Lower extremity arterial obstruction leading to ischemic claudication or critical limb ischemia is generally caused by atherosclerotic obstructive disease and affects an estimated 40 million Americans where up to 10 million are symptomatic.1 Treatment options in the past have ranged from simple medical therapy and exercise programs to revascularization strategies. These revascularization approaches have included surgical bypass or endovascular therapies.
The femoropopliteal segment is increasingly treated via an endovascular-first approach for both lifestyle-limiting claudication and critical limb ischemia. Nitinol stents have been shown to be superior to percutaneous transluminal angioplasty (PTA) and have become one of the primary modalities for the treatment of femoropopliteal obstructive atherosclerotic disease because of the improved structural integrity and conformability of newer devices.
Background: In patients with symptomatic peripheral artery disease with a history of limb revascularization, the optimal antithrombotic regimen for long-term management is unknown.
Background: This project by the ICVR (International Consortium of Vascular Registries), a collaboration of 11 vascular surgical quality registries, was designed to evaluate international variation in the contemporary management of abdominal aortic aneurysm (AAA) with relation to recommended treatment guidelines from the Society for Vascular Surgery and the European Society for Vascular Surgery.
Background: Multiple randomized clinical trials comparing renal artery stent placement plus medical therapy with medical therapy alone have not shown any benefit of stent placement. However, debate continues whether patients with extreme pressure gradients, stenosis severity, or baseline blood pressure benefit from stent revascularization.
Background: Evidence from large, randomized, controlled peripheral artery disease trials reporting long-term outcomes using drug-coated balloons (DCBs) is limited. Previously, the DCB showed favorable 1-year outcomes compared with conventional percutaneous transluminal angioplasty (PTA), yet durability of the treatment effect with DCBs remains unknown.
Background: Endovenous recanalization of iliofemoral stenosis or occlusion with angioplasty and stent placement has been increasingly used to maintain long-term venous patency in patients with iliofemoral venous outflow obstruction. The purpose of this systematic review and meta-analysis was to determine safety and effectiveness of venous stent placement in patients with iliofemoral venous outflow obstruction.
Subacute lower limb ischemia is defined as occurring more than 14 days and less than 3 months from symptom onset (1). Despite tremendous advancements in the treatment of vascular disease, no treatment strategy has been established for subacute lower limb ischemia. A 67-year-old man with a history of intermittent claudication in the left lower limb experienced a sudden worsening of claudication and pain at rest 3 weeks previously. The patient was referred to our vascular team for diagnosis and treatment.
Background: Critical limb ischemia (CLI) is increasing in prevalence, and remains a significant source of mortality and limb loss. The decision to recommend surgical or endovascular revascularization for patients who are candidates for both varies significantly among providers and is driven more by individual preference than scientific evidence.
Background: Intracranial aneurysms (IAs), abdominal aortic aneurysms (AAAs), and thoracic aortic aneurysms (TAAs) all have a familial predisposition. Given that aneurysm types are known to co‐occur, we hypothesized that there may be shared genetic risk factors for IAs, AAAs, and TAAs.
Background End: stage renal disease is accompanied by functional and structural vascular abnormalities. The objective of this study was to characterize vascular function in a large cohort of patients with end‐stage renal disease, using noninvasive physiological measurements, and to correlate function with demographic and clinical factors.
Background: The clinical implications of ankle‐brachial index (ABI) cutpoints are not well defined in patients with chronic kidney disease (CKD) despite increased prevalence of high ABI attributed to arterial stiffness. We examined the relationship of ABI with cardiovascular disease (CVD) and all‐cause mortality among CKD patients.
Background Drug: eluting stents are replacing bare‐metal stents, but in‐stent restenosis (ISR) remains a problem. Reactive hyperemia index (RHI) assessed by peripheral arterial tonometry evaluates endothelial function noninvasively. We prospectively assessed the prognostic value of RHI in predicting ISR after percutaneous coronary intervention.
A 42-year-old man presented to his local hospital with sepsis. He was cyanotic and had finger clubbing with oxygen saturation of 85% to 90%. A computed tomographic pulmonary angiogram led to an initial diagnosis of left-sided superior vena cava and partial anomalous pulmonary venous drainage. He had been generally well but always had limited exercise capacity (New York Heart Association class 2) and mild cyanosis and finger clubbing had been noted previously but had never been investigated.
Abstract: Aortic wall complications can occur in unrepaired aortic coarctation (CoA) and after surgical repair or endovascular treatment. This review summarizes the available literature and current understanding of aortic wall injury (AWI) surrounding the management of CoA, focusing specifically on acute and follow-up AWI after endovascular treatment.
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