Peripheral arterial disease: Diagnosis and treatment

Abstract

Peripheral arterial disease: Diagnosis and treatment Jay D. Coffman and Robert T. Eberhardt; Totowa, NJ; 2002; Humana Press; 356 pages; $129.50. This book is a recent addition to the “Contemporary Cardiology” series edited by a cardiologist, Christopher P. Cannon. Although the preface implies that the book's target readership is the “practicing physician and cardiologist”, there is sufficient authoritative information within to be of some value to a wider array of clinicians involved with patients suffering from peripheral vascular disease. The senior editor of this volume, one of the founders of the subspecialty of vascular medicine, enlisted 27 well-known contributors to author 19 chapters on a full array of topics with no glaring omissions. To the contrary, in addition to the usual fundamentals of pathogenesis, diagnosis, and treatment of peripheral atherosclerosis, useful chapters on the diabetic foot, arterial disease in women, atheroembolism, Buerger's disease, and large vessel vasculitis are included. There is a wistful chapter on angiogenesis and gene therapy, full of promise though as yet thin on published results. The chapter on perioperative cardiac evaluation and management for patients undergoing vascular surgery is excellent. Each chapter stands well by itself and usually includes adequate tables and figures as well as a plump bibliography. The organization of the book is somewhat jumbled, with the chapter on clinical evaluation of intermittent claudication placed in the midst of chapters on natural history, vascular laboratory, and diagnostic imaging rather than with the chapters on acute and chronic limb ischemia. There is some overlap, as is inevitable in a collection of essays such as this. Inconsistency is also inevitable and illustrative in areas of rapid change, as is evident in conflicting views of the relative place of endovascular and open surgical revascularization. The editors might have taken the opportunity to insist that the authors of the chapters in this area of controversy pursue the same scope and use the same terms, definitions and outcome measures based only upon high-quality recent data. Rather than providing a forum for helpful comparisons between therapeutic modalities, the endovascular therapy author's enthusiasm was allowed to bubble over into gratuitous sections on carotid, renal, and abdominal aortic aneurysm stenting. The depth of coverage of topics varies from chapter to chapter, ranging from elementary to more advanced. Since the goal of this book is to review a broad and deep topic in a manageable format, it must cover a lot of territory relatively lightly in its 386 pages. As an overview, this collection of essays is an excellent introduction to trainees in medicine, radiology, and surgery who have not yet differentiated into a subspecialty. It is also likely to be of value to generalists who deal regularly with patients subject to peripheral vascular disease or to specialists in fields allied to vascular surgery and vascular medicine. Most specialists who focus mainly on peripheral vascular disease may find this work too basic to be regularly useful as a reference for their daily work, particularly if they are engaged in moving this complicated field forward.