**Meet the editors**

Dr. Marvin D. Atkins, MD, FACS is an Assistant Professor of Surgery at Texas A&M Health Science Center in Temple,TX. He is also a Senior Staff Vascular Surgeon at the Scott & White Hospital & Clinic. Dr Atkins is the assistant program director for the two year Vascular Surgery Fellowship and serves as the director for the Center for Aortic Disease at Scott & White. Dr Atkins main

clinical and research interest is in the management of thoracic, thoracoabdominal, and abdominal aortic disease. He has an active open thoracic and thoracoabdominal aneurysm practice. He serves on the editorial board for the Journal of Endovascular Therapy and as a reviewer for the Journal of Vascular Surgery.

Dr. Ruth L. Bush is currently Professor of Surgery at Texas A&M University Health Sciences Center, Division of Vascular Surgery in the Department of Surgery and Senior Vice President of Education at Scott & White Memorial Hospital, the Associate Dean for Education at Texas A&M Health Science Center College of Medicine - Temple, and Chief of Vascular Surgery at the Olin

E. Teague VA Medical Center in Temple, Texas. Her innovative approach to the medical education mission has led to the development of programs such as the Rural Health Rotation for medical students and new and expanded residency programs. Her extensive pursuit of research in vascular surgery, public health and education has resulted in more than 150 scientific articles, abstracts, books, chapters and presentations. She is an active leader in multiple professional organizations and governmental advisory committees and is currently pursuing a law degree.

Contents

**Preface IX** 

Chapter 1 **The Evidence for Management** 

**Controlled Trials 3** 

Chapter 3 **Abdominal Aortic Aneurysms:** 

Chapter 4 **Alternative Surgical Management** 

Chapter 5 **Aortic Valve Sparing Operation 101** 

Chapter 6 **Endovascular Repair of** 

**Part 1 Evolution of Care for Aortic Disease 1** 

**of Abdominal Aortic Aneurysms: Lessons Learned from Randomised** 

Reza Mofidi and Stuart A. Suttie

Chapter 2 **The Evolution of Aortic Aneurysm Repair:** 

**Part 2 Improvements in the Endovascular and** 

**of Ascending Aorta Aneurysm 81**  Sossio Perrotta and Salvatore Lentini

Júlia Čanádyová and Aleš Mokráček

**Past Lessons and Future Directions 21**  Ricky Harminder Bhogal and Richard Downing

**Changing Paradigms in Treatment 55**  Christopher J. Marrocco and Ruth L. Bush

**Surgical Management of Aortic Disease 79** 

**Ruptured Abdominal Aortic Aneurysms 121**  Cheong J. Lee, Andrew Gonzalez and Mark D. Morasch

### Contents

#### **Preface XI**

	- **Part 2 Improvements in the Endovascular and Surgical Management of Aortic Disease 79**
	- **Part 4 Molecular Management in Aortic Disease 191**

### Preface

The first successful open surgical repair of an abdominal aortic aneurysm was in 1951 by Dubost and represented a tremendous milestone in the care of this challenging disease. The introduction of endovascular repair in 1991 by Parodi furthered the care of these patients by allowing for lower morbidity and mortality rates and also, enabling surgeons to extend surgical treatment to patients traditionally deemed too high of a surgical risk. This new book on Aortic Disease covers many interesting and vital topics necessary for both the practicing surgeon as well as a student of vascular disease. The book starts with background information on the evolution of aortic management from traditional open surgical repair to modern endovascular therapies. There is also a chapter covering the data supporting current treatment modalities and how these data have supported modern management. Also, the use of endovascular means for care of the challenging situation of ruptured aneurysms is discussed. In addition to management of abdominal aneurysm, there is a chapter on treatment of aneurysms of the ascending aorta. Along with surgical treatment, one must also understand the molecular basis for how blood vessels remodel and thus, the role of cathepsins in aortic disease is elucidated. Lastly, chapters discussing the perioperative management of radiation exposure and ultrasound-guided nerve blocks as well as the need for high-quality postoperative nutrition will lend well to a full understanding of how to management patients from presentation to hospital discharge. We hope you enjoy this book, its variety of topics, and gain a fuller knowledge of Aneurysmal Disease of the Thoracic and Abdominal Aorta.

> **Marvin D. Atkins, M.D.**  Assistant Professor of Surgery Scott & White Hospital, Texas A & M College of Medicine, Temple, Texas USA

**Ruth L. Bush, M.D., M.P.H.**  Professor of Surgery Scott & White Hospital, Texas A & M College of Medicine, Temple, Texas USA

**Part 1** 

**Evolution of Care for Aortic Disease** 
