Surgery of the arteries to the head

Surgery of the arteries to the head

JOURNAL OF VASCULARSURGERY Volume 18, Number 4 vascular surgeons, radiologists and cardiologists involved in the treatment of patients with vascular ...

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JOURNAL OF VASCULARSURGERY Volume 18, Number 4

vascular surgeons, radiologists and cardiologists involved in the treatment of patients with vascular disease. It will be especially useful to introduce trainees in these fields to the principles and applications of intravas~lar imaging. Robert J. Hye, MD University of California, San Diego San Diego, Calif. Surgery of the arteries to the head Ramon Berguer, Edouard Kieffer, New York, 1992, Springer-Verlag New York, Inc., 236 pages, $150.

This slim but expensive volume of 236 pages, to quote the preface, '%vas written by two friends who, for the last decade, have shared an interest in the repair of the arteries supplying the head." The authors further state "To-date we have done 6514 reconstructions in these arteries . . . . " It must have been a busy decade. Surgery of the Arteries to the Head is written in essay style, with few references. The work is profusely and superbly illustrated with 215 excellent color drawings by medical artist Lorie Manzardo. The book is neither a surgical atlas nor a comprehensive textbook but rather a presentation of the two authors' opinions regarding surgery of the innominate, subclavian, carotid, and vertebral arteries, and the techniques that they find useful. There are 13 chapters, ranging from History, Anatomy, and Patterns of Disease to Presentation and Selection of Patients, Surgical Maneuvers, and various chapters describing operations on the various arteries. The authors' perspective that emerges from these pages is that of surgical enthusiasts. Complete arteriography, including the aortic arch and all four cerebral vessels, is advocated in every case. Lesions of the supraaortic tnmks are sought, and intrathoracic repairs of these arteries are illustrated and described in detail. The authors' indications for operations on the innominate artery and the proximal carotid and subclavian arteries include asymptomaric stenoses, and ulcerated atheromas in the artery supplying the territory of silent brain infarctions discovered on computed tomography scanning. Emergency operations for acute internal carotid artery ocdusions are advocated. Compression of the vertebral arteries resulting from head positioning during angiography is demonstrated in multiple illustrations and surgical correction described. The visual and verbal descriptions of operations are extensive, detailed, and practical, clearly the work of seasoned experts. The controversy surrounding some of the recommended indications for operation is not discussed, reflecting the essay nature of the book. The high price of this book and the esoteric nature of much of the subject matter make it an unlikely choice for purchase by resident physicians. I believe its proper place is in the personal library of experienced vascaflar surgeons. Most of the operations described will be performed rarely, if ever, in the course of most vascular practices. When faced with these unusual situations there is enough information in this book to allow each surgeon to make the decision

Book reviews 723

whether to perform the procedures as described, or to refer patients to a colleague whose practice content mirrors that of the authors. Lloyd A/l. Taylor,Jr., dlKD Oregon Health Sciences University Portland, Ore. Varicose veins and related disorders David J. Tibbs, Stoneham, Mass., 1992, ButterworthHeinemann, 576 pages, $350. Those who appreciate architecture view it both as a public structure and as a monument to the architect. As a monument to the architect a structure retains the artist's signature no matter the opinion of the observers. This book is much like architecture, and as such it will not be to everyone's taste. However, for those who believe that the care of varicose veins and related disorders should be in the mainstream of general and vascular surgery, this book must be acquired. Interestingly the author suggests in his introduction that "the book is not intended to be read from cover to cover but rather to be dipped into." Throughout, wellexecuted line drawings, clearly reproduced phlebograms, and high-quality clinical photographs catch the eye. In dipping in, one finds that the book is a seamless whole and does not readily separate itself into sections, although it does contain 24 chapters, an important appendix, and a fascinating historical note. The chapters and the addenda reflect the experience of the author, who is now an honorary consulting surgeon to the Radcliffe Hospital in Oxford. Because the book is so profusely illustrated with phlebograms and accompanying diagrams, such a volume is unlikely to appear again simply because of the cost of publication. All of the topics covered are listed in the chapter rifles, supplemented by an admirable index. However, some things are missing. The volume curiously lacks reference to leukocyte trapping and leukocyte-endothelial adherence in chronic venous insufficiency, for example. Similarly, the consultants called on to contribute specific sections have presented their clinical experience with wisdom but without an eye towards the accumulating experience on the international scene. Perhaps this can be explained by the time between writing and publication, but one would have liked to see more on quantitarion of venous reflux by color-coded ultrasonography and some information on the applicability of air displacement plethysmography to dinical practice. These are minor annoyances and are overwhelmingly overcome by the clarity of the presentation and the precision of the prose used throughout the volume. Experts in the care of venous disorders will appreciate this volume, as will less experienced surgeons who realize the importance of venous disorders in the mainstream of clinical practice. Libraries of institutions that train general and vas~lar surgeons will be incomplete without this tome. John J. Bergan, ME) La Jolla, Calif.