Daniel G. Clair, MD, discusses the risk factors leading to limb failure and device elements that can help diminish this complication.
Iliac limb occlusion after endovascular aneurysm repair (EVAR) can result in acute ischemic symptoms and subsequent major morbidity or mortality. In contemporary investigational device exemption (IDE) trials, the incidence of limb occlusion at 12 months has ranged from approximately 1% to 8%. Despite the fact that these rates far and away surpassed that of type I endoleaks in these same trials, the importance of improving limb patency has received comparatively little focus.
During the last decade, endovascular aneurysm repair (EVAR) has gained wide acceptance as the preferred method of treating suitable patients with abdominal aortic aneurysms.1 EVAR is associated with lower 30-day mortality and morbidity rates, faster discharge, and fewer complications than with surgery, but seems to be associated with higher secondary intervention rates.2 Graft limb stenosis or thrombosis are important causes of secondary interventions after EVAR.
An expert panel discusses the current role, data, and techniques for the use of drug-coated balloons in tackling PAD.
Atherosclerosis is the primary cause of peripheral artery disease (PAD), which continues to increase in the United States and Europe and affects more than 27 million people.1,2 The symptoms of PAD widely vary from mild claudication to critical limb ischemia (CLI) with gangrene and limb loss, and it is associated with high morbidity, especially in the elderly.
It is well-recognized that peripheral artery disease (PAD) affects millions of individuals worldwide. In countries with an aging population, and with a growing prevalence of diabetes, there is an even greater growth of this malady. Although it has been common for PAD to be undiagnosed or misdiagnosed in the past, educational efforts by health care workers, professional societies, and industry have enhanced awareness in recent years.
Few endovascular technologies have been as anticipated as drug-coated balloons (DCBs). For at least 5 years, the endovascular community has been discussing the role of paclitaxel in the peripheral arterial system and its potential value, first on stents and now on angioplasty balloons. Do we finally have a solution for restenosis and intimal hyperplasia? Can we potentially eliminate the need to leave stents in patients? How will the long-term patency and, more importantly, the clinical efficacy of these technologies change our practice? These are all questions that we are just beginning to answer.
Dr. Koen Deloose talks to Dr. Martin Werner about available options, cost-effectiveness considerations, and what the future holds for complex SFA disease.
Background: Although renal sympathetic denervation therapy has shown promising results in patients with resistant hypertension, the human anatomy of peri-arterial renal nerves is poorly understood.
Carotid artery stenting (CAS) has achieved clinical equipoise with carotid endarterectomy (CEA), as evidenced by 2 large U.S. randomized clinical trials, multiple pivotal registry trials, and 2 multispecialty guideline documents endorsed by 14 professional societies. The largest randomized trial conducted in patients at average surgical risk of CEA, CREST (Carotid Revascularization Endarterectomy Versus Stenting Trial) found no difference between CAS and CEA for the combined endpoint of stroke, death, and myocardial infarction (MI) after 4 years of follow-up.
Objectives: This study sought to examine sex-related differences in outcomes related to peripheral vascular intervention (PVI) procedures.
Objectives: The study sought to identify specific morphological characteristics of ruptured culprit plaques (RCP) responsible for acute events, and compare them with ruptured nonculprit plaques (RNCP) and nonruptured thin-cap fibroatheroma (TCFA) in patients presenting with acute coronary syndromes (ACS).
Background: Studies investigating the role of alcohol consumption in the development of abdominal aortic aneurysm (AAA) are scarce. We aimed to examine associations between total alcohol consumption and specific alcoholic beverages and the hazard of AAA.
Backgroun: Preclinical data suggest that an acute inflammatory response following myocardial infarction (MI) accelerates systemic atherosclerosis. Using combined positron emission and computed tomography, we investigated whether this phenomenon occurs in humans.
Background: Patients with peripheral artery disease (PAD) experience significant morbidity and mortality. The OMEGA‐PAD I Trial, a randomized, double‐blinded, placebo‐controlled trial, addressed the hypothesis that short‐duration, high‐dose n‐3 polyunsaturated fatty acids (n‐3 PUFA) oral supplementation improves endothelial function and inflammation in PAD.
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