Objectives: The aims of the study were to test the safety and efficacy of a custom-made endovenous valve transfer stent, and delivery system in animals and humans.
Objective: There is an increasing use of minimal invasive techniques to treat saphenous vein reflux. Among these radiofrequency ablation (RFA), endovenous laser ablation (EVLA), and foam sclerotherapy are frequently used. A new method of thermal ablation is the steam vein sclerosing (SVS) system. This study evaluates the histological changes after ablation of the saphenous veins in goats with RFA, EVLA, and SVS.
Although endovascular techniques have markedly improved over the past decades, the important rates of restenosis and the frequent need for target vessel revascularization (TVR) remain challenging when nominating any endovascular approach as the gold standard technique. Particularly in areas as difficult as the femoropopliteal tract, long-term procedural success is hindered by extensive plaque burden, as well as numerous external mechanical stressors. Long (TASC II C and D), severely calcified (grade 3–4, > 270° calcium) lesions in the distal femoropopliteal segment in patients with critical limb ischemia with multilevel disease and significant runoff still have high TVR rates.
Perforations along the superficial femoral artery (SFA) can occur from a variety of causes; if unrecognized or mismanaged, they can result in significant morbidity and even mortality. In the worst cases, uncontrolled bleeding can lead to hemodynamic instability and the need for open surgical management, blood transfusions, and prolonged hospital stays. From a procedural standpoint, perforations can result in prolonged procedure times, incomplete treatment, and tremendous frustration to the operator. This article focuses on SFA perforations related to endovascular interventions, although many of the treatment methods can be applied to other causes of perforation, such as penetrating trauma or crush injury. The prevention of perforations will be discussed first, because the best way to manage any complication is to avoid it altogether. Then, common mechanisms of perforation and the most effective treatment options will be reviewed (see Common Procedure-Related Causes of SFA Perforations and Techniques to Treat SFA Segment Perforations).
Acute arterial thrombosis can cause myocardial infarction (MI), ischemic stroke, and acute limb ischemia (ALI). The annual incidences of such events are high; there were 935,000 MI and 795,000 stroke events in the United States in 2008.1 However, the incidence and prevalence of acute peripheral arterial thrombosis is not well described, even in lieu of its devastating consequences, including morbidity, mortality, and limb loss.1,2
Distal embolization (DE) occurs frequently during femoropopliteal (FP) interventions. Treatment of FP atherosclerotic lesions with balloon angioplasty, stenting, atherectomy, embolectomy, or catheter-directed lysis is likely to yield significant debris.1-11 Despite a high rate of DE reaching 100% in some reports,3,10 data suggest that only 2% to 3% of patients will eventually require additional pharmacological and/or mechanical treatment.12
Despite advances in endovascular therapy, femoropopliteal in-stent restenosis (FP-ISR) remains a frequent clinical challenge. It is estimated that approximately 115,000 cases of FP-ISR occur each year in the United States.1 Therefore, identifying optimal treatments for FP-ISR is critical for improving the outcomes of endovascular therapy. This article reviews the safety and efficacy of current treatment options for FP-ISR, including balloon angioplasty, laser atherectomy with adjunctive balloon angioplasty, drug-eluting stents, and emerging uses of drug-coated balloons (DCBs).
Although the drug-coated balloon (DCB) was initially thought to be an alternative to stenting in superficial femoral artery (SFA) interventions, it is our opinion that the DCB will never walk alone, as the limitations of this technology (in particular, the lack of mechanical scaffolding and uncertainties regarding adequate drug delivery to complex, calcified lesions) prevent its solo use in several cases.
The superficial femoral artery (SFA) is highly exposed to biomechanical forces occurring during leg movement. The superficial course of the artery, with crossing of flexion points as well as interaction with the surrounding musculature, exposes the artery to external forces, including compression, torsion, and elongation.1 The implantation of metallic stents is standard for the treatment of SFA atherosclerotic disease; however, concerns exist about the potential for nitinol stents to fracture and the clinical implications of these stent fractures.1 Some reports suggest that stent fractures are associated with a higher incidence of in-stent restenosis, thrombosis, or embolism.2-4 Others do not report a significant association between stent fracture and clinical deterioration.5,6-8
More than 19 million Americans now suffer from peripheral artery disease (PAD),1,2 and, correspondingly, the economic cost of this disease is becoming increasingly overwhelming. It is now estimated that the annual economic burden from PAD is between $160 and $290 billion.3,4
To investigate factors in patients with critical limb ischemia (CLI) and isolated infrapopliteal lesions that adversely affect outcomes of endovascular therapy (EVT) with or without angiosome-oriented revascularization.
Chronic renal insufficiency (CRI) is a growing global problem. PTA can be performed without nephrotoxic contrast, utilizing Doppler-ultrasound (Duplex) guidance.
We performed indocyanine green angiography (ICGA) in patients with peripheral arterial disease (PAD), and established a method for the quantitative measurement of appropriate parameters to assess peripheral perfusion and the applicability of ICGA tests.
To evaluate the feasibility, efficacy and safety of ultrasound-accelerated catheter-directed thrombolysis (UACDT) in the delayed treatment of lower extremity deep venous thrombosis (DVT).
This study was designed to evaluate the effectiveness of endovascular treatment (EVAR) for ruptured abdominal aortic aneurysms (rAAAs).
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