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ESTUDIOS


12 noviembre 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. New Techniques Adventitial Nab-Rapamycin Injection Reduces Porcine Femoral Artery Luminal Stenosis Induced by Balloon Angioplasty via Inhibition of Medial Proliferation and Adventitial Inflammation

Warren J. Gasper, MD, Cynthia A. Jimenez, MD, Joy Walker, MD, Michael S. Conte, MD, Kirk Seward, PhD and Christopher D. Owens, MD

Background: Endovascular interventions on peripheral arteries are limited by high rates of restenosis. Our hypothesis was that adventitial injection of rapamycin nanoparticles would be safe and reduce luminal stenosis in a porcine femoral artery balloon angioplasty model.

19 septiembre 2014

CIRCULATION. Vascular Medicine. Clinical Trials in Peripheral Vascular Disease. Pipeline and Trial Designs: An Evaluation of the ClinicalTrials.gov Database

Sumeet Subherwal, MD, MBA; Manesh R. Patel, MD; Karen Chiswell, PhD; Beth A. Tidemann-Miller, PhD; W. Schuyler Jones, MD; Michael S. Conte, MD; Christopher J. White, MD; Deepak L. Bhatt, MD, MPH; John R. Laird, MD; William R. Hiatt, MD; Asba Tasneem, PhD; Robert M. Califf, MD

Background: Tremendous advances have occurred in therapies for peripheral vascular disease (PVD); until recently, however, it has not been possible to examine the entire clinical trial portfolio of studies for the treatment of PVD (both arterial and venous disease).

01 septiembre 2014

AMERICAN HEART JOURNAL. Suboptimal risk factor control in patients undergoing elective coronary or peripheral percutaneous intervention

Lisa Tully, MD, Eugenia Gianos, MD, Anish Vani, BS, Yu Guo, MA, Revathi Balakrishnan, MD, Arthur Schwartzbard, MD, James Slater, MD, Richard Stein, MD, James Underberg, MD, Howard Weintraub, MD, Edward Fisher, MD, Jeffrey S. Berger, MD, MS

Background: The American Heart Association recommends targeting 7 cardiovascular (CV) health metrics to reduce morbidity and mortality. Control of these targets in patients undergoing CV intervention is uncertain.

01 diciembre 2014

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. Initial Experience With Ticagrelor in Patients With Critical Limb Ischemia and High On-Clopidogrel Platelet Reactivity Undergoing Complex Peripheral Endovascular Procedures

Stavros Spiliopoulos, Konstantinos Katsanos, Georgios Pastromas, Athanasios Diamantopoulos, Panagiotis Kitrou, Dimitris Siablis, Dimitris Karnabatidis

To investigate the safety and efficacy of ticagrelor in patients with critical limb ischemia (CLI) and high on-clopidogrel platelet reactivity (HCPR) undergoing complex, limb-salvage, peripheral endovascular procedures (PEP).

01 octubre 2014

ANNALS OF VASCULAR SURGERY. Urinary Cystatin C as an Early Biomarker of Acute Kidney Injury after Open and Endovascular Abdominal Aortic Aneurysm Repair

Konstantinos M. Pirgakis, Konstantinos Makris, Ilias Dalainas, Andreas M. Lazaris, Chrisostomos K. Maltezos, Christos D. Liapis

Background: Acute kidney injury (AKI) after open repair (OR) and endovascular repair (EVAR) of abdominal aortic aneurysm (AAA) is associated with increased mortality and hospital costs. Early detection of AKI is critical to prevent its progression. Recent findings demonstrate that elevated levels of urinary cystatin C (uCysC) may reflect tubular dysfunction. We prospectively evaluated whether uCysC can detect renal dysfunction earlier than serum creatinine (sCr).

01 octubre 2014

ANNALS OF VASCULAR SURGERY. Electrophysiological, Hemodynamic, and Metabolic Response to Open Procedure or Endovascular Repair of Infrarenal Aortic Aneurysms

Jowita Biernawska, Mariusz Kaczmarczyk, Katarzyna Kotfis, Miłosław Cnotliwy, Małgorzata Zegan-Barańska, Agnieszka Żukowska, Arkadiusz Greczan, Maciej Żukowski

Background: The occurrence of cardiovascular diseases in the group of patients undergoing vascular surgery because of abdominal aorta aneurysm is very high. Endovascular procedures are regarded as hemodynamically safer for the patients. The aim of this study was to compare the changes in electrophysiological, hemodynamic, and metabolic parameters depending on the type of operation, using invasive hemodynamic monitoring and Holter electrocardiography recording.

01 octubre 2014

ANNALS OF VASCULAR SURGERY. Neural Damage Biomarkers during Open Carotid Surgery versus Endovascular Approach

Enrico Giuliani, Susanna Genedani, Roberto Moratto, Jessica Veronesi, Chiara Carone, Cinzia Bonvecchio, Francesco Mosca, Gioachino Coppi, Alberto Barbieri

Background: Carotid endarterectomy (CEA) is the gold standard for treating severe carotid artery stenosis, whereas carotid artery stenting (CAS) represents an endovascular alternative. The objective of this study was to assess the potential neural damage following open or endovascular carotid surgery measured by peripheral blood concentration of 3 biomarkers: S100β, matrix metalloproteinase-9 (MMP-9), and d-dimer.

01 octubre 2014

ANNALS OF VASCULAR SURGERY. Laparoscopy versus EVAR for the Treatment of Abdominal Aortic Aneurysms in the Octogenarian

Raphaël Coscas, Marc Dennery, Isabelle Javerliat, Isabelle Di Centa, Tristan Cudennec, Laurent Teillet, Olivier Goëau-Brissonniere, Marc Coggia

Background: Octogenarians are considered at high surgical risk for the treatment of abdominal aortic aneurysms (AAA). The laparoscopic aortic surgery (LAS) and the endovascular treatment (EVAR) are 2 minimum invasive techniques whose objective is to limit the operative traumatism. The objective of this study was to compare our results with short- and medium-term results with these 2 techniques in the octogenarians.

01 octubre 2014

ANNALS OF VASCULAR SURGERY. The Incidence and Outcome of Endothermal Heat-induced Thrombosis after Endovenous Laser Ablation

Katherine Kane, Tammy Fisher, Monica Bennett, William Shutze Jr., Taylor Hicks, Brad Grimsley, Dennis Gable, Greg Pearl, Bert Smith, William Shutze Sr.

Background: Endovenous laser ablation (EVLA) of the saphenous vein has become one of the preferred treatments for treating saphenous vein reflux that has resulted in symptomatic lower extremity venous insufficiency or varicose veins. This procedure was noted during initial reports to have a low incidence of postoperative thrombosis of the femoral or popliteal vein adjacent to the treated great saphenous vein (GSV) or small saphenous vein (SSV). Later clinical experience suggested that the actual incidence of this event is higher and it was subsequently termed endothermal heat-induced thrombosis (EHIT).

01 octubre 2014

ANNALS OF VASCULAR SURGERY. Endovascular Stent Grafting of a Posterior Tibial Artery Pseudoaneurysm Secondary to Penetrating Trauma: Case Report and Review of the Literature

Alessandro de Troia, Lukla Biasi, Luigi Iazzolino, Matteo Azzarone, Tiziano Tecchio, Cristina Rossi, Pierfranco Salcuni

Endovascular treatment of posttraumatic pseudoaneurysms has become a viable less-invasive option when compared with open repair. In this study, we present a case of a posttraumatic pseudoaneurysm of the posterior tibial artery in a 34-year-old man treated with endovascular stent grafting. An extensive review of the literature has been performed.

01 octubre 2014

ANNALS OF VASCULAR SURGERY. From Aortouniiliac Bifurcated to Aortobisiliac Trifurcated Endograft for Hypogastric Artery Preservation during EVAR

Holta Kasemi, Mario Marino, Costantino Luca Di Angelo, Patrizia Pileri, Carlo Patrizio Dionisi, Gian Franco Fadda

An 81-year-old man presented with rapid enlargement of a 2-year known abdominal aortic and common iliac aneurysms. A hybrid approach to preserve both hypogastric arteries (HAs) was planned: a bifurcated endograft for the right aortoiliac axis, right femoral–to–left femoral artery bypass, and left external–to–internal iliac artery stent graft placement. Urethral stenosis requiring an epicystostomy rendered this approach not feasible. After left HA embolization, a bifurcated endograft was deployed for the abdominal aortic aneurysm exclusion. The endograft right limb was extended using a second bifurcated endograft for the ipsilateral aortoiliac axis. Surgical femoral accesses were used for the 2 bifurcated endografts and left HA embolization. Through the left brachial access, 2 stent grafts were used to preserve the right hypogastric artery revascularization. The 5-year follow-up computed tomography scan demonstrated complete aneurysm exclusion and HA patency.

01 octubre 2014

ANNALS OF VASCULAR SURGERY. Endovascular Management of a Penetrating Abdominal Aortic Injury

Christopher G. Ghazala, Barnabas R. Green, Robin Williams, Michael G. Wyatt

Penetrating aortic trauma is associated with high mortality rates. We report the case of a 24-year-old man who presented with a self-inflicted abdominal aortic penetration injury, resulting in a pseudoaneurysm. Rather uniquely, he was managed through prophylactic stenting to his abdominal aorta; this case was also rare in that there were remarkably no associated visceral injuries. Stenting was preferred because of risks of an aortic graft in a young man. A 14-mm Atrium Advanta™ stent was deployed, and angiography confirmed adequate exclusion of the pseudoaneurysm. He had no complications at follow-up.

01 octubre 2014

ANNALS OF VASCULAR SURGERY. Successful Thrombolysis of a Late Acute Thrombotic Occlusion of an Aortic Prosthesis after Endovascular Aneurysm Repair

James Waiting, Abigail Dias, Tulsi Patel, Tim Pencavel, Kevin Rosenfeld, Sanjeev Sarin

A 79-year-old man with a previous endovascular aneurysm repair (EVAR) for a 5.4-cm abdominal aortic aneurysm presented 3 years after the procedure with sudden onset lower limb paralysis and pain. The diagnosis of acute aortic thrombosis within the aortic prosthesis graft was made and confirmed on computed tomography. Thrombolysis delivered into the graft via a radiologically placed catheter successfully dissolved the thrombus and resulted in improvement of the patient´s symptoms. We discuss the presentation of, and role in management of thrombolysis in, this rare complication of aneurysm repair.

01 octubre 2014

ANNALS OF VASCULAR SURGERY. Endovascular Aortoiliac Reconstruction to Allow Excision of an Infected Axillobifemoral Bypass

Thomas A. Heafner, Michael Clemens, Daniel Scott, Yiming Ching, Sean Hislop, Zachary M. Arthurs

Axillofemoral graft reconstructions were initially intended to restore lower extremity perfusion in high-risk patients with symptomatic aortoiliac atherosclerotic occlusive disease. However, these reconstructions are now relegated to “bailout” procedures for infected grafts or high-risk critical limb ischemia patients that fail endovascular therapy. Infection of an extra-anatomic bypass graft is a challenging complication as it occurs in poor operative candidates with limited revascularization options and failure has a high rate of amputation and mortality. Described is a novel approach using endovascular reconstruction to treat symptomatic Trans-Atlantic Inter-Society Consensus-II type D aortoiliac lesions allowing for complete excision of an infected axillobifemoral bypass.

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