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- This book will be edited by recognized experts
- Focused questions will be posed specifically and analyzed carefully according to the level of supporting evidence that is available
- Each chapter will contain a table summarizing specific characteristics relative to the question using PICO formatting (population, intervention, comparator and outcome)
The complexity of decision making in medicine, and in surgery in particular, is growing exponentially. As new technology is introduced, physicians from nonsurgical specialties offer alternative and competing therapies for what was once the exclusive province of the surgeon. In addition, there is increasing knowledge regarding the efficacy of traditional surgical therapies. How to select among these varied and complex approaches is becoming increasingly difficult. The first two editions of Difficult Decisions in Thoracic Surgery: An Evidence Based Approach have found wide acceptance among practicing surgeons, trainees, and educators. Chapters from them are regularly cited by the Thoracic Surgery Directors Association as valuable resources for their weekly curriculum exercises. Downloads of individual chapters have been very popular. The 3rd edition is in production. Based on this success, this book is part of a series of such books covering other surgical specialties. The volumes will be multi-authored, containing brief chapters, each of which will be devoted to one or two specific questions or decisions within that specialty that are difficult or controversial. The volumes are intended as a current and timely reference source for practicing surgeons, surgeons in training, and educators that describe the recommended ideal approach, rather than customary care, in selected clinical situations. Table of ContentsSection 1: Aortic Disease - Ch. 1: In patients with Acute Type B Aortic dissection, do current operative therapies reduce complications compared to medical management?
- Ch. 2: In patients with a Chronic Type B dissection, does Endovascular treatment reduce long term complications?
- Ch.3: In patients with a retrograde Type A Aortic dissection, does treatment like a type B Aortic dissection improve outcomes?
- Ch.4: In patients with small AAA, does medical therapy prevent growth?
- Ch.5: Challenging AAA Neck Anatomy: Does the Fenestrated or Snorkel/Chimney Technique Improve Mortality and Freedom from Reintervention Relative to Open Repair?
- Ch.6: In patients who require Hypogastric artery coverage to treat an AAA with EVAR, does preservation improve outcomes when compared to exclusion of the vessel?
- Ch.7: In patients with aortic graft infections, does EVAR improve long term survival compared to open graft resection?
- Ch.8: Does EVAR improve outcomes or quality of life in patients unfit for open surgery?
- Ch.9: In patients with type 2 endoleaks does intervention reduce aneurysm related morbidity and mortality compared to observation?
- Ch.10: Ruptured Abdominal Aortic Aneurysm Treated with Endovascular Repair; Does Decompressive Laparotomy Result in Improved Clinical Outcomes?
- Ch.11: In a Patient with Blunt Traumatic Aortic Injury, Does TEVAR Improve Survival Compared to Open Repair or Expectant Management?
Section 2: Lower Extremity Arterial Disease - Ch.12: In patients with Aortoiliac occlusive disease, does Endovascular repair improve outcomes when compared to open repair?
- Ch.13: In Patients with Aortoiliac Occlusive Disease, Does Extra-anatomic Bypass Improve Quality of Life and Limb Salvage?
- Ch.14: In Patients with Critical Limb Ischemia Does Bypass Improve Limb Salvage and Quality of Life When Compared to Endovascular Revascularization?
- Ch.15: In patients with limb-threatening ischemia who are not candidates for revascularization do non-operative options improve outcomes compared to amputation?
- Ch.16: In the patient with Profunda artery disease, is open revascularization superior to endovascular repair for improving rest pain?
- Ch.17: In patients with limb-threatening vascular injuries, is there a role of prophylactic fasciotomy to reduce ischemic injury?
- Ch.18: In patients with Popliteal Entrapment Syndrome, does surgery improve quality of life?
Section 3: Mesenteric Disease - Ch.19: In patients with Acute Mesenteric Ischemia does an endovascular or hybrid approach improve morbidity and mortality compared to open revascularization?
- Ch.20: Chronic Mesenteric Arterial Disease
- Does an endovascular/hybrid approach improve morbidity and mortality as compared to open revascularization?
- Ch.21: In patients with mesenteric ischemia is single vessel reconstruction equivalent to multiple vessel revascularization?
- Ch.22: In patients with celiac artery compression syndrome, does surgery improve quality of life?
- Ch.23: In patients with the Superior Mesenteric Artery syndrome is Enteric Bypass superior to Duodenal Mobilization
- Ch.24: In patients with Renovascular hypertension is there a role for open or endovascular revascularization compared to medical management?
- Ch.25: Does endovascular repair reduce the risk of rupture compared to open repair in splanchnic artery aneurysms?
Section 4: Cerebrovascular Disease - Ch.26: In patients with asymptomatic carotid artery stenosis does current best medical management reduce the risk of stroke compared to intervention (endarterectomy or stent)?
- Ch.27: In patients with symptomatic carotid artery stenosis is endarterectomy safer than carotid stenting?
- Ch.28: In Patients Undergoing Carotid Endarterectomy, is the Eversion Technique Superior to a Patch Technique to Reduce Restenosis?
- Ch.29: In patients with a stroke attributable to a carotid artery stenosis, does waiting to operate reduce the risk of complications?
- Ch.30: In patients with a peri-procedural cerebral thromboembolism, Does Neurovascular rescue improve Clinical Outcome?
- Ch.31: In patients with extra-cranial carotid artery aneurysms, does an endovascular approach improve clinical outcomes compared to open repair?
- Ch.32: In Patients with Carotid Artery Dissection, is Stenting Superior to Open Repair to Improve Clinical Outcomes?
- Ch.33: In patients with cervico-thoracic vascular injuries is endovascular repair superior in long-term durability when compared to open repair?
Section 5: Venous and Arteriovenous Disease - Ch.34: In Patients with Iliofemoral Deep Vein Thrombosis Does Clot Removal Improve Functional Outcome when Compared to Traditional Anticoagulation?
- Ch.35: In morbidly obese patients undergoing major abdominal operative procedures, does inferior vena cava filter placement prevent massive PE?
- Ch.36: In patients with chronic venous stenosis, does placement of a stent improve patency compared to recurrent angioplasty?
- Ch.37: In Patients with Chronic Venous Ulcer is the Unna Boot Still the Best Approach to Wound Care
- Ch.38: In Patients with Threatened or Occluded Access Grafts, Is it Better to Salvage the Graft, or Create a New Site?
- Ch.39: In patients with new arteriovenous fistulas, are there effective strategies to enhance AVF maturation and durability beyond waiting?
Section 6: Peri-operative Management - Ch.40: In patients with cardiovascular disease, do statins alone, or in combination with other medications improve mortality?
- Ch.41: In patients who have undergone a lower extremity bypass for PAD, does dual anti-platelet therapy improve outcomes?
- Ch.42: In patients undergoing vascular surgery, does preoperative coronary revascularization reduce the risk of myocardial infarction and death?
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