Yearbook of Vascular and Endovascular Surgery 2016 R Sekhar
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ge1Yearbook of Vascular and Endovascular Surgery 2016ge2
ge3Yearbook of Vascular and Endovascular Surgery 2016
R Sekhar MS FRCS (Edin) FRCS (Glasg) FVSI Consultant Vascular and Endovascular Surgeon Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai Maharashtra, India Foreword Pradip K Datta
ge4
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Yearbook of Vascular and Endovascular Surgery 2016
First Edition: 2017
9789386261250
Printed at
ge5Dedication
My mother, wife Meena, daughter Rohini and my extended family,
India and abroad.
Blessed to be a member of this illustrious group of
wonderful human beings.ge6
ge7Contributors
  • Amman Bolia MBChB DMRD FRCR
  • Consultant Interventional Radiologist
  • Department of Radiology, Heartlands Hospital
  • Heart of England NHS Foundation Trust, Birmingham, UK
  • Aniket Pradhan DNB (Gen Surg) DNB (Vascular Surgery)
  • Senior Fellow in Vascular Surgery
  • Vascular and Endovascular Surgery Unit,
  • The Royal Adelaide Hospital
  • (Discipline of Surgery, The University of Adelaide)
  • North Terrace
  • Adelaide, SA
  • Ashwini Naveen Gangadharan DNB
  • Senior Registrar
  • Vascular and Endovascular Services
  • Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute
  • Mumbai, Maharashtra, India
  • Cho Ee Ng MRCS
  • Senior Clinical Fellow in Vascular Surgery
  • Queen Elizabeth Hospital NHS Foundation Trust
  • Gateshead, United Kingdom
  • Dayananda Shamurailatpam
  • Chief Physicist and Radiation
  • Safety Officer
  • Kokilaben Dhirubhai Ambani Hospital and
  • Medical Research Institute
  • Mumbai, Maharashtra, India
  • Dovile Gudzinskaite- Brar MD
  • Senior Vascular Fellow
  • King's College Hospital
  • London
  • G Atturu FRCS
  • Leeds Vascular Institute
  • Leeds General Infirmary
  • United Kingdom
  • Harshal Vora MD DNB (Nephro)
  • Senior Registrar
  • Centre for Kidney Disease
  • Kokilaben Dhirubhai Ambani Hospital and
  • Medical Research Institute
  • Mumbai, Maharashtra, India
  • J De Siqueira MRCS
  • Leeds Vascular Institute
  • Leeds General Infirmary
  • United Kingdom
  • Jessica Shah DNB
  • Registrar
  • Vascular and Endovascular Services
  • Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute
  • Mumbai, Maharashtra, India
  • Kapil Mathur MS MCh (Vascular Surgery)
  • Associate Professor
  • Department of Vascular Surgery
  • Sri Ramachandra University Chennai, Tamil Nadu, India
  • Krishna Gummalla DMRD EDIR FRCR
  • Consultant
  • Department of Radiology
  • Tan Tock Seng Hospital
  • 11 Jalan TanTock Seng
  • Singapore
  • ge8Lauren D Giamberardino MHA
  • Palmetto Health – University of South Carolina Medical Group
  • Department of Neurology
  • Columbia, South Carolina
  • USA
  • Marzanna T Zaleska
  • Medical Research Centre
  • Polish Academy of Sciences
  • Warsaw, Poland
  • Neghal Kandiyil MBChB MRCS FRCR PhD
  • Consultant Interventional Radiologist
  • Department of Radiology, University Hospitals of Leicester NHS Trust, Leicestershire, UK
  • Neil Patel MD
  • Palmetto Health – University of South Carolina Medical Group
  • Department of Neurology
  • Columbia, South Carolina
  • USA
  • Niranjan Kulkarni MD DM
  • Consultant Nephrologist
  • Centre for Kidney Disease, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai
  • Maharashtra, India
  • Paul Scott MD FRCR
  • Consultant Vascular Radiologist
  • Hull and East Yorkshire Hospitals NHS Trust, Hull, UK
  • Pranav Thusay DNB
  • Senior Registrar
  • Vascular and Endovascular Services
  • Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai
  • Maharashtra, India
  • R Sekhar MS FRCS (Glasg)FRCS (Edin) FVSI
  • Consultant Vascular and Endovascular Surgeon
  • Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute
  • Mumbai, Maharashtra, India
  • Raghvinder Pal Singh Gambhir MS DNB FRCS (Ed & Eng) FACS
  • Consultant Vascular Surgeon
  • King's College Hospital
  • London
  • Raghuram Lakshminarayan DMRD DNB FRCR FRANZCR EBIR
  • Consultant Vascular Radiologist
  • Hull and East Yorkshire Hospitals NHS Trust, Hull, UK
  • Rajesh Hydrabadi MS MCh
  • Vein Clinic
  • Ahmedabad, Gujarat, India
  • Ravish Kothari MD
  • Palmetto Health–University of South Carolina Medical Group
  • Department of Neurology
  • Columbia, South Carolina, USA
  • Ritu K Kashikar MD
  • Consultant Radiologist
  • Department of Imaging and Interventional Radiology
  • Jaslok Hospital and Research Center.
  • Mumbai, Maharashtra, India
  • Riza Ibrahim FRCS (Gen Surg) FRCS (Vascular Surgery)
  • Consultant Vascular and Endovascular Surgeon
  • Clinical Director for Vascular and Endovascular Services
  • The Pennine Acute Hospitals NHS Trust, UK
  • ge9Robert Fitridge MS FRACS
  • Professor of Vascular Surgery
  • Vascular and Endovascular Surgery Unit,
  • The Royal Adelaide Hospital
  • (Discipline of Surgery
  • The University of Adelaide)
  • North Terrace, Adelaide, SA
  • Sameer Tulpule MD MRCP (UK) FRCPath (UK)
  • Consultant
  • Clinical Hematology
  • Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai
  • Maharashtra, India
  • Satheesh Ramamurthy MD
  • Department of Interventional Radiology
  • Sri Ramachandra University
  • Chennai, Tamil Nadu, India
  • S Homer-Vanniasinkam BSc MD FRCSEd FRCS
  • Consultant Vascular Surgeon
  • The General Infirmary at Leeds
  • Clinical Sub‐Dean
  • University of Leeds Medical School
  • Professor of Surgery (Founding) University of Warwick Medical School and University Hospitals Coventry and Warwickshire NHS Trust
  • Professor of Engineering and Surgery, University College London
  • United Kingdom
  • Shrinivas B Desai MD
  • Director and Head
  • Department of Imaging and Interventional Radiology
  • Jaslok Hospital and Research Center
  • Mumbai, Maharashtra, India
  • Siddharth Rajput DNB MSc (Neuro)
  • Intensive Care Unit
  • Westmead Hospital NSW
  • Australia
  • Simit Vora DNB FVES
  • Vascular Associate
  • Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute
  • Mumbai, Maharashtra, India
  • Souvik Sen MD MS MPH FAHA
  • Professor and Chair
  • Department of Neurology
  • University of South Carolina School of Medicine
  • Columbia, South Carolina, USA
  • Sundeep Punamiya MD FSIR FAMS
  • Senior Consultant and Head Vascular and Interventional Radiology
  • Department of Radiology
  • Tan Tock Seng Hospital
  • 11 Jalan TanTock Seng
  • Singapore
  • T Vidyasagaran MS MCh (Vascular Surgery)
  • Head
  • Department of Vascular Surgery
  • Sri Ramachandra University, Chennai, Tamil Nadu, India
  • Vish Bhattacharya FRCS (Glas and Edin) FRCS (Gen Surg)
  • Consultant in Vascular Surgery
  • Clinical Lead in Surgery
  • Queen Elizabeth Hospital NHS Foundation Trust
  • Gateshead
  • United Kingdom
  • Associate Clinical Lecturer
  • Newcastle University
  • ge10Waldemar Olszewski
  • Medical Research Centre
  • Polish Academy of Sciences
  • Warsaw, Poland
  • WNDP Chinthaka Appuhamy MBBS MD MMed FRCR
  • Clinical Associate
  • Department of Neuroradiology
  • National Neuroscience Institute
  • 11 Jalan Tan Tock Seng
  • Singapore
ge11Foreword
Dr R Sekhar should be congratulated for editing this Yearbook of Vascular and Endovascular Surgery 2016. The vascular and endovascular surgical world in the subcontinent would be most grateful to him for his immense efforts. He should justly be compared with the conductor of a finely tuned orchestra in which the players are truly international. The contributors that he has gathered come from Australia, Poland, Singapore, UK and USA; some of them would rightly get a mention in ‘Who's Who in Vascular Surgery’.
This book reminds me of another monumental work in vascular surgery of yesteryear (1999) called The Evidence for Vascular Surgery by J J Earnshaw and J A Murie. Although the purpose of both these books are slightly different, their value as a font of knowledge in the speciality cannot be overestimated. This particular yearbook touches upon most aspects of recent advances and controversies, besides every chapter is extensively referenced. I dare say that the knowledge imparted will continue to be useful in future years.
Vascular surgery is now regarded as a speciality in its own right in the National Health Service in the UK. Gone are the days when there were ‘general surgeons with an interest in vascular surgery’. It is high time that vascular surgery is recognised as a superspeciality, and this yearbook testifies to that concept. Like other specialities, vascular surgery in particular works very closely as a team with the interventional radiologist, cardiologist and haematologist. This book reflects that ethos as Dr Sekhar has recruited into his team of collaborators, such specialists with great success.
As one who has edited and authored several books to do with MRCS and FRCS, I can appreciate the huge amount of work the editor has to put in, particularly to liaise with all the contributors in getting their chapters on time to meet the deadline. Dr Sekhar, previously a consultant vascular surgeon at a busy government hospital in Mumbai, has brought to bear his vast experience from that teaching hospital in publishing this book. The readers of this book and vascular surgeons in the Indian subcontinent should be indebted to him for this publication which hopefully will be the first of others to follow.
Pradip K Datta
MBE MS FRCS(Ed) FRCS(Eng) FRCS(Irel) FRCS(Glasg) FIMSA(Hon FCSSL(Hon)
Honorary Consultant Surgeon
Caithness General Hospital
Wick, Scotland, UK
Honorary Secretary (2003-2007)
Member of Council (2000-2012)
Royal College of Surgeons of Edinburghge12
ge13Preface
Yearbook of Vascular and Endovascular Surgery 2016 is an effort to give vascular practitioners access to recent concepts in vascular and endovascular therapy based on current evidences and consensus statements accepted internationally. Vascular surgery when I took it up several years ago has evolved a great deal, and despite what detractors might say or wish, endovascular work is slowly and steadily becoming the backbone of the practicing vascular surgeon worldwide. Thus, keeping abreast with changing concepts and backing procedures with evidence has become mandatory. The contributors to this book include vascular surgeons, most of whom are doing their own endovascular work, radiologists who function as part of a well-knit team of vascular specialists, clinical haematologists and nephrologists.
Bringing out a book of this nature was always a dream for me since taking up this subspeciality. The fulfilment of this dream can be attributed to several things. The good wishes of my teacher Professor Dipak Ghosh at the beginning of my career as a surgeon, the inspirational teaching methods of Mr Pradip Dutta when I was in the UK, the encouragement to teach and share knowledge that I got from Professor Gautam Sen and the resilience to struggle and succeed despite adversity from my late father Professor RC Sekhar come foremost to mind.
I am extremely indebted to the doyens in vascular surgery in India whose vision has kept the speciality evolving in India and helped grow to a stature it is today. Some like Professor Vidyasagaran have contributed to this book and I am humbled. Surgeons like Surg. Comm (Retd) Dr VS Bedi, Professor Ramesh Tripathi, Dr KR Suresh, and Dr Rajiv Parakh have taken endovascular work to a different level in India and their zeal to spread and share knowledge with trainees and mentor them has been an inspiration for me.
I am indebted to the management of Kokilaben Dhirubhai Ambani Hospital, my “karmabhoomi”, in particular Dr Ram Narain and Dr Santosh Shetty, who believed in my abilities when I joined them and continue to support me in all my academic and professional endeavours, vascular and endovascular included.
My trainee registrars, both past and present, have been brilliant. They make me proud and emotional. They have risen to the occasion time and again and their contribution to this book has been immense, to say the least.
Thank you to all the contributors, the quality and class of your chapters speaks for itself. I sincerely apologise for the pressures to meet the deadlines. A big thanks to Mr Kumaresh Menon and Mr Sabarish Menon (Mumbai branch) of M/s Jaypee Brothers Medical Publishers (P) Ltd., New Delhi India, whose support has been amazing.
R Sekharge14ge15ge16ge17ge18