Vascular surgery, a comprehensive review, ed. 2

BOOK REVIEWS v,eorge Johnson, Jr., M.D., B o o k Review Section E d i t o r

Vascular surgery principles and practice Samuel E. Wilson, Frank J. Veith, Robert W. Hobson II, and Russell A. Williams, eds. New York, 1987, McGraw-Hill Book Company, 976 pages, $120.00. Since the publication of the last major authoritative vascular surgical textbooks, a steady and broad-based expansion of both knowledge and techniques has occurred. Accordingly, the editors have undertaken to record the current state of the art and practice of this discipline in a ~omprehensive volume directed primarily toward the practicing vascular surgeon. The book's 74 chapters are organized into 11 sections. An introductory section reviews pzthophysiology and diagnostic techniques and is followed by a compilation of ancillary medical therapy and radiographic procedures. The remaining sections follow stan~dard topical organization, such as occlusive disease, aneurysms, venous and lymphatic disorders, and trauma. Most of the chapters are well illustrated and referenced, the latter serving as valuable source material for further indepth study. With 132 authors, most of the topics are thoroughly reviewed. Notable shortcomings include a cursory discusgion of prophylactic methods for prevention of deep venous ~rombosis and congenital venous malformations. In particular, the clinical sections of the text, with many of the chapters written in the first person, appear to be organized according to authors and their specific research interests rather than by subjects. This approach provides a thorough ~nalysis of many of the newer techniques in vascular surgery; however, the material presented is often subjectively ,colored by the author's own preferences, occasionally resuiting in all-too-briefdiscussions of other options in therapy. The knowledgeable vascular surgeon will find this fe'°mat informative, but it may be confusing for the reader who specializes in another field or is still in training. As is inevitable in a text with so many authors, there is frequent repetition and even contradiction, particularly ~vhen comparing the clinical chapters to the introductory chapters on clinical presentation and diagnosis and in the chapters on angioplasty. Furthermore, a book oriented toward the practicing surgeon would clearly benefit from a more comprehensive review of the clinical presentations, 4 decisions, and options in therapy for standard vascular conditions, such as aortoiliac occlusive disease and aneurysms, as well as more esoteric problems in management of graft infections. Clearly, a stronger editorial hand and better organization would remedy many of these difficulties. At its best, however, this author-oriented approach ~rmits in-depth review of topics that are frequently treated lightly in authoritative texts, such as the many nuances of ~arotid vascular disease, combined peripheral vascular and coronary disease, and the relationship between vascular problems and sexual function. Of particular note are ex-

cellent chapters on the pathophysiology of atherosclerosis, vascular hemodynamics, digital subtraction angiography, anticoagulation, renovascular hypertension, medical management of arteriosclerosis, and vascular trauma. An early highlight is an introductory review of the genesis of vascular surgery from its earliest beginnings through its recent elevation to formal subspecialty recognition. Despite organizational problems, Vascular Su~ery Principles and Practice will be a valuable authoritative text for some time. Although the novice may find interpretation and application somewhat difficult, this volume should find a well-deserved place in the library of both clinical and academic vascular surgeons. William Blackshear,.M~D. University of South Florida

Vascular surgery, a comprehensive review, ed. 2 Wesley S. Moore, ed. Orlando, 1986, Grune & Stratton, Inc., 1245 pages, $99.50. The editor has assembled a qualified group of chapter authors to present the body of knowledge essential to the vascular surgeon. He has clearly provided sufficient guidelines to the many authors to allow for remarkable uniformity of quality. The book is of a manageable size and easily readable. The illustrations are well-chosen, wellreproduced, and enhance the text. The first edition of tbAs text was originally conceived to accompany a postgraduate course to prepare candidates for specialty board examinations. This edition has been expanded to meet the editor's objective of sufficient comprehensiveness to be a standard textbook. This objective has been achieved admirably, and the book is a splendid example of presentation of the core of information essential to the understanding of vascular anatomy and physiology, as well as to the understanding of vascular diseases in the context of the multiple problems usually found. Most important, the text presents the information essential for selective judgment in the context of total management of a patient with vascular disease. Nonsurgical alternatives are well presented. Although technical details are not emphasized, the written material is augmented in many chapters by excellent black-and-white illustrations. This presentation will be sufficient for most students and readers, but the resident surgeon may wish to augment the presentation here with reviews of operative manuals. The strong editorial guidance has eliminated most of the disadvantages of multiauthored texts. Proofreading, especially of proper names, could bc improved. The bibliographies at the end of each chapter sometimes contain frequent references to the author's own work, reflecting 895

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BookReviews

bias rather than balance. The questions at the end of each chapter serve little purpose in a comprehensive text. The book is a meritorious achievement that will take its place as a standard reference text of high quality. It belongs in the library of every vascular surgeon. Garland D. Perdue, Jr., ~ld). Emory University

Vascular surgical emergencies John J. Bergan and James S. T. Yao, eds. Orlando, 1986, Grune & Stratton, Inc., 549 pages, $89.50. Almost 10 years ago, Drs. Bergan and Yao organized the first of what has become an extremely popular, wellattended, annual vascular symposium. Each program is limited to a single topic and the invited contributors are typically selected to create a distinguished panel of international experts. In addition to the uniformly high quality of these programs, they have become so popular because of the preparation of a monograph summarizing the symposium, which is presented to the participants at the time of registration. This volume represents the most recent addition to that series. Its subject matter is indeed ambitious and touches on all aspects of vascular surgery. The book is divided into 11 sections. The initial one deals with general considerations common to most surgical emergencies and is followed by

VASCULAR SURGERY

particularly masterful discussions of angiography and C~ scanning. The subsequent sections are devoted ~o tho~s~ emergency conditions involving various regions of the body, such as cerebrovascular, aortic, and venous emergencies. Although the volume is heavily weighted towards traumatic lesions, spontaneous vascular emergencies, such as ruptured abdominal aortic aneurysm, carotid artery dissection, acute lower extremity ischemia, and iliofemoral, thrombophlebitis, are also discussed. Because of the breadth of the subject matter, selection of topics and their subsequent discussion are necessarily eclectic. In addition, as is true with most multiauthored texts such as this, there is some repetition and inconsistency of style. The overall subject matter (i.e., vascular surgical emergencies) only loosely ties the topics together and th~ volume would best be described as a collection of related essays rather than as a coherent monograph. These reservations notwithstanding, the subject mater is topical and important and the contributors are generaiiy well-recognized experts in their respective fields. The monograph, like its predecessors in the series, is hand-~ somely produced, well-edited, and generously illustrated. It will be of interest to all physicians who regularly treat vascular surgical emergencies and contains many useful and pertinent recommendations in the care of such patients. Richard F. Kempczinski, M.D. University of Cincinnati