WordNet

a room where a doctor or dentist can be consulted; "he read the warning in the doctors surgery"
the branch of medical science that treats disease or injury by operative procedures; "he is professor of surgery at the Harvard Medical School"
see ones performance improve; "He levelled the score and then surged ahead"
a sudden or abrupt strong increase; "stimulated a surge of speculation"; "an upsurge of emotion"; "an upsurge in violent crime" (同)upsurge

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〈U〉『外科,』外科医術 / 〈U〉手術 / 〈C〉《英》診察室;〈C〉〈U〉診察時間
波のように押し寄せる,殺到する / 〈感情が〉こみあげる《+up》 / 急増する,〈株などが〉急騰する / (…が)押し寄せること,(…の)襲来,殺到《+of+名》 / (感情の)高まり,急増,急騰

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/09/03 15:58:20」(JST)

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Endovascular surgery is a form of minimally invasive surgery that was designed to access many regions of the body via major blood vessels.

Endovascular techniques were originally pioneered for diagnostic purposes by radiologists. Basic techniques involve the introduction of a catheter percutaneously into a large blood vessel (Seldinger technique). Typically the blood vessel chosen is the femoral artery or a vein found near the groin. Access to the femoral artery for example, is required for coronary, carotid, and cerebral angiographic procedures. The catheter is injected with a radio-opaque dye that can be seen on live X-ray or fluoroscopy. As the dye courses through the blood vessels, characteristic images are seen by experienced viewers and can assist in the diagnosis of diseases such as atherosclerosis, vascular trauma, or aneurysms.

In recent years, however, the development of intravascular balloons, stents and coils have allowed for new therapies as alternatives to traditional surgeries such as Coronary artery bypass surgery (CABG), carotid endarterectomy and aneurysm clipping. Stents and coils are composed of fine wire materials such as platinum, that can be inserted through a thin catheter and expanded into a predetermined shape once they are guided into place.

Endovascular surgery is performed by radiologists, neurologists, neurosurgeons, cardiologists, and vascular surgeons. The field is rapidly growing as its minimally invasive techniques would seem to offer a lower risk of complications compared to traditional highly invasive surgeries. However, as shown by the Stenting vs. Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial, the complication rates for some endovascular procedures surpass those present after "aggressive medical management" (i.e., management without surgery).^[1] In the case of SAMMPRIS, the technique in question was intracranial arterial stenting with the use of the Wingspan stent system, with some resulting complications possibly due to "the fact that stenting of the intracranial vasculature is technically more challenging" than stenting of vessels elsewhere.^[2] Other trials examining the comparative effectiveness of endovascular procedures include the Carotid Revascularization Endarterectomy versus Stent Trial (CREST), and International Subarachnoid Aneurysm Trial (ISAT), among others.^{[examples needed]}

Examples of Endovascular Surgery

EVAR, an endovascular treatment for abdominal aortic aneurysm
Carotid stenting, for treatment of carotid artery stenosis

References

^ Chimowitz MI, Lynn MJ, Derdeyn CP, et al. Stenting versus aggressive medical therapy for intracranial arterial stenosis. NEJM. 2011 Sep 15;365(11):993-1003. PMID 21899409
^ Broderick JP. The challenges of intracranial revascularization for stroke prevention. NEJM. 2011 Sep 15;365(11):1054-5. PMID 21899410

External links

RSNA Interventional Radiology. Basics of endovascular techniques.
http://www.endovascular.org/. The Endovascular Forum.
The International Society of Endovascular Specialists (ISES)
The Journal of Endovascular Therapy

UpToDate Contents

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1. Overview of open surgical repair of the thoracic aorta
2. Anesthesia for open abdominal aortic surgery
3. 膝窩動脈瘤の手術および血管内修復 surgical and endovascular repair of popliteal artery aneurysm
4. 上肢血行再建術の外科的治療および血管内治療手技の概要 overview of surgical and endovascular techniques for upper extremity revascularization
5. 感染性（真菌）大動脈瘤の概要 overview of infected mycotic arterial aneurysm

English Journal

Intracranial dural arteriovenous fistulas: a review of their current management based on emerging knowledge.

Signorelli F1, Gory B, Maduri R, Guyotat J, Pelissou-Guyotat I, Chirchiglia D, Riva R, Turjman F.
Journal of neurosurgical sciences.J Neurosurg Sci.2017 Apr;61(2):193-206. doi: 10.23736/S0390-5616.16.03168-4. Epub 2015 Feb 13.
Intracranial dural arteriovenous fistulas are a rarely diagnosed type of vascular malformations, yet they are clinically relevant in a subspecialized neurovascular setting because a misdiagnosis may lead to permanent morbidity and mortality. Modern brain imaging techniques such as flat panel detecto
PMID 25677401

Real-Time Patient and Staff Radiation Dose Monitoring in IR Practice.

Sailer AM1,2, Paulis L3, Vergoossen L3, Kovac AO3, Wijnhoven G3, Schurink GW4,5, Mees B4, Das M3,5, Wildberger JE3,5, de Haan MW3, Jeukens CR3.
Cardiovascular and interventional radiology.Cardiovasc Intervent Radiol.2017 Mar;40(3):421-429. doi: 10.1007/s00270-016-1526-8. Epub 2016 Dec 9.
PURPOSE: Knowledge of medical radiation exposure permits application of radiation protection principles. In our center, the first dedicated real-time, automated patient and staff dose monitoring system (DoseWise Portal, Philips Healthcare) was installed. Aim of this study was to obtain insight in th
PMID 27942927

Endovascular Therapy Research in Lower Limb Peripheral Arterial Disease Published Over a 5-Year Period: Who is Publishing and Where?

Asadi H1, Lee RJ1, Sheehan M1, Thanaratam P1, Lee DM1, Lee AM1, Lee MJ2.
Cardiovascular and interventional radiology.Cardiovasc Intervent Radiol.2017 Mar;40(3):343-350. doi: 10.1007/s00270-016-1504-1. Epub 2016 Nov 14.
INTRODUCTION: Peripheral arterial disease (PAD) is being increasingly managed by endovascular therapies. In this study, we identified the clinical services publishing research as well as the journals of publication over a 5-year period.METHODS: Twenty keywords and phrases related to endovascular int
PMID 27844109

Japanese Journal

胸部大動脈ステントグラフト内挿術中に逆行性上行大動脈解離を来した1症例

藤田将英,福田妙子,矢口裕一 [他]
麻酔 64(10), 1080-1084, 2015-10
NAID 40020609888

Validation of Patient Selection for Endovascular Aneurysm Repair or Open Repair of Abdominal Aortic Aneurysm : Single-Center Study

Yamamoto Kiyohito,Komori Kimihiro,Banno Hiroshi [他]
Circulation journal : official journal of the Japanese Circulation Society 79(8), 1699-1705, 2015-08
NAID 40020531966

症例広範囲胸部大動脈瘤に対する二期的ハイブリッド手術の1例

林太郎,戸部智,杉山博信 [他]
胸部外科 = The Japanese journal of thoracic surgery
NAID 40020521867

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