Vascular Diseases for the Non-Specialist: An Evidence-Based Guide

 

Description:

This book aims to provide non-specialist healthcare practitioners with current, focused and objective information on the most common vascular diseases encountered in daily clinical practice. In day-to-day clinical practice many healthcare practitioners do not have a working knowledge of the most common vascular diseases that frequently arise in patient care. Some of these topics include: aneurysms, peripheral arterial disease, diabetic foot, venous thromboembolism, cerebrovascular disease, aortic dissection, and acute limb ischemia. These commonly encountered vascular diseases are becoming public health issues due to their high morbidity and mortality as well as increasing healthcare costs. Since patients with vascular diseases are often referred to non-specialists, the general practitioner must know how to proper handle the most common vascular diseases encountered in daily clinical practice. For each disease the concept, epidemiology, natural history, diagnosis and treatment are described, followed by essential advice on what the non-specialist can do for the patient and when to refer the patient to a specialist.

 

Table of Contents:

 

1: How to Make Decisions in Healthcare?

Clinical Question and Study Design

Evidence-Based Healthcare and Systematic Reviews

Harms, Not Just Efficacy

How to Make Decisions in Healthcare

References

2: Anatomical Principles of the Circulatory System

Introduction

The Cardiovascular System

The Heart

Vessels’ Wall: The Endothelium

Coronary Irrigation

The Arterial System

Aorta and Its Branches

Cervical and Intracranial Irrigation

Thorax and Upper Limb

Lower Limb

The Venous System

Cervical and Intracranial

Thorax and Upper Limb

Lower Limb

The Lymphatic System

Lymphatic Vessels

Lymphoid Organs

References

3: Atherosclerosis

Introduction

Epidemiology

Pathophysiology

Cerebrovascular Disease

Coronary Artery Disease

Peripheral Artery Disease

Reno-Vascular Atherosclerosis

Diagnosis

Determining the Presence of Significant Atherosclerotic Disease or Its Equivalent

Ankle-Brachial Index

Carotid Ultrasonography

Femoral Ultrasonography

Electron-Beam Computed Tomography

Pressures and Pulse-Volume Recordings

Others Cardiovascular Methods of Evaluation

Utilization of Risk Stratification Scores

Treatment

General Practitioner’s Role

Medical Specialist Evaluation

References

4: Hemostasis and Anticoagulation Therapy

Introduction

Primary Hemostasis

Endothelium

Platelets

Platelet Adhesion

Platelet Activation

Platelet Aggregation

Secondary Hemostasis

Coagulation

The Initiation Phase

The Amplification Phase

The Propagation Phase

Fibrinolysis

Anticoagulant Treatment

Parenteral Anticoagulants

Unfractionated Heparin

Low Molecular Weight Heparins

Fondaparinux

Direct Thrombin Inhibitors

Oral Anticoagulants

Vitamin K Antagonists

Warfarin

Acenocoumarol

New Oral Anticoagulants

Dabigatran

Rivaroxaban

Apixaban

Edoxaban

References

5: Peripheral Artery Disease

Introduction

Epidemiology

Natural History and Clinical Presentation

Asymptomatic

Intermittent Claudication

Critical Limb Ischemia

Diagnosis

Treatment

Risk Factors Control

Treatment of Intermittent Claudication

Treatment of Critical Limb Ischemia

References

6: Acute Limb Ischemia

Introduction

Arterial Thrombosis

Arterial Embolism

Epidemiology

Clinical Presentation

Diagnosis

Differential Diagnosis

Treatment

Endovasculartherapy

Conventional Open Surgery

Complications

Syndrome of Reperfusion

References

7: Cerebrovascular Disease

Concept

Epidemiology

Clinical Presentation

Natural History

Diagnosis

Treatment

Medical Treatment

Surgical Treatment

What Generalist Doctor Can Do for This Patient?

When Is the Time to Refer to Specialist?

References

8: Abdominal Aortic Aneurysms

Concept

Epidemiology

Clinical Presentation

Image Exams

Abdominal Ultrasonography

Angiotomography

Magnetic Resonance Imaging

Screening Program

Treatment

Medical Approach

Smoking Cessation

Exercise

Pharmacotherapy

Doxycycline and Roxithromycin

Beta-Blockers

Antiplatelet Therapy

Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers

What the Generalist Practioner Can Do for This Patient?

When to Refer to Vascular Surgery?

References

9: Peripheral and Visceral Aneurysm

Femoral Artery Aneurysms

Popliteal Artery Aneurysm

Subclavian Artery Aneurysm

Visceral Artery Aneurysms

Splenic Artery Aneurysms

Hepatic Artery Aneurysm

Superior Mesenteric Artery Aneurysms

Celiac Artery Aneurysms

Renal Arteries Aneurysm

What the General Practitioner Can Do for This Patient?

When to Refer to the Expert?

References

10: Thoracic, Thoracoabdominal, and Iliac Artery Aneurysms

Thoracic Aortic Aneurysm

Thoracoabdominal Aortic Aneurysm

Iliac Artery Aneurysm

What the General Practitioner Can Do for This Patient?

When to Refer to the Expert?

References

11: Risk Factors and Prophylaxis of Deep Vein Thrombosis and Pulmonary Embolism

Introduction

Natural History of Venous Thromboembolism and Complications

Identification of Risk Factors for Venous Thromboembolism

Classification of Groups of Risk for Venous Thromboembolism According to the Individual Risk F

Prophylaxis

Hospitalized Nonsurgical Patients

Hospitalized Surgical Patients

Early Mobilization

Intermittent Pneumatic Compression

Elastic Compression Stockings

Anticoagulant Medications

Other Anticoagulants

Prophylaxis Duration

Outpatient

References

12: Venous Thromboembolism: Diagnosis and Treatment

Introduction

Epidemiology

Clinical Presentation

Deep Vein Thrombosis

Pulmonary Embolism

Diagnosis

Deep Vein Thrombosis Diagnosis

Additional Tests That Increase Accuracy for the Diagnosis of Deep Vein Thrombosis

Strategies for the Diagnosis of Deep Vein Thrombosis in Specific Clinical Situations

Pulmonary Embolism

Treatment

Compression Therapy

Unfractionated Heparin

Low Molecular Weight Heparins

Fondaparinux

Vitamin K Antagonist

Non-vitamin K Antagonists Oral Anticoagulants

Interventional Treatment

Fibrinolysis via Locoregional Intravenous Catheter in Patients with Deep Vein Thrombosis

Loco-regional or systemic fibrinolysis in the Pulmonary Embolism

Lower Vena Cava Filter Implant

What Can Any General Practitioner Do for the Patient?

When to Refer to a Specialist?

References

13: Diabetic Foot

Introduction

Epidemiology

Natural History

Clinical Manifestations

Peripheral Neuropathy

Charcot’s Neuropathy

Peripheral Arterial Disease

Infection

Wounds

Diagnosis

Diabetic Neuropathy Evaluation

Vascular Assessment

Treatment

Antibiotic Treatment

Surgical Treatment

Debridement

Revascularization Procedures

Limb Amputation

Wound Care

Dressings

Adjuvant Treatments

What Can the Primary Care Physician Do for This Patient?

When to Refer the Diabetic Foot Patient for an Expert?

References

14: Chronic Venous Disease and Varicose Veins

Introduction

Epidemiology

Pathophysiology

Natural History

Clinical Manifestations

Classification

Diagnosis

Differential Diagnosis

Treatment

Clinical Treatment

Compression Therapy

Graduated Compressive Stockings

Unna Boot

Elastic and Nonelastic Bandages

Intermittent Pneumatic Compression

Pharmacotherapy

Interventional Treatment

Sclerotherapy

Transdermal Laser and Intense Pulsed Light

Surgical Treatment

Endovenous Ablation

Radiofrequency Ablation

Endovenous Laser Ablation

Comparison Between the Methods

What the Generalist Can Do?

When to Refer to the Expert?

References

15: Vascular Anomalies

Epidemiology

Vascular Tumors

Vascular Malformations

Natural History of the Disease

Clinical Presentation and Diagnosis

Vascular Tumors

High-Flow Malformations

Low-Flow Malformations

Venous Malformations

Lymphatic Malformations

Imaging Methods

Doppler Ultrasonography

Magnetic Resonance Angiography

Computed Tomography

Angiography

Differential Diagnosis

Treatment

Vascular Tumors

Clinical Treatment and Laser for Vascular Tumors (Hemangioma) [5]

Vascular Malformations

What Can Non-specialists Do for This Patient?

When Should the Patient Be Referred to the Specialist?

References

16: Aortic Dissection

Introduction

Definition

Epidemiology

Pathophysiology

Classification

Acute Versus Chronic

Anatomic

Risk Factors

Clinical Presentation

Pain

Neurological Symptoms

Cardiac Complications

Malperfusion Syndrome and Limb Ischemia

Diagnosis

Thorax X-ray

Computed Tomography Angiography

Transthoracic/Transesophageal Echocardigraphy

Aortography

Nuclear Magnetic Resonance

Treatment

Medical Therapy

Antihypertensive Treatment

Analgesia

Interventional Therapy

Type A Dissection

Type B Dissection

Post-treatment Care

References

17: Lower Limb Ulcers

Introduction

Epidemiology

Diagnosis

Venous Stasis Ulcers

Concept

Epidemiology

Pathophysiology

Clinical Presentation

Medical Imaging

Treatment

Compression Therapy

Oral Medications

Intervention

Arterial (Ischemic) Ulcers

Concept

Epidemiology

Pathophysiology

Clinical Presentation

Treatment

Mixed Ulcers

Hypertensive Ulcers

Neuropathic Ulcers

Other Less Common Causes of Ulcers

Topical Treatment of the Ulcers

References

18: Lymphedema and Erysipelas

Lymphedema

Concept

Epidemiology and Classification

Primary Lymphedema

Secondary Lymphedema

Natural History

Clinical Findings

Diagnosis

Treatment

Complex Decongestive Physiotherapy

Intermittent Pneumatic Compression

Pharmacologic Treatment

Surgical Treatment

Erysipelas

Concept

Epidemiology

Natural History

Clinical Findings

Diagnosis

Treatment

Complications

What Can the Nonspecialist Do for the Patient with Lymphedema?

When to Refer to Specialist?

References

19: Clinical Treatment of Vascular Diseases

Categories of Cardiovascular Risk

Management of Dyslipidemia

Statins

Mechanism of Function: Pleiotropic Effect of Statins

Screening

How to Screen?

Who Should Take This Drug?

Special Situation

Targets of Treatment

Statin Therapy: Daily Doses

Hipolipedemiant Non-statin Drugs

Antiplatelet Therapy

Aspirin

Thienopyridines (Clopidogrel, Ticlopidine, and Prasugrel)

Other Antiplatelet Drugs

Dual Platelet Drugs

Who Must Take This Drug?

Antihypertensive

Renovascular Disease

Renin-Angiotensin-Aldosterone Inhibitors

Beta-Blockers

Calcium Channel Blockers

Options for Treatment

Handling of Symptoms

Pain Control

Pentoxyfilline

Cilostazol

Naftidrofuryl (Nafronyl)

Prostanoids (Iloprost, Beraprost, Prostaglandin E1, and Prostacyclin)

Other Peripheral Artery Disease Medical Therapy

Homocysteine

Levocarnitine (L-Carnitine)

L-Arginine

Gingko Biloba

Medical Therapy in Aortic Aneurysm and Acute Aortic Syndrome

Beta-Blockers

Calcium Channel Blockers

Angiotensin-Converting-Enzyme Inhibitors

Angiotensin-Receptor Blockers

Statins

Tetracycline and Macrolides (Doxycycline and Roxithromicin)

Antiplatelet Therapy

References

Appendix A: Doppler Ultrasound and Ankle–Brachial Pressure Index

Abstract

Doppler Ultrasound

Sphygmomanometer

Ankle–Brachial Pressure Index

Appendix B: Vascular Imaging Techniques

Abstract

Ultrasonography (Ultrasound)

Computed Tomography

Magnetic Resonance Imaging

Scintigraphy

Glossary

Index

 

An aparitie	26 Jan. 2017
Autor	Tulio Pinho Navarro , Alan Dardik , Daniela Junqueira , Ligia Cisneros
Dimensiuni	15.88 x 2.54 x 23.5 cm
Editura	Springer
Format	Hardcover
ISBN	9783319460574
Limba	Engleza
Nr pag	279