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April 9, 1982

Aneurysms: Diagnosis and Treatment

Author Affiliations

Evansville, Ind


edited by John J. Bergan and James S. T. Yao (symposium), 670 pp, with illus, $54.50, New York, Grune & Stratton Inc, 1982.

JAMA. 1982;247(14):2027-2031. doi:10.1001/jama.1982.03320390085061

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While hospital mortality for abdominal aneurysmectomy has fallen tenfold since 1951, most vascular surgery texts neglect mentioning that life after aneurysm surgery is still too short. Not so this book, which emphasizes the need to liberalize coronary angiography and surgery in abdominal aneurysm patients, 40% of whom will otherwise die too early from myocardial infarction. As 30% of aortic dissection patients succumb to another aneurysm after the initial "successful" repair, better diagnostic follow-up and closer control of blood pressure are also advised.

Other dark recesses of this field, such as why some atherosclerotic arteries develop aneurysms while others stenose, or why anastomotic false aneurysms occur, are brightly illuminated. The pros and cons of routine preoperative aortography, the prevention and treatment of complications, and unusual manifestations of aneurysmal disease are all brilliantly reviewed. Visceral, peripheral, mycotic, and pediatric aneurysms are articulated with notable cogency. Special problems, like infected groin aneurysms in heroin addicts,