Fundamentals of Endovascular Surgery

Abstract

Endovascular techniques are an important part of vascular surgery. The initial step in endovascular surgery is selection of the vascular access site and how to choose the ideal access site is described. Thereafter, the general technical principles of artery puncture (femoral, brachial, and axillary artery puncture as well as translumbar puncture) are described along with troubleshooting principles for each procedure. Once vascular access has been obtained through arterial puncture, it is maintained through placement of a guide wire. The placement of a sheath or guide is typically placed over the guide wire to maintain a stable pathway for catheter exchange or for placement of a device. Insertion of catheters and placement of vascular stents are discussed in detail, including troubleshooting techniques. Type of stents are discussed and include balloon expandable, self-expanding, and covered stents. Postprocedural management of the arterial access site is described. The need for large sheath access during aortic interventions is also presented. The review concludes with a numerical listing of the more than two dozen steps of the basic steps in endovascular procedures, and more than a dozen figures represent the aforementioned procedures. This review contains 21 references.