A tutorial on how to optimize transradial success by avoiding obstacles.
A simple update to access technique could lead to substantial improvements in outcomes.
Is transpedal access the future of peripheral revascularization?
What’s on the market, and what’s in the pipeline.
The importance of understanding potential adverse outcomes and how they can affect procedural planning.
How improved EVAR technology and techniques are enabling successful outcomes in patients with complex anatomy.
With the introduction of percutaneous arterial access by Seldinger in 1953, the need for surgical arteriotomy was eliminated.1 However, potential trauma to the artery from needle puncture, the introduction of multiple catheters, and the process of closure was recognized early and has, to some degree, remained unresolved for 60 years. Manual compression is generally effective for closure, but it has a number of undesirable features, including discomfort, risks associated with stasis in the artery and adjacent vein during vessel occlusion, and the substantial inflammatory response associated with arteries subjected to manual compression.2 A number of alternatives to manual compression have been introduced. Unfortunately, despite several generations of device development, the most recent studies of these devices still demonstrate that the optimal solution for arterial closure has not been achieved by the deposition of clips, plugs, or sutures into the arterial tract. Acute arterial complications, as well as the histopathological sequelae caused by closure device debris left behind in the arterial system and tissue tract, have been well documented.3 In general, review of the literature and the FDA MAUDE (Manufacturer and User Facility Device Experience) database demonstrates that vascular closure device (VCD) use exposes patients to risks of bleeding, infection, and vessel obstruction among others.
In fall 2014, investigators began enrolling patients in BEST-CLI, a prospective, multicenter, randomized trial comparing “best endovascular” versus “best surgical” options for treating critical limb ischemia (CLI). The trial is funded by the National Institutes of Health and aims to enroll 2,100 patients at 120 centers in North America over the next 4 years.
We retrospectively reviewed our prospectively maintained database in search of patients who, until December 2011, had persistent type II endoleaks, with growth of their aneurysm diameter of > 5 mm and were treated with Onyx™ liquid embolic system.
The aim of this study was to investigate whether the liquid embolic agent Onyx™ liquid embolic system, an ethylene vinyl alcohol copolymer, can be used to seal type 1 endoleaks during endovascular aneurysm repair (EVAR).
To evaluate the safety, efficacy, and clinical outcomes of superselective embolization using ethylene-vinyl alcohol copolymer (Onyx™ liquid embolic system) as the primary treatment for acute and massive lower gastrointestinal bleeding (LGIB).
As Onyx™ was initially approved for embolization of intracranial pathologies, its high tantalum content (TC) ensured fluoroscopic contrast despite the high x-ray absorption of the braincase. Tantalum, however, causes relevant beam hardening artifacts in CT examinations that might limit diagnostic information of any follow-up imaging. We developed an aortic phantom to simulate treatment and follow-up imaging of endoleaks, and assessed the diagnostic performance of Onyx™ liquid embolic system formulations with different, reduced TCs in order to determine a tantalum dosage that interferes less with diagnostic CT imaging, but still enables fluoroscopic visualization during embolization.
Purpose: To compare the acute procedure and angiographic outcomes of peripheral artery disease (PAD) patients treated with orbital atherectomy stratified by gender.
Purpose: To prospectively assess current limitations and complication rates of the transbrachial access technique for endovascular treatment of peripheral vascular pathologies.
Purpose: To report a novel technique for endovascular retrieval of a maldeployed vascular closure device, obviating the need for a femoral cutdown.
Cookies Sociales
Son esos botones que permiten compartir el contenido del sitio web en sus redes sociales (Facebook, Twitter y Linkedin, previo tu consentimiento y login) a través de sistemas totalmente gestionados por dichas redes sociales, así como los recursos (pej. videos) y material que se encuentra en nuestra web, y que de igual manera se presta y gestiona completamente por un tercero.
Si no acepta estas cookies, no podrá compartir nuestro contenido a través de los botones, y en su caso, no podrás visualizar el contenido de terceros que hayamos incrustado en el sitio.
No las utilizamos