01 enero 2014

JOURNAL OF VASCULAR SURGERY. ITalian Excluder Registry and results of Gore Excluder endograft for the treatment of elective infrarenal abdominal aortic aneurysms

Carlo Pratesi, MD , Gabriele Piffaretti, MD, PhD , Giovanni Pratesi, MD , Patrizio Castelli, MD , ITalian Excluder Registry (ITER) Investigators

Background: To report the midterm results of elective endovascular aortic repair (EVAR) of abdominal aortic aneurysms (AAAs) in a multicenter, clinical unsponsored registry using the Gore Excluder endograft.

01 enero 2014

JOURNAL OF VASCULAR SURGERY. Ambulatory percutaneous endovascular abdominal aortic aneurysm repair

Hasan H. Dosluoglu, MD , Purandath Lall, MBBS , Raphael Blochle, MD , Linda M. Harris, MD , Maciej L. Dryjski, MD

Objective: Percutaneous endovascular abdominal aortic aneurysm repair (PEVAR) has been associated with fewer groin wound complications and shorter operative times, but same-day discharge (SDD) has not been reported. The goal of our article is to assess the feasibility and safety of ambulatory PEVAR and identify patient characteristics that are eligible for this approach.

01 enero 2014

JOURNAL OF VASCULAR SURGERY. One-year outcomes from an international study of the Ovation Abdominal Stent Graft System for endovascular aneurysm repair

Manish Mehta, MD, MPH , Francisco E. Valdés, MD , Thomas Nolte, MD , Gregory J. Mishkel, MD , William D. Jordan, MD , Bruce Gray, DO , Mark K. Eskandari, MD , Charles Botti, MD , “A Pivotal Clinical Study to Evaluate the Safety and Effectiveness of the Ovation Abdominal Stent Graft System” Investigators

Objective: This study evaluated 1-year safety and effectiveness outcomes of the United States regulatory trial for the Ovation Abdominal Stent Graft System (TriVascular Inc, Santa Rosa, Calif) for endovascular repair of abdominal aortic aneurysms (AAAs).

01 diciembre 2013

JOURNAL OF ENDOVASCULAR THERAPY. Early Experience With the First Commercially Available Off-the-Shelf Multibranched Endograft (t-Branch) in the Treatment of Thoracoabdominal Aortic Aneurysms

Michel J. Bosiers , MD; Theodosios Bisdas , MD; Konstantinos P. Donas , MD; Giovanni Torsello , MD; and Martin Austermann , MD

Purpose: To assess the feasibility and safety of the first commercially available off-the-shelf multibranched endograft for total endovascular repair of thoracoabdominal aortic aneurysms (TAAA).

01 enero 2014

ENDOVASCULAR TODAY. Early Experience With Peripheral Rotablator Atherectomy

By Sonya S. Noord, MD

Revascularization with endovascular therapy has become an accepted mainstay of treatment by most interventionists. However, the Achilles’ heel with all peripheral interventions remains long, calcified lesions both above and below the knee. The concern with these lesions is the ability to remove or displace calcium to allow luminal gain while preventing dissection, perforation, and embolization.

01 diciembre 2013

EURO INTERVENTION. Aortoiliac and common femoral endovascular interventions

Robert Francis Bonvini, MD; Marco Roffi*, MD, FESC, FACC Interventional Cardiology Unit, Division of Cardiology, University Hospital, Geneva, Switzerland

Introduction: Symptomatic peripheral arterial disease (PAD) may be observed as frequently as cardiac angina, with an estimated annual incidence of 26/10,000 in the male and 12/10,000 in the female population.1 The infrarenal abdominal aorta and iliac arteries are among the most common sites of chronic obliterative atherosclerosis, accounting for about one third of all symptomatic PAD cases. In the past, aortoiliac artery obstructions were treated surgically, mainly with aortofemoral or aortoiliac bypass. On occasion, axillo-femoral bypass for patients with occlusive disease of the distal abdominal aorta and severe comorbidities or femoro-femoral crossover bypass in patients with unilateral iliac disease were performed. The percutaneous approach has become the treatment of choice for the majority of patients presenting with atherosclerotic aortoiliac stenoses and occlusions. A step-wise approach of aortoiliac and common femoral interventions for atherosclerotic obstructive disease is described and technical features of several supra-inguinal treatments modalities are highlighted.

01 diciembre 2012

RADIOLOGY. Iliac Vein Compression as Risk Factor for Left- versus Right-Sided Deep Venous Thrombosis: Case-Control Study

Anand Narayan, MD, PhD, , John Eng, MD, , Lemore Carmi, MD, , Siobhan McGrane, MBBCh, , Muneeb Ahmed, MD, , A. Richey Sharrett, MD, DrPH, , Michael Streiff, MD, , Josef Coresh, MD, PhD, MHS, , Neil Powe, MD, MPH, MBA, and , Kelvin Hong, MD

Introduction: Deep venous thrombosis (DVT) has been noted to occur as much as 60% more frequently in the left lower extremity than in the right lower extremity (1). Investigators since Virchow have suggested that this disparity may be related to compression of the left common iliac vein (LCIV) by the right common iliac artery (2). In the 1950s, May and Thurner (3) found pathologic changes (venous spurs) at the point where the right common iliac artery crosses over the LCIV. They proposed a causal mechanism by which chronic pulsations of the right common iliac artery resulted in venous spur formation in the LCIV, predisposing patients to DVT at this location. Preliminary studies comparing limbs with left DVT to limbs without left DVT have suggested that iliac vein compression may be associated with a higher percentage of left-sided DVT (4) and a lower percentage of symptomatic pulmonary embolism (PE) (5). However, Kibbe et al (6) also found a high prevalence of iliac vein compression in patients without DVT, suggesting that iliac vein compression may represent a normal variation without pathologic consequences. In addition, prior studies have been limited by small sample sizes and a lack of control groups. The purpose of our study was therefore to determine (a) if greater than 70% LCIV compression is a risk factor for left-sided DVT and (b) whether increasing percentage LCIV compression is associated with increased odds of left-sided DVT below 70% compression.

01 noviembre 2013

CIRCULATION. Percutaneous Treatment of Peripheral Artery Disease. Novel Techniques

Martin Schillinger, MD; Erich Minar, MD

Percutaneous transluminal angioplasty is a minimally invasive therapy for the treatment of patients with peripheral artery disease who suffer from intermittent claudication or critical limb ischemia. The main advantages of the endovascular approach are a low complication rate ranging between 0.5% and 4%, a high technical success rate approaching 90% even in long occlusions, and an acceptable clinical outcome.1,2 Traditionally, percutaneous transluminal angioplasty (PTA) has been the standard for revascularization in aortoiliac, femoropopliteal, and below-the-knee arteries,1 and in many interventional centers, PTA still is the first and most frequently used methodology. However, high rates of failure resulting from an unacceptable incidence of restenosis, particularly in long and complex disease, are the main limitations of PTA.3

01 noviembre 2012

DIAGNOSTIC AND INTERVENTIONAL RADIOLOGY. Early clinical improvement in chronic venous insufficiency symptoms after laser ablation of saphenous veins

Uğur Özkan, Çağla Sarıtürk

PURPOSE: e aimed to assess the degree of improvement in chronic venous disease-related symptoms after endovenous laser ablation (EVLA) for saphenous vein insufficiency.

01 agosto 2013

JOURNAL OF ENDOVASCULAR THERAPY. Clinical Outcomes of 5358 Patients Undergoing Direct Open Bypass or Endovascular Treatment for Aortoiliac Occlusive Disease: A Systematic Review and Meta-Analysis

Jeffrey E. Indes , MD1; Miles J. Pfaff , BA1; Forough Farrokhyar , MPhil, PhD2,3; Hillary Brown , MD1; Peter Hashim , BA1; Kevin Cheung , MD, MSc2; and Julie Ann Sosa, MD, MA1

Purpose: To examine clinical outcomes of endovascular and open bypass treatment for aortoiliac occlusive disease (AIOD).

01 agosto 2012

CIRCULATION. Development of a Clinical Prediction Rule for Risk Stratification of Recurrent Venous Thromboembolism in Patients With Cancer-Associated Venous Thromboembolism

Martha L. Louzada, MD, MSc; Marc Carrier, MD, MSc; Alejandro Lazo-Langner, MD, MSc; Vi Dao, MD; Michael J. Kovacs, MD; Timothy O. Ramsay, PhD; Marc A. Rodger, MD, MSc; Jerry Zhang, BSc; Agnes Y.Y. Lee, MD, MSc; Guy Meyer, MD; Philip S. Wells, MD, MSc

Background—Long-term low-molecular-weight heparin (LMWH) is the current standard for treatment of venous thromboembolism (VTE) in cancer patients. Whether treatment strategies should vary according to individual risk of VTE recurrence remains unknown. We performed a retrospective cohort study and a validation study in patients with cancer-associated VTE to derive a clinical prediction rule that stratifies VTE recurrence risk.

01 septiembre 2013

CIRCULATION: CARDIOVASCULAR INTERVENTIONS. Endovascular Repair of Type B Aortic Dissection. Long-term Results of the Randomized Investigation of Stent Grafts in Aortic Dissection Trial

Christoph A. Nienaber, MD, PhD, Stephan Kische, MD, Hervé Rousseau, MD, PhD, Holger Eggebrecht, MD, Tim C. Rehders, MD, Guenther Kundt, MD, PhD, Aenne Glass, MA, Dierk Scheinert, MD, PhD, Martin Czerny, MD, PhD, Tilo Kleinfeldt, MD, Burkhart Zipfel, MD, Louis Labrousse, MD, Rossella Fattori, MD, PhD and Hüseyin Ince, MD, PhD for the INSTEAD-XL trial

Background—Thoracic endovascular aortic repair (TEVAR) represents a therapeutic concept for type B aortic dissection. Long-term outcomes and morphology after TEVAR for uncomplicated dissection are unknown.

01 agosto 2012

CIRCULATION. Development of a Clinical Prediction Rule for Risk Stratification of Recurrent Venous Thromboembolism in Patients With Cancer-Associated Venous Thromboembolism

Martha L. Louzada, MD, MSc; Marc Carrier, MD, MSc; Alejandro Lazo-Langner, MD, MSc; Vi Dao, MD; Michael J. Kovacs, MD; Timothy O. Ramsay, PhD; Marc A. Rodger, MD, MSc; Jerry Zhang, BSc; Agnes Y.Y. Lee, MD, MSc; Guy Meyer, MD; Philip S. Wells, MD, MSc

Background—Long-term low-molecular-weight heparin (LMWH) is the current standard for treatment of venous thromboembolism (VTE) in cancer patients. Whether treatment strategies should vary according to individual risk of VTE recurrence remains unknown. We performed a retrospective cohort study and a validation study in patients with cancer-associated VTE to derive a clinical prediction rule that stratifies VTE recurrence risk.

01 septiembre 2013

ENDOVASCULAR TODAY. Bringing PEVAR Into Mainstream Aortic Aneurysm Repair. Critical factors for success: the importance of device attributes and physician experience.

By Nikhal Kansal, MD, FACS, and Zvonimir Krajcer, MD, FACC

“Maintaining the minimal invasiveness of the percutaneous approach to aortic endografting reduces patient discomfort and permits earlier ambulation and hospital discharge. Initial success seems to be maintained at 1 month; however, longer follow-up will be required … ”

01 septiembre 2012

AMERICAN JOURNAL OF ROENTGENOLOGY. Automated Attenuation-Based Kilovoltage Selection: Preliminary Observations in Patients After Endovascular Aneurysm Repair of the Abdominal Aorta

Robert Goetti, Anna Winklehner, Sonja Gordic, Stephan Baumueller, Christoph A. Karlo, Thomas Frauenfelder and Hatem Alkadhi

OBJECTIVE. The objective of our study was to assess prospectively the impact of automated attenuation-based kilovoltage selection on image quality and radiation dose in patients undergoing body CT angiography (CTA) after endovascular aneurysm repair (EVAR) of the abdominal aorta.