Content from the Journal of the American Neurological Surgeons.
Dr. Mack began his practice in Dallas in 1982 and soon became involved in the creation and development of minimally invasive surgical techniques including video assisted thoracic surgery (VATS). He was also instrumental in the development of endoscopic spine surgery and has continued research on endoscopic applications of cardiac surgery. Michael Mack, MD, has been a…
As one of the country’s current leaders in the field of thoracic surgery, Mark B. Orringer, MD, has focused much of his academic career on the diagnosis and treatment of benign and malignant esophageal disease. He has developed two leading esophageal operations: the combined Collis-Nissen hiatal hernia repair and transhiatal esophagectomy without thoracotomy. Dr. Orringer…
David P. Taggart, MD, reviews the Guidelines on Myocardial Revascularization, developed in 2010 by the European Society of Cardiology (ESC) and the European Association for Cardio-thoracic Surgery (EACTS). Dr. Taggart is a cardiac surgeon at the John Radcliffe Hospital in Oxford. After becoming a consultant, he completed a PhD and wrote a systematic review on…
Peter Vincent Moulder, Jr. was born January 26, 1921. He died May 10, 2010, at age 89. Dr. Moulder was known as Pete to his residents and colleagues, even when familiarity between layers of the surgical hierarchy was uncommon. He earned his B.S. degree magna cum laude at Notre Dame University in 1942, and was…
Precision cautery excision, or the Perelman procedure, is ideal for: Resection of multiple lung lesions as in metastasectomy where preservation of lung tissue is important. Deep-seated lesions where placement of staplers is precluded by the thickness of the lung tissue. The principle behind this technique is to core out the nodule from the surrounding lung…
The article describes the 2-year follow-up of a patient with a 5-cm aneurysm of the descending thoracic aorta associated with a chronic Type B aortic dissection, which was successfully treated with an endovascular stent-graft. Introduction The current generation of endovascular stent-grafts are approved exclusively for the treatment of atherosclerotic aneurysms of the descending thoracic aorta.…
Introduction Introducer sheaths currently provide the safest method of maintaining access to the vascular system during an endoluminal procedure. The use of sheaths is now recommended for nearly every endoluminal procedure, whether diagnostic or interventional. Sheaths are essential if exchanging of guidewires or catheters is planned, if any large or irregular devices are to be…
Introduction Whether diagnostic or interventional, catheters and other endovascular devices are rarely sufficiently maneuverable to be used without guidewires. The purpose of guidewires is to create a pathway in the vascular system through which the endoluminal practitioner may act. In most endovascular procedures guidewires achieve and maintain the critical access across the target lesion, making…
Introduction “Diagnostic” catheters allow the endoluminal practitioner to assess areas of the vascular system and to evaluate for a possible intervention; additionally, they assist in performing an intervention. This often involves the delivery of radiographic contrast for opacification of the vessel lumen in radiographic studies. This can involve visualization of a specific branch vessel using…
Introduction Balloon catheters have two principal applications in peripheral endoluminal procedures. Therapeutic or angioplasty ballooning is the forceful inflation of a balloon to dilate stenotic/occlusive lesions in a vessel. This is accomplished using noncompliant balloons, constructed of material that resists deformation when subjected to pressure; the more noncompliant (i.e. stiffer) the balloon material, the greater…
Patient Selection Indications for endovascular repair of the abdominal aortic aneurysm are: Patients with asymptomatic abdominal aortic aneurysm greater than 5 cm in an orthogonal projection or larger than twice the size of the normal abdominal aorta or an aneurysm diameter of 4–5 cm, which has also increased in size by 0.5 cm in last…
Patient Selection Indications for endovascular repair of the thoracic aortic aneurysm (Figure 1) are: Figure 1: The three-dimension reconstruction (Medical Metrx Solutions, West Lebanon, NH) off the aortic-centerline from a contrast-enhanced high-resolution computer tomography scan showing an “ideal candidate” for TEVAR. Patients with an asymptomatic descending aortic aneurysm larger than twice the size of the…
Patient Selection Indications for endovascular repair of the iliac artery are: Stenosis or (short-segment) occlusion of iliac artery (TASC type A and B, TASC C lesions are controversial) with ipsilateral lower extremity ischemia (lifestyle-limiting, progressive claudication, rest pain, gangrene). Patients with asymptomatic aneurysm greater than 4 cm in diameter. An iliac aneurysm which has also…
Patient Selection Renal artery stenosis (RAS) of >70% of one or both renal arteries AND poorly controlled hypertension despite multiple antihypertensive regimen, or chronic renal insufficiency related to RAS Dialysis dependent renal failure in patients without another definite cause Recurrent congestive heart failure or flash pulmonary edema not attributed to active ischemia Renal artery aneurysm…
In 1932, the radiologist Henry Pancoast first described a superior pulmonary sulcus tumor (SST) as a carcinoma (of uncertain origin) developing in the apex of the chest. Patient Selection In 1932, the radiologist Henry Pancoast (Figure 1) first described a superior pulmonary sulcus tumor (SST) as a carcinoma (of uncertain origin) developing in the apex of…
STSA Surgical Motion Picture 2009 Annual Meeting Type IV paraesophageal hernia can be a complicated problem which may be managed from various surgical approaches. This video describes the technical aspects of a laparascopic approach and the necessity of adhering to the surgical principles required for a successful repair. Hernia sac excision and reduction of its…
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