Carotid Artery Surgery: A Problem-Based Approach
Year: 2001
Type: article
Abstract: Although the editors themselves question whether there is a need for yet another text on the subject of carotid endarterectomy (CEA), their monograph titled Carotid Artery Surgery: A Problem-Based Approach succeeds in being a unique contribution, and well worth the reasonable purchase price. With chapters titled as questions, such as, ‘When should I perform CEA after a completed stroke?’ the text is designed for the practicing vascular surgeon, and provides concise recommendations for the treatment of patients with complex carotid problems.
Boasting contributions from 55 world-renowned vascular surgeons, neurologists, and diagnosticians, the text addresses each of the ‘questions’ by allowing one European and one American author to espouse their opinions through several pages of personal experience and supporting data. Following each chapter is a brief synopsis by the co-editors, usually comprising one or two pages. The prosaic style is colloquial, with many authors using first person and exclamatory punctuation, and the result is an engaging and informative treatise on current controversies in this field.
Although the contributors’ sections are thoughtful, the most provocative and helpful aspects of the textbook are the editorial comments that follow. These brief installments reflect the combined opinion of the authoritative co-editors and thus serve as a window into the reality of clinical practice. For instance, the editors suggest that centers with an historical operative stroke-death risk greater than 7% should ‘review their patient selection and operative technique’ before enrolling more patients (p. 14). This blunt aphorism, while generally held by many vascular surgeons, would rarely be found in more traditional texts. Numerous other examples abound, including, ‘Surgeons should stop blaming the shunt, patch, or monitoring modality for perioperative strokes’ (p. 313).
Several minor weaknesses challenge the reader’s attention. The very first sentence of the foreword contains a distracting typographical error, and the first chapter is mislabeled. The inclusion of national flag icons on every page are constant reminders of the origin of the material and seem somewhat out of place in our global society (moreover, why is the section from the European author always printed first?). Although the 30 clinical questions posed are certainly relevant, several important topics are omitted including, ‘How should carotid aneurysms and fibromuscular dysplasia be managed?’, ‘When should I perform external carotid endarterectomy?’, and ‘What is the role of thrombolysis in acute stroke?’
These deficiencies notwithstanding, Carotid Artery Surgery: A Problem-Based Approach is a useful addition to the vascular surgeon’s library. This reviewer hopes that similar volumes addressing aneurysmal and peripheral vascular disease might soon follow.
Source: Annals of Surgery
Author: LEWIS B. SCHWARTZ
Institution: University of Chicago
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2326979447