Interventional Cardiovascular Medicine: Principles and Practice, 2nd edition.
Richard R. Stack, Gary S. Roubin, William W. O’Neill, eds.
976 pp. Philadelphia, Pa: Churchill Livingstone; 2002. $189. ISBN 0-443-07979-X.
This book contains an extensive body of information of both theoretical and practical importance to all interventional cardiologists and succeeds admirably in merging practical and pragmatic techniques with solid scientific evidence. The editors have organized the contributions of the 93 contributors into 7 sections in this second edition, state-of-the-art review of the major clinical subject areas of interventional cardiovascular medicine.
The first section is a historical perspective that deals with the topic of comprehensive interventional therapy and highlights the significant shift among interventional cardiologists into the field of peripheral vascular intervention, where their ability to modify risk factors of atherosclerosis and the increased recognition of atherosclerotic vascular disease is predicted to significantly improve patient outcomes.
Section two addresses intervention and the atherosclerotic vessel, with emphasis on the vascular biology of mechanical intervention, the pathology of atherosclerotic plaques, the various mechanical interventions, and an overview of the vascular biology of restenosis, and includes a chapter on the basis for secondary prevention strategies. This section is comprehensive and well illustrated and contains a full complement of references.
Section three deals with intervention and the patient with cardiovascular disease and includes well-written chapters on epidemiology, assessment of prognosis, and management of chronic stable angina pectoris, including comparing and contrasting medical therapy versus percutaneous or surgical revascularization. Included is an excellent, well-referenced, and detailed review of primary percutaneous intervention for acute myocardial infarction with focus on subgroups, technical considerations, and the expanding reach of mechanical reperfusion. A subsequent chapter addresses new approaches, both pharmacological (low molecular weight heparin, direct antithrombins, parenteral platelet glycoprotein IIb/IIIa inhibitors, new oral antiplatelet drugs, and adenosine [Acute Myocardial Infarction Study Adenosine (ARMISTAD) Trial]) and catheter-based. The latter includes the use of stents (Primary Angioplasty in acute Myocardial Infarction [PAMI; heparin-coated stents], Controlled Abciximab and Device Investigation to Lower Late Angioplasty Complications [CADILLAC], and numerous European and Japanese studies), newer devices (thrombectomy/atherectomy, AngioJet, hydrolyzer, ultrasound thrombolysis), and distal protection devices. There is a chapter focusing on interventional treatment of cardiogenic shock that includes a practical treatment algorithm and specifically challenges us to identify patients for comfort care, probably one of the most difficult decisions in medicine. The final chapters in this section deal with the complex and challenging issues of intervention after coronary artery bypass surgery. They highlight the limited role of newer technologies to date but are optimistic about the potential role of distal protection devices, and they end with economic and medico-legal issues in intervention.
The fourth section outlines the practice and technique of coronary intervention and includes a comprehensive review of catheterization laboratory design, physical principles, angiographic views, and techniques for percutaneous intervention, including different approaches, potentially complementary interventions (angioscopy, doppler flow), and alternate interventional strategies (high speed rotational atherectomy, transluminal extraction catheter atherectomy, direct laser ablation etc), as well as complications of the procedure and the challenges of chronic total occlusions and left mainstem intervention. Included are chapters on percutaneous balloon valvuloplasty and adjunctive pharmacotherapy.
Section five is a comprehensive review of coronary stents, including stent selection and optimal deployment techniques, and includes strategies for bifurcation stenting, left mainstem stenting, calcified lesions, chronic total occlusions, small caliber vessels, and saphenous vein graft stenting. Chapters follow on different stent types including the Gianturco-Roubin, Palmaz-Schatz, ACS Multilink, Wallstent, and AVE Microstent. In addition, the role of intravascular ultrasound, debulking, and predilatation are discussed.
The sixth section outlines new approaches to restenosis and thrombosis, including a chapter on local drug delivery (catheter systems, pharmacological agents, and limited clinical trials), vascular brachytherapy, and the role of the cutting balloon.
The seventh and final section deals with peripheral vascular interventions, including renal artery stenosis, carotid artery stenting, and aortic disease. The chapter on renal artery interventions outlines both the role of balloon angioplasty and stenting and the current indications for and an approach to specific subsets, including fibromuscular dysplasia and atherosclerotic obstruction. There is an excellent and comprehensive section on carotid artery intervention that not only highlights the evolving indication for percutaneous intervention, future developments in equipment, and neuroprotection, but also includes a description of the National Institutes of Health-sponsored multicenter Carotid Revascularization Endarterectomy versus Stent Trial (CREST). The final chapter describes endovascular treatment for abdominal aortic aneurysms and the management of abdominal aortic occlusive disease.
This is an extremely well-written, comprehensive, and yet easy to read book authored by experts in the field. Attention is paid to providing a practical approach to the vast array of information necessary to deliver the best interventional approach to a specific patient. The only obvious omission from this book relates to drug-eluting stents. I assume that many of the clinical trials were not available at the time that this edition was written. I have no doubt that this revolutionary strategy in interventional cardiology will be the centerpiece of the next edition of this book. Although most interventionalists will probably not read this book in its totality, it will serve as an excellent reference for interventionalists at all levels. The editors are to be congratulated on an excellent addition to the interventional literature.