Atlas of Vascular Disease

Vascular diseases constitute the most common causes of disability and death in Western society. Atherosclerosis, throm- bosis, hypertension, and their clinical sequelae, including myocardial infarction, disabling claudication, limb loss, and stroke, occur far too frequently. Indeed, vascular pathology in one form or another is responsible for over one hundred billion dollars of costs annually in the United States for medical expenses and lost productivity.
There have been rapid advancements in vascular biology, pharmacology, and technology for vascular disease. Basic science discoveries have led to our recognition of the human vasculature as not simply a passive conduit, but as a complex organ that responds to both intrinsic and extrinsic stimuli with definable pathologic processes. In addition, technologic advances have redefined the role of imaging modalities. The enhanced resolution of techniques such as ultrasonography, computed tomography, and magnetic resonance angiography has enabled the clinician to accurately diagnose vascular diseases noninvasively, thereby avoiding the risks inherent to invasive procedures. As diagnostic modalities have become less invasive, therapeutic options have moved from the purely surgical arena. Innovations in endovascular intervention have provided less invasive therapeutic strategies for patients affected by clinically significant atherosclerosis of peripheral and renal arteries. Endovascular placement of stented grafts is now employed for selected patients with aortic aneurysms. Advances in surgical techniques coupled with perioperative cardiac risk assessment and management have yielded lower operative mortality and morbidity rates and consequently improved the outcome for patients with arterial aneurysms, ischemic extremities, and cerebrovascular disease.