Table Of ContentVascular Medicine
TherapyandPractice
ThomasZeller,MD WilliamA.Gray,MD
Professor Director,EndovascularServices
HeadoftheDepartmentAngiology, AssociateProfessorofMedicine
ClinicCardiologyandAngiologyII CenterforInterventionalVascularTherapyat
UniversityHeartCenterFreiburg-BadKrozingen ColumbiaUniversityMedicalCenter
BadKrozingen,Germany PresbyterianHospital
NewYork,USA
ThomasCissarek,MD
DepartmentofAngiology,Phlebology, KnutKröger,MD
VascularSurgery Professor
GefaesskrankheitenRhein-Ruhr Head,DepartmentofAngiology
Essen,Germany HELIOSHospitalKrefeld
Krefeld,Germany
AssistantEditor
JerzyWojciuk,MD,LRCPEdin,
LRCSEdin,LRCPSGlasg,MRCP(UK)
LancashireCardiacCentre
Blackpool
Lancashire,UK
2ndedition
Withcontributionsby
JensAchenbach,FarzinAdili,HeleneArns,AliAydin,JörnO.Balzer,KaiM.Balzer,UlrichBeschorner,
FriedheimBeyersdorf,Hans-GeorgBone,ThomasCissarek,SebastianDebus,CurtDiehm,UweDietrich,
AliDodge-Khatami,ArndtDohmen,ChristineEspinola-Klein,JenniferFranke,ThomasFrieling,
SophiaGöricke,ErnstGröchenig,HeinrichHakuba,JörgHeckenkamp,BernhardHellmich,
JoachimHermanns,PhilipHilgard,PeterHorn,VerenaKhan,DietrichKoch,ManuelaKoch,
YskertvonKodolitsch,TiloKölbel,MarwanEl-Koussy,KnutKröger,EricLorenz,FelixMahfoud,ErichMinar,
ShantiNaskar,AchimNeufang,SigridNikol,ClausNolte-Ernsting,EliasNoory,GeorgNowak,
MichaelOffermann,ChristophOzdoba,WolfgangPeck,MichaelPillny,RobertaPini,SiamakPourhassan,
MaximilianJ.A.Puchner,ReinhardPutz,ClaudioRabbia,AljoschaRastan,MarcusRebel,WilhelmSandmann,
FransSantosa,DierkScheinert,TomSchilling,MarcSchlamann,AndrejSchmidt,WaltherSchmiedt,
ThomasSchmitz-Rixen,EvaSchönefeld,GerhardSchroth,HorstSievert,SebastianSixt,EddaSpiekerkötter,
MatthiasThielmann,GiovanniTorsello,DierkVorwerk,IsabelWanke,WernerWeber,ThomasZeller
948illustrations
Thieme
Stuttgart·NewYork·Delhi·Rio
LibraryofCongressCataloging-in-PublicationDataisavailablefromthe Importantnote:Medicineisanever-changingscienceundergoingcontinual
publisher. development.Researchandclinicalexperiencearecontinuallyexpandingour
knowledge,inparticularourknowledgeofpropertreatmentanddrugther-
Thisbookisanauthorizedtranslationofthe2ndGermaneditionpublished apy.Insofarasthisbookmentionsanydosageorapplication,readersmayrest
andcopyrighted2013byABWWissenschaftsverlag,Berlin.TitleoftheGer- assuredthattheauthors,editors,andpublishershavemadeeveryeffortto
manedition:Gefäßmedizin:TherapieundPraxis ensurethatsuchreferencesareinaccordancewiththestateofknowledgeat
thetimeofproductionofthebook.
Translator:Dr.MichaelRobertson,Augsburg,Germany Nevertheless,thisdoesnotinvolve,imply,orexpressanyguaranteeorrespon-
sibilityonthepartofthepublishersinrespecttoanydosageinstructionsand
Illustrator:brandnewdesign,Hamburg,Germany formsofapplicationsstatedinthebook.Everyuserisrequestedtoexamine
carefullythemanufacturers’leafletsaccompanyingeachdrugandtocheck,if
Anatomicaldrawings:KarinBaum,Paphos,Cyprus necessaryinconsultationwithaphysicianorspecialist,whetherthedosage
schedulesmentionedthereinorthecontraindicationsstatedbythemanufac-
turersdifferfromthestatementsmadeinthepresentbook.Suchexamination
isparticularlyimportantwithdrugsthatareeitherrarelyusedorhavebeen
newlyreleasedonthemarket.Everydosagescheduleoreveryformofapplica-
tionusedisentirelyattheuser’sownriskandresponsibility.Theauthorsand
publishersrequesteveryusertoreporttothepublishersanydiscrepanciesor
inaccuraciesnoticed.Iferrorsinthisworkarefoundafterpublication,errata
willbepostedatwww.thieme.comontheproductdescriptionpage.
©2010,2014ABWWissenschaftsverlagGmbH Someoftheproductnames,patents,andregistereddesignsreferredtointhis
Altensteinstraße42,14195Berlin,Germany bookareinfactregisteredtrademarksorproprietarynameseventhoughspe-
www.abw-verlag.de cificreferencetothisfactisnotalwaysmadeinthetext.Therefore,theappear-
anceofanamewithoutdesignationasproprietaryisnottobeconstruedasa
Distributor: representationbythepublisherthatitisinthepublicdomain.
GeorgThiemeVerlagKG
ThiemePublishersStuttgart Thisbook,includingallpartsthereof,islegallyprotectedbycopyright.Any
Rüdigerstrasse14,70469Stuttgart,Germany, use,exploitation,orcommercializationoutsidethenarrowlimitssetbycopy-
+49[0]7118931421 rightlegislation,withoutthepublisher’sconsent,isillegalandliabletoprose-
[email protected] cution.Thisappliesinparticulartophotostatreproduction,copying,mimeo-
graphing,preparationofmicrofilms,andelectronicdataprocessingandstor-
ThiemePublishersNewYork age.
333SeventhAvenue,NewYork,NY10001,USA,
1-800-782-3488
[email protected]
ThiemePublishersDelhi
A-12,secondfloor,Sector-2,NOIDA-201301,UttarPradesh,India,
+911204556600
[email protected]
ThiemePublishersRio
ThiemePublicaçõesLtda.
ArgentinaBuilding,16thfloor,AlaA,228PraiadoBotafogo,RiodeJaneiro
22250-040Brazil,+55213736-3631
Coverdesign:ThiemePublishingGroup
TypesettingbymedionetPublishingServicesLtd.,Berlin
PrintedinGermanybyMedia-PrintInformationstechnologie,Paderborn
ISBN978-3-13-176841-4
Alsoavailablease-book:
eISBN978-3-13-176851-3
Preface
The first edition of the interdisciplinary volume on Vascular increasingornewimportanceinrecentyearsandinwhichtre-
Medicine—TherapyandPracticemetwithanextremelypositive mendousprogressininterventionaltherapyoftheclinicalfields
responsefromreadersofboththeGermanandtheEnglishedi- involved can be expected in the future. We are particularly
tions.Wehavethereforedecidedtoproduceaneweditioneven pleasedthatpioneersofeachofthesetreatmentmethodshave
thoughonlyfouryearshavepassedsincethepublicationofthe agreedtobeco-authorsforthesesections.Thesectiononthe
first. The advances that have been made in recent years have treatmentofrenalarterystenosis,“Surgicaltreatmentofrenal
beentremendous,particularlyintheareaofendovascularther- arterystenosis,”isanotherimportantadditionandcomesfrom
apy,andinthissecondeditionwehavetwomajoraims. Prof.Sandmann’sschoolinDüsseldorf,oneofthemostexperi-
Firstly,weupdatedandimprovedthecontentoftheexisting encedinternationalspecialistsinthisfield.
chapters.Improvementshavemainlyinvolvedaddinganintro- Wewouldliketothankalloftheauthorsfortheirvaluable
ductoryanatomysectiontoeachofthemajorchapters.Inaddi- revisions and new contributions. We are also grateful to Dr.
tion, although the book’s emphasis is still on treatment, a Bedürftig,Ms.Behle,andMs.Sängerandtoalltheotherstaff,
detailed duplex ultrasonography section has been added for whoalongwiththegraphicdesignerMs.Baumhaveonceagain
eachvascularregion.Thisisbecauseduplexultrasoundrepre- giventhebookitsexcellentdesign.
sentsthefundamentalmethodofimagingdiagnosisinvascular Readersmaynoticethattherehasbeenachangeintheorder
medicineandisincreasinglybeingcarriedoutineveryspecialty oftheeditors’names.Wewouldliketocontinuethisrotationin
fieldinvascularmedicine.Wehopeinthiswaytocontributeto thecomingyearsaswellastocontinuetokeepreadersinformed
astandardizationofthemethodineverydayusage. abouttheverylateststateofdevelopmentsinthetreatmentof
Thesecondaimoftheneweditionistoachieveasubstantial vasculardiseases.
expansion of the content of the book by adding sections and
mainchaptersthatdidnotfindtheirwayintothefirstsection
for various reasons. This mainly involves the addition of the ThomasZeller
chapteron“Diseasesofthelymphaticsystem,”alongwithchap- ThomasCissarek
ters on “Treatment of acute stroke” and “Renal sympathetic WilliamA.Gray
denervation”—two treatment fields that have acquired an KnutKröger
V
ListofContributors
List of Contributors
JensAchenbach,MD SebastianDebus,MD
DepartmentofAngiology Professor
CenterforVascularDiseasesRhein-Ruhr Head,DepartmentofVascular
MülheimanderRuhr/Essen,Germany andEndovascularSurgery,Angiology
UniversityHeartCenterHamburg
FarzinAdili,MD Hamburg,Germany
Head,DepartmentofVascularandEndovascularSurgery
DarmstadtHospital CurtDiehm,MD
Darmstadt,Germany Professor
Head,DepartmentofInternalMedicine
HeleneArns,MD KlinikumKarlsbad-Langensteinbach
DepartmentofPhlebology,Lymphology Karlsbad,Germany
CenterforVascularDiseasesRhein-Ruhr
MülheimanderRuhr/Essen,Germany UweDietrich,MD
Head,DepartmentofNeuroradiology
AliAydin,MD EvangelicHospitalBielefeld
DepartmentofCardiology,Electrophysiology Bielefeld,Germany
UniversityHeartCenterHamburg
UniversityMedicalCenterHamburg-Eppendorf AliDodge-Khatami,MD
Hamburg,Germany ProfessorofSurgery
DivisionofPediatricandCongenitalHeartSurgery
JörnO.Balzer,PD,MD UniversityofMississippiMedicalCenter
Head,DepartmentofRadiologyandNuclearMedicine Mississippi,USA
CatholicHospitalMainz
Mainz,Germany ArndtDohmen,MD
InterdisciplinaryCenterforVascularMedicine
KaiM.Balzer,MD UniversityHeartCenterFreiburg-BadKrozingen
AssociateProfessor BadKrozingen,Germany
ChiefResident
DepartmentofVascularSurgeryandKidneyTransplantation ChristineEspinola-Klein,MD
UniversalHospitalDüsseldorf Professor
Düsseldorf,Germany Head,DepartmentofAngiology
UniversityMedicalCenterofthe
UlrichBeschorner,MD JohannesGutenbergUniversityMainz
AttendingPhysician Mainz,Germany
DepartmentofAngiologyandCardiology
HeartCenterFreiburgUniversity JenniferFranke,MD
BadKrozingen,Germany Resident
DepartmentofInternalMedicine
FriedhelmBeyersdorf,MD,MDh.c. HeidelbergUniversityHospital
Professor Heidelberg,Germany
MemberoftheBoardofMedicalDirectors
Head,DepartmentofCardiovascularSurgery ThomasFrieling,MD
UniversityHeartCenterFreiburg Professor
BadKrozingen,Germany Head,DepartmentofInternalMedicine
HELIOSKlinikumKrefeldGmbH
Hans-GeorgBone,MD Krefeld,Germany
Professor
Head,DepartmentofAnaesthesiologyand SophiaGöricke,MD
Intensive-CareMedicine AttendingPhysician
ClinicumVestGmbH DepartmentofNeuroradiology
Recklinghausen,Germany EssenUniversityHospital
Essen,Germany
ThomasCissarek,MD
DepartmentofAngiology,Phlebology,VascularSurgery ErnstGröchenig,MD
GefaesskrankheitenRhein-Ruhr Head,DepartmentofInternalMedicine
Essen,Germany KantonspitalAarau
Aarau,Switzerland
VII
ListofContributors
HeinrichHakuba,MD MarwanEl-Koussy,MD
Head,DepartmentofLymphology ChiefResident
Hochrhein-EggbergHospitalBadSäckingen DepartmentofDiagnosticandInterventionalNeuroradiology
BadSäckingen,Germany BernUniversityHospital
Bern,Switzerland
JörgHeckenkamp,MD
Professor KnutKröger,MD
Head,DepartmentofVascularandEndovascularSurgery Professor
Niels-StensenHospital Head,DepartmentofAngiology
MarienhospitalOsnabrück HELIOSKlinikumKrefeldGmbH
Osnabrück,Germany Krefeld,Germany
BernhardHellmich,MD EricLorenz,MD
Professor DepartmentofVisceralandVascularSurgery
Head,DepartmentofRheumatologyandClinicalImmunology St.HedwigHospital
KirchheimHospital Berlin,Germany
Kirchheim-Teck,Germany
FelixMahfoud,MD
HansJoachimHermanns,MD DepartmentofCardiology,AngiologyandIntensiveCare
PrivatePractice SaarlandUniversityMedicalCenter
PracticeforAngiology Homburg/Saar,Germany
Krefeld,Germany
ErichMinar,MD
PhilipHilgard,PD,MD Professor
Head,DepartmentofGastroenterology Angiologist
EvangelicHospitalMülheim PrivatePractice
MülheimanderRuhr,Germany Vienna,Austria
PeterHorn,MD ShantiNaskar,MD
Head,DepartmentofTranfusionMedicine ChiefResident
UniversityHospitalEssen DepartmentofVascularSurgery
Essen,Germany St.MarienHospitalBuer
Gelsenkirchen,Germany
VerenaKhan,MD
DepartmentofRadiology AchimNeufang,MD
NurembergHospital Head,DepartmentofVascularSurgery
Nuremberg,Germany Dr.HorstSchmidtKlinikenGmbH
Wiesbaden,Germany
DietrichKoch,MD
DepartmentofVascularSurgery SigridNikol,MD
ClinicforVascularDiseases Professor
Essen,Germany Head,DepartmentofAngiology
AsklepiosHospitalSt.Georg
ManuelaKoch,MD Hamburg,Germany
DepartmentofVascularSurgery
ClinicforVascularDiseases ClausNolte-Ernsting,MD
Essen,Germany Professor
Head,DepartmentofdiagnosticandinterventionalRadiology
YskertvonKodolitsch,MD EvangelicHospitalMülheim
Professor MülheimanderRuhr,Germany
ChiefResident
DepartmentofGeneralandInterventionalCardiology EliasNoory,MD
UniversityHeartCenterHamburg ChiefResident
Hamburg,Germany DepartmentofAngiology
HeartCenterFreiburgUniversity
TiloKölbel,MD BadKrozingen,Germany
ChiefResident
DepartmentofVascularMedicine
UniversityHeartCenterHamburg
Hamburg,Germany
VIII
