Inc.,
- 19 Firstfield Road
- Gaithersburg, Maryland, USA
- Yasumi Uchida MD
- President
- Japan Foundation for Cardiovascular Research
- Associate Professor
- Head, Section of Cardiology
- Second Division of Internal Medicine Toho University Medical Center
- Tokyo, Japan
- The Institute of Japanese Foundation for Cardiovascular Research
- Funabashi, Japan
- Yasuto Uchida MD
- Cardiologist
- Department of Cardiology
- Toho University Medical Center
- Tokyo, Japan
- Gilad W Vainer MD PhD
- Department of Pathology
- The Tel Aviv Sourasky Medical Center
- The Tel Aviv University
- Tel Aviv, Israel
- Suresh Vedantham MD FSIR
- Professor of Radiology and Surgery
- Washington University School of Medicine in St Louis
- Interventional Radiology
- Mallinckrodt Institute of Radiology
- St Louis, Missouri, USA
- Michael J Verta MD
- Associate Professor of Surgery
- Feinberg School of Medicine Northwestern University
- Vascular Surgery and Interventional Radiology Partners/VSIR
- Northwestern Medicine Regional Medical Group
- Winfield, Illinois, USA
- Rajendran Vilvendhan MD
- Assistant Professor of Radiology
- Boston University School of Medicine
- Director of Vascular and Interventional Radiology
- Boston Medical Center
- Boston, Massachusetts, USA
- Renu Virmani MD
- President, CV Path Institute Inc.,
- 19 Firstfield Road
- Gaithersburg, Maryland, USA
- Thomas W Wakefield MD
- Professor of Surgery
- Head, Section of Vascular Surgery
- Director, Frankel Cardiovascular Center
- University of Michigan Medicine
- Ann Arbor, Michigan, USA
- Matthew Walsworth MD
- Assistant Professor
- David Geffen School of Medicine
- University of California, Los Angeles
- West Los Angeles VA Medical Center
- Los Angeles, California, USA
- David S Wang MD
- Clinical Assistant Professor
- Division of Interventional Radiology
- Stanford University School of Medicine
- Stanford, California, USA
- Alison Witkin MD
- Department of Internal Medicine
- Division of Pulmonary/Critical Care
- Massachusetts General Hospital
- Instructor in Medicine
- Harvard Medical School
- Boston, Massachusetts, USA
- Paolo Zamboni MD
- Director of Vascular Disease Center
- Institute of Translational Medicine and Surgery, University of Ferrara
- Ferrara, Italy
- Steven Zangan MD
- Associate Professor of Radiology
- Sections of Interventional and Thoracic Radiology
- Associate Program Director Interventional Radiology Residency
- University of Chicago Medicine Chicago, Illinois, USA
- Mohamed A Zayed MD
- Assistant Professor of Surgery
- Section of Vascular and Endovascular Surgery
- Washington University School of Medicine
- Staff Physician
- Department of Surgery
- VA St Louis Health Care
- St Louis, Missouri, USA
- Wayne W Zhang MD
- Professor of Surgery
- Division of Vascular Surgery
- University of Washington
- Seattle, Washington, USA
We (Drs Ducksoo Kim and Dan E Orron) begin by reproducing the Foreword to the original book Peripheral Vascular Imaging and Intervention, CV Mosby, 1992, prepared by the late Professor Sven Paulin, our department chair in 1992. Svens' description of the conceptual design of the original book holds true today for the expanded second edition.
Ducksoo Kim MD
Dan E Orron MD
The discovery of the X-ray nearly 100 years ago, undoubtedly, can be considered as one of the most important milestones when acknowledging the profound impact of technology on the practice of clinical medicine and health care. In fact, over time, it has led to the development of a clinical specialty—radiology—the professional performers of which, in developed countries, now includes approximately four percent of the total number of physicians. Further subspecialization has occurred and, as radiologists do not develop de novo, they were represented by inquisitive and innovative young clinicians who had a strong belief in the new technology's value and usefulness.
Consequently, it should not be a surprise if also many of the “grandfathers” in vascular and interventional radiology originated from different fields of medicine and science. Examples are the Portuguese neurologist Antonio Moniz, who was credited with the first carotid angiogram in 1928, and the young surgeon, Werner Forssmann (Nobel Prize winner, 1956), who, during the same year and while still in training, inserted a ureteric catheter into his own antecubital vein to follow its advance into the heart under fluoroscopic control. A cardiologist, F Mason Sones, Jr., first intentionally injected contrast selectively into a human coronary artery in 1959 and from there on dedicated himself totally to the development and practice of selective coronary angiography for the remainder of his life.
Sven-Ivar Seldinger, on the other hand, already enjoyed the benefit of a complete radiologic education and several years of practice before he, in 1953, described his ingenious wire exchange technique over the needle and thereby introduced percutaneous vascular catheterization, which eventually became one of the most widely used. The same is true for Melvin Judkins and his chief, Dr Charles Dotter, who must be credited with the concept and first application of intraluminal vessel dilatation; whereas Andreas Griintzig, who subsequently perfected the technique by using dilating balloons, received his initial training in medicine and angiology. Consequently, credit for progress must be given to a great number of major or minor contributions by individual scientists or clinicians, rather than to a particular discipline.
None of these achievements, which ultimately led to the establishment of vascular and interventional radiology, would have been possible without the enormous strides made in biologic sciences and technology, not infrequently brought to fruition in research collaboration supported by industry. Examples of such development include the ongoing improvement of radiographic contrast agents, the latest formulations of which can be administered in sufficient quantity without noticeable subjective or objective side effects. Of similar importance was the development of improved and refined catheters and guiding systems. These have an important role in achieving today's impressive success rate and safety for most complex procedures, which are performed with high-gain X-ray image intensifiers and displayed on high-definition screens with simultaneous tape or disk recording, and capabilities for instant replay and real-time subtraction.
The field is growing in all dimensions-quantitatively, qualitatively, and in complexity. There have always been available a number of good and excellent texts. The most comprehensive effort to encompass the entire field was Abrams’ Angiography, of which the third edition appeared less than a decade ago. It comprises three volumes with a total of 2400 pages, the majority of which are devoted to diagnostic problems; only a minority address interventions with therapeutic intentions. It was in this third edition (1983) that Charles Dotter was able to account for transluminal angioplasty in 24 pages and Andreas Griintzig for percutaneous transluminal coronary angioplasty in 12 pages of text, a task which would be impossible today.
Apparently, Drs Ducksoo Kim and Dan E Orron have taken such reflections to heart and wisely decided to focus on the peripheral vascular system, for which this work is to provide a state-of-the-art comprehensive source, although many of the included chapters may describe topics that have wider applications elsewhere in the human body.
The first part of the book, which is dedicated to peripheral vascular imaging, discusses the basics of our present approach to peripheral arterial disease as it confronts angiographically active radiologists in major teaching hospitals that are referral and trauma centers. To the description of the various technical aspects of arteriography, its performance, and interpretation are added chapters that address normal anatomy, general vascular pathology, the impact of contrast agents, and potential side effects and complications. Extensive chapters on the clinical and operative aspects of peripheral vascular disease are a logical consequence of the examination's purpose; namely, to establish precisely the degree and extent of the disease process and thus to provide the basis for a sound therapy, whether medically conservative, surgically aggressive, or both.
X-ray angiography has lost its monopoly of in vivo diagnosis of vascular disease. Consequently, in the subsequent two sections, the book discusses diagnostic modalities that permit vascular imaging using less invasive, more lenient, and therefore better-tolerated approaches. This is an important evolution considering the ever-increasing application of diagnostic and therapeutic measures to the elderly population. Most remarkable in this respect are the recent advances in magnetic resonance angiography, opening the prospects for a completely noninvasive imaging of nearly all components of the human vascular system. On the other hand, the development of even more advanced invasive techniques such as angioscopy or transluminal ultrasound offer the direct analysis of vascular pathology. Their introduction may well herald the beginning of a new era during which we shall unravel more precisely the natural history of disease processes and develop specific therapy.
The second part of the text describes, under the heading “Peripheral Vascular Intervention,” the present status of nonsurgical, vascular, therapeutic approaches. Dr Ducksoo Kim, who entered this field a decade ago as a cardiovascular radiology fellow at Stanford University and who from that time on dedicated his entire professional activities to this field, with a considerable amount of personal experience, contributes to several of the more than 20 chapters (expanded to 72 chapters in the second edition “Vascular Imaging and Intervention”) that deal with different technical or pharmacological approaches in the field. Some of the approaches already are established quite firmly; others are in the state of clinical testing or are undergoing evaluation with high prospects for clinical use.
Dr Ducksoo Kim has solicited contributions from a great number of outstanding angiographers and researchers, who graciously contributed irrespective of their busy schedules and heavy workloads. They have added to this work's value in providing the reader with an up-to-date description of the state-of-the-art in intravascular interventions. They constitute a useful reference for those actively performing diagnostic and interventional peripheral angiography, as well as to others, particularly the vascular surgeons and referring clinicians, who care for people with peripheral vascular disease and whose close collaboration is essential for ultimate success.
Sven Paulin MD PhD
Former Radiologist-in-Chief
Beth Israel Deaconess Medical Center
Miriam H Stoneman
Professor of Radiology
Harvard Medical School
Boston, Massachusetts, USA
Foreword
I would like to begin by congratulating Drs Ducksoo Kim, Dan E Orron, Nilesh H Patel and Alik Farber for editing this new, modern, comprehensive textbook on Vascular Imaging and Intervention. Interventional radiology is a quickly advancing discipline that tests the outer limits of what is possible in medicine today. It is well known to anyone practicing in this innovative field, that new information and techniques are paramount to good patient outcomes. In this textbook, the editors were able to gather the best and brightest physicians practicing vascular medicine and publish a beautiful new textbook with 72 chapters, more than 100 authors and thousands of images.
A review of the Table of Contents attests to the title of the textbook, as every topic related to vascular imaging and intervention is covered. The first chapter titled Digital Subtraction Imaging and Cone-beam C-Arm CT Imaging is a chapter filled with information and illustrations that benefit both the novice and experienced angiographers. Subsequent chapters are written with the same mindset. This textbook can be used either as a reference or as required reading for anyone training in this vast field of medicine.
I often ask young trainees what they would do if after they completed their training, they were asked to do a procedure that they had never actually performed during training, and no other physician with direct experience in this procedure was available. The answers vary from “of course I would not do it” to “of course I would.” Our discipline trains us to be good physicians and to “do no harm,” while attempting to do what is in the best interest of the patient. My response to this question would be to see the patient and assess the situation. If the patient requires the procedure and would benefit from it, then it should be done by the most experienced operator available to perform the procedure. In my experience, that individual is often the trained Interventional Radiologist, even if he had not performed that particular procedure. We are taught catheter and guidewire techniques that can be adapted to any aspect of medicine. There are many procedures that were not in our armamentarium when we trained yet they are routine procedures today. However, prior to performing the procedure, one should review any information available on the subject. Vascular Imaging and Intervention can be the go to text in these situations.
I look forward to having this textbook on my shelf, referring to it and having my trainees read it and discuss its contents. I thank Dan E Orron, Ducksoo Kim, Nilesh H Patel and Alik Farber for including me in this monumental work and for the opportunity to write the Interventional Radiology foreword. I wish you much success.
Jacob Cynamon MD
Professor of Radiology
Albert Einstein College of Medicine
Director
Division of Vascular and Interventional Radiology
Montefiore Medical Center
Bronx, New York, USA
Foreword
Our understanding of the many manifestations of peripheral vascular disease and its management is rapidly evolving; which most would consider an understatement.
Vascular Imaging and Intervention serves both as a core curriculum and a current treatise for all aspects of diagnostic imaging and endovascular management of noncardiac vascular disease. This textbook serves as a foundation and treatment guide for experts in the field of vascular disease, as well as fellows, residents and students. It can be viewed as an information source of practical clinical utility, as basic vascular anatomy and physiology have been reviewed and integrated with clearly descriptive color figures. Additionally, the many descriptive angiographic images lend themselves to a clear understanding of the underlying disease states being investigated and the rationale for treatment.
The rapid evolution of our knowledge of atherosclerotic vascular disease has led to decreased death from heart and cerebrovascular disease. However, despite these demographic trends, there are increasing cardiovascular risks such as the epidemic of obesity, diabetes, insulin resistance, persistence of smoking and a decline in physical activity. This amalgamation of risk factors reminds us that the ongoing prevalence of arterial disease will continue to challenge our vascular resources, and continue to require the increasing expertise of vascular specialists. This textbook reviews the important aspects of diagnosis and treatment of arterial occlusive disease in all of the vascular beds. This includes vasculogenic erectile dysfunction due to arterial occlusive disease of the pudendal circulation, which is an area frequently overlooked.
Contemporary data on intervention for lower extremity peripheral arterial occlusive disease reveal that the majority of interventions are now endovascular. Years ago, endovascular repair for abdominal aortic aneurysms eclipsed open repair because of the significantly reduced procedural morbidity. We are observing the same for the endovascular management of thoracic aortic aneurysms.
In most patients with high risk carotid bifurcation disease, surgical endarterectomy is still the best procedure to manage the culprit carotid lesion compared to traditional femoral approach carotid angioplasty and stenting. However, techniques designed to access the cervical carotid, thereby avoiding the aortic arch during carotid cannulation, appear to be changing the risk-benefit ratio of the procedure.
Venous thromboembolism continues to be an increasing public health concern. Pulmonary embolism is the leading cause of avoidable hospital death, and is the second leading cause of maternal mortality. Deep Vein Thrombosis (DVT) affects from 500,000 to 1,000,000 persons per year in the United States, depending upon the estimates used. Suffice it to say, it is an increasingly large number of patients affected both acutely and chronically. Considering that 50% of those affected with DVT will develop post-thrombotic syndrome (PTS), and that 25% will develop moderate to severe PTS, one can quickly appreciate the increasing number of patients who will require skilled vascular care, both for their acute, extensive DVT, and for the chronic central collagenous venous occlusion causing their severe post-thrombotic morbidity. Proper diagnosis of these complex problems is then followed by catheter-based techniques to either eliminate the acute thrombus to avoid the severe PTS, or to correct the underlying chronic central venous obstruction, if the acute thrombus was not eliminated during treatment of the acute thrombosis. The importance of proper and safe pre-treatment imaging, appropriate intraprocedural imaging, proper procedural selection and technique are crucial to successful patient outcomes and is the substance of this textbook.
I look forward to having this textbook in hand. It will be a welcome addition to my vascular library and occupy a space reserved for those volumes which are important and frequently reviewed. It will assist with guiding patients to make the correct decision for their vascular care. It will assist with the proper diagnostic approach, procedural selection the performance of the technique. Additionally, it will be a valuable resource for preparation for conferences, discussion of case presentations and grand rounds. This textbook is an excellent investment for ones’ education and has the potential of being one of the most worn vascular textbooks on the shelf.
Anthony J Comerota MD FACS FACC
Medical Director, Eastern Region
Inova Heart and Vascular Institute
Inova Alexandria Hospital
Alexandria, Virginia, USA
Preface
Endovascular practice requires not only technical expertise but a familiarity with the clinical features of the disease being treated and a commitment to patient care and follow-up. This textbook is an expanded version of the original book Peripheral Vascular Imaging and Intervention, (Mosby-Yearbook 1992), which was designed as a singular resource for the peripheral endovascular practitioners at that time. In the nearly 30 years which have passed, endovascular techniques have become a mainstay of therapy for aortic and peripheral vascular disease, and have been applied to a wide array of other pathologies in the realm of the “peripheral” endovascular specialist. Equally impactful has been the progress of imaging techniques which to a large degree have replaced diagnostic catheter angiography. This book represents an expanded version of the original book and includes 72 chapters divided into 17 sections covering all modalities of Vascular Imaging, Radiation Safety, Contrast Agents, Patient Care and Pharmacologics, Vascular Anatomy, Vascular Pathology, Angiographic Techniques, Endovascular Devices, and arterial and venous endovascular interventions of the neck, thorax, abdomen, pelvis and extremities. This book provides a rich collection of more than 4,500 images, illustrations and tables to reinforce knowledge of vascular diseases and treatments. The contributor list includes authors intimately involved with the development of the relevant technique or technology.
Each chapter combines instruction on methodology with a review of the indications, limitations, and complications.
By incorporating a review of the current status of research and development, the readers will be provided with a background that will facilitate critical evaluation of new technology in the future.
Ducksoo Kim
Dan E Orron
Nilesh H Patel
Alik Farber
Acknowledgments
We are sincerely indebted to the contributing authors who found the time to prepare their chapters despite extremely busy schedules.
We greatly appreciate the staff of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for their assistance, thoroughness, patience and professional work.
We are very grateful to our families for their tremendous support and understanding.
We are thankful to Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Ms Chetna Malhotra Vohra (Associate Director—Content Strategy), and Ms Madhuri Aggarwal (Development Editor) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for giving a go-ahead at the very beginning and helping us in every way possible to bring out this book.
Ducksoo Kim
Dan E Orron
Nilesh H Patel
Alik Farber