Waksman, MD Department of Cardiology MedStar Washington Hospital Center Washington, DC, USA
Gerald S. Werner, MD, PhD, FACC, FSCAI, FESC Professor of Cardiology and Director Medizinische Klinik I (Cardiology & Intensive Care) Klinikum Darmstadt GmbH Darmstadt, Germany
Robert Whitbourn, MD St Vincent’s Hospital Melbourne Victoria, Australia
Jose M. Wiley, MD, MPH, FACC, FACP, FSCAI Associate Professor of Clinical Medicine Albert Einstein College of Medicine Director of Endovascular Interventions Division of Cardiology Montefiore Einstein Center for Heart & Vascular Care Bronx, NY, USA
Syed Zaid, MD Division of Cardiology, Westchester Medical Center Valhalla, NY, USA
Foreword
Application of the term “exponential” requires careful consideration so as to avoid the hazard of “hyperbole.” However, that concept is well suited for the field of Interventional Cardiology, or perhaps the broader label of Interventional Cardiovascular Disease. In the past several decades, at least since 1977, there has been an exponential growth in scientific knowledge about underlying cardiac pathophysiology, optimal patient care strategies and the development, testing and implementation of new technology. All of these have been aimed at treating unmet clinical needs in diagnosing and treating not only coronary artery disease (CAD) but also congestive heart failure (CHF), structural heart disease (SHD), prevention and treatment of stroke and arrhythmias. We have learned about new technology for matching specific coronary anatomy with specific devices as well as when and how to image both coronary, valves, and large vessel disease. Throughout this journey, we have learned the central tenet of the importance of close collaboration with cardiovascular surgery as the tools we use, the skill sets required, and the knowledge base have been conjoined under the umbrella of the Heart Team and shared decision‐making. This will continue to evolve as the specialties become more together than separate.
This 3rd Edition of Interventional Cardiology Principles and Practice is a complete compendium that serves this exponential growth field exceedingly well; with 87 chapters that cover the range from basics of knowledge and techniques through imaging and physiology to strategies of revascularization in different vascular distributions and in different clinical settings. The textbook encompasses special techniques including “rich emotional experiences,” clinical trials and how to do them as well as stop them, interventional pharmacology, medical therapy, and interventions for CAD, SHD, CHF, and central and peripheral cardiovascular disease beds.
This is an exhaustive resource brought by multiple international experts with emphasis on principles and practice, exchange of knowledge, and techniques to enhance learning with multiple choice questions after each chapter to emphasize key points with the whole project served by CD/Internet platforms.
This important work by Dr. Dangas and his co‐editors and associates serves all readers and ourselves exceedingly well, with a continued focus and emphasis on life‐long learning.
David R. Holmes, Jr., MD
Michael J. Mack, MD
Preface
Minimally invasive cardiovascular interventions continue to expand worldwide with many new indications and a broad body of clinical investigations guiding many aspects of patient care and research innovation. Importantly, specialists from neighboring areas of medicine and surgery are becoming well‐versed in interventional, percutaneous, minimally invasive methods and techniques. The technological advancements are vast and essentially drive the overall growth of this field.
Hence, we had to critically revise and update all the sections of this book to encompass the principles and practice of coronary interventions, interventional pharmacology, structural heart interventions, and endovascular therapy. Each section includes key subjects presented in an organized way: starting with the pathophysiological problem and relevant pathology, to mechanisms of treatment, therapeutic options, risks, contraindications and complications, where applicable. The inclusion of multiple‐choice questions with each chapter allows a well‐framed self‐assessment. This innovative learning method was introduced by our 1st edition nearly a decade ago and has been adopted by many other textbook since that time.
The modular presentation of this textbook, both as a printed book, as well as e‐book, with a companion website providing extra material, reflects the effort of the publisher and the editors to reach out to many generations of physicians in training. The evolution of specialty certification and recertification has indeed made life learning a reality in our era. Therefore, the present textbook must also fulfill the quest to approach the new and tech‐savvy learner, those ahead of an initial certification examination, those in advanced clinical practice who need practical instruction for a certain specialized subject, as well as those who have been practicing for a long time and need to refresh their knowledge with or without a recertification examination ahead of them. We hope that readers will find our approaches both useful and practical.
George D. Dangas, Carlo Di Mario, Holger Thiele, and Peter Barlis
Acknowledgments
The editorial team and all authors wish to thank our families for the time‐away allowance that ultimately permitted this book’s completion.
About the Companion Website
Don’t forget to visit the companion website for this book:
www.wiley.com/go/dangas/cardiology
The website contains:
Videos illustrating key procedures
Interactive multiple choice questions
CHAPTER 1
Atherogenesis and Inflammation
Daisuke Shishikura, Yanti Octavia, Umair Hayat, Vikas Thondapu, and Peter Barlis
The importance of atherosclerosis and its clinical consequences are well known as the leading cause of vascular disease worldwide [1]. The aetiology of atherosclerosis is multifactorial, and it affects various regions of the circulation preferentially resulting in heart attack, stroke, and peripheral vascular disease [2]. Atherosclerosis is considered a chronic immunoinflammatory disease fuelled by lipid, which typically occurs over many years [3]. The growth of atherosclerotic plaques does not occur in a smooth, linear fashion but discontinuously, with a stage of relative ‘silent’ period, punctuated by a period of rapid evolution which manifests clinically [4].
The formation of atherosclerosis is a complex process involving the interaction of plasma lipids with the vascular wall and immune cells [5]. Multiple independent