ENDOVASCULAR SURGERY FOR AORTIC ANEURYSMS. Brian Hopkinson, Waquar Yusuf, Simon Whitaker and Frank Veith. 310 pp. Illust. W.B. Saunders Company Ltd., London. 1997. Can$117. ISBN 0-7020-2148-2
Endovascular treatment of aortic aneurysms was first described by Parodi in 1991. Since then, many devices have been deployed, most constructed from already existing materials. This textbook attempts to report on the current status of this evolving technique. Thirty-five contributing authors relate their experience with respect to endovascular grafting.
The early chapters, designed as an introduction, outline optimal preoperative and intraoperative imaging techniques. Of particular strength is the chapter by Ivancev and Chuter on adjunctive manoeuvres for endovascular exclusion of abdominal aortic aneurysms, in which they discuss common difficulties encountered and provide useful solutions on how to deal with the difficult anatomy seen on preoperative imaging.
The major portion of the book reviews the experience of the various endovascular systems. These include the MinTec system, Chuter–Gianturco bifurcated stent-grafts, EndoVascular Technologies, Corvita system, Ivance–Malmo system and Parodi system. In addition, the Australian experience with a variety of endovascular grafts is reviewed. All authors have attempted to describe the procedure for endoluminal grafting in detail. Overall, 515 procedures are reviewed by 10 different institutions, the smallest series comprising 14 patients and the largest 88. The final chapters review the mechanisms of renal injury, ischemic–reperfusion injury and colonic perfusion as well as anesthetic implications for open and endovascular procedures.
The authors should be commended for the difficult task of writing a textbook on a topic that is in its infancy and evolving rapidly. One distraction is the repetitive description of each device by the various authors. Since none of these are currently approved for widespread use, a more concise description would have made reading easier. The problems encountered during placement of the devices and techniques used to avoid and solve these problems are an asset for anyone considering entering the field of endovascular graft surgery.