Complications in vascular surgery, ed. 2

Abstract

Complications in vascular surgery, ed. 2 Victor M. Bernhard and Jonathan B. Towne, eds. Orlando, 1985, Grune & Stratton, Inc., 793 pages, $89.50. This is the second edition of a popular, multiauthored text considering a wide range of complications in vascular surgery. The contributions originated at a symposium held in the spring of 1985. The authors are well selected; all are experienced clinicians and most are recognized experts in their assigned topics. The organization of the 46 chapters and the complete index allows rapid reference to specific problems. Chapters of particular interest in the field of peripheral occlusive disease include those relating to spinal cord ischemia occurring after aortic surgery, lower extremity amputations, and the care of the diabetic foot. A senior author, Dr. Bernhard, also provides a well-reasoned discussion of the management of late graft thromboses. The entire section devoted to renal revascularization (three chapters) is particularly pertinent and up-to-date; diagnostic and surgical options are included along with a discussion of transluminal angioplasty complications. Cerebrovascular surgery is represented by a wellferenced critique of techniques of cerebrovascular protection during endarterectomy. The chapter on avoidance and recognition of cranial nerve injuries and baroreceptor dysfunction is concise and useful. The authors have included several “basic science” contributions relating to anastomotic intimal hyperplasia and progressive atherosclerosis. In particular, the material on atherosclerosis seems somewhat dated, although the general theories of progression and regression of lesions are presented. An apparent weakness of the text is the absence of any consideration of anesthetic management and the newer techniques of intraoperative monitoring. Such a chapter would have complemented the offerings on renal failure and cardiopulmonary complications. A frequent failing of multiauthored texts is the lack of a consistent format among authors. Unfortunately, such irregularity of approach is evident in this book. Certain authors have chosen to report only their personal experience and limit discussion to a very brief review of the literature, whereas others have expanded from their material and included varying and even opposed points of view. Although many of the illustrations are excellent, few of the drawings are original. Operative photographs and angiograms are well reproduced. In summary, this text continues to be a valuable asset to the practicing vascular surgeon. The topics are appropriate and well organized. Although the book does suffer in part from its diverse authorship, the presentation and material are quite good.