Spinal cord ischemia (SCI) remains a significant concern in patients undergoing endovascular repair involving the thoracic aorta (thoracic endovascular aortic repair [TEVAR]). Perioperative lumbar spinal drainage has been widely practiced for open repair, but there is no consensus treatment protocol using lumbar drainage for SCI associated with TEVAR. This study analyzes the efficacy of an institutional protocol using selective lumbar drainage reserved for patients experiencing SCI following TEVAR. Journal of Vascular Surgery Volume 55, Issue 1 , Pages 1-8, January 2012. Copyright © 2012 by the Society for Vascular Surgery.
Carotid artery stenting has weathered a withering attack during the past year.1,–,3 Comparisons of the 3 recent randomized trials from Europe comparing carotid stenting with endarterectomy in symptomatic patients4,5 lead many to favor endarterectomy.1,–,3 The other 2 trials from North America included a mix of symptomatic and asymptomatic patients with carotid stenosis,6,7 and suggest more muted differences, pointing to equivalence or at least equipoise between the 2 modes of revascularization (Figure). This transatlantic tug-of-war is particularly focused on the importance of adequate training and experience in stenting among operators, the different end points between these trials, and patient selection. Circulation. 2011; 123: 2522-2525 Published online before print May 23, 2011, doi: 10.1161. Copyright © 2011 American Heart Association, Inc. All rights reserved. Print ISSN: 0009-7322. Online ISSN: 1524-4539.
Purpose: To evaluate the safety and effectiveness of a new system to facilitate intraluminal advancement of conventional guidewires through chronic total occlusions (CTO) of the superficial femoral artery (SFA) and popliteal artery. Copyright © 2012 by the INTERNATIONAL SOCIETY OF ENDOVASCULAR SPECIALISTS. Available at www.jevt.org. J ENDOVASC THER 2012;19:131–139.
Purpose: To evaluate the safety and performance of Relay stent-grafts in patients with acute or chronic aortic dissections. Copyright © 2011 by the INTERNATIONAL SOCIETY OF ENDOVASCULAR SPECIALISTS. Available at www.jevt.org. J ENDOVASC THER 2011;18:131–143.
Background: Conventional repair of aortic arch pathology is associated with significant mortality and stroke rates of 6-20% and 12%, respectively. Because endografting has excellent results for descending thoracic aortic disease, extension of thoracic endovascular repair (TEVAR) to the arch is a consideration. Annals of Vascular Surgery Volume 26, Issue 1 , Pages 55-66, January 2012. Ann Vasc Surg 2012; 26: 55-66 DOI: 10.1016/j.avsg.2011.08.009. Copiryght © Annals of Vascular Surgery Inc.
Combined or tandem lesions of the common carotid artery and the ipsilateral carotid bifurcation are uncommon and the management of patients with this disease pattern can be challenging. The development of endovascular techniques has contributed a variety of options for managing these combined lesions; either as part of a hybrid approach (carotid endarterectomy and common carotid artery stent) or with stenting alone for both lesions. In this article, we review the technique and results of managing carotid revascularization in the context of tandem common carotid and internal carotid artery lesions in the endovascular era. Seminars in Vascular Surgery Volume 24, Issue 1 , Pages 2-9, March 2011. Copiryght © 2011 Elsevier Inc. All rights reserved.
Metabolic syndrome (MetS) has been related to type 2 diabetes and cardiovascular diseases. Different criteria for diagnosis of MetS have been recommended, but there is no agreement about which criteria are best to use. The aim of the present study was to investigate agreement between the National Heart, Lung, and Blood Institute, American Heart Association (NHLBI/AHA) and the International Diabetes Federation (IDF) definitions of MetS in patients with symptomatic carotid disease and to compare the frequency of cardiovascular risk factor in patients with MetS diagnosed by these two sets of criteria. BMC Cardiovascular Disorders 2012, 12:2. Copyright © 2012 Maksimovic et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License.
Functional performance influences quality of life in individuals with peripheral artery disease (PAD) and is also a powerful prognostic marker in these patients. The pathophysiology of impaired functional performance in patients with PAD is incompletely understood. The severity of atherosclerotic burden, non-invasively assessed by the ankle–brachial index (ABI), does not reliably predict the degree of functional impairment observed in PAD patients. We review associations of measures of arterial function (arterial stiffness and endothelial dysfunction) with functional performance in PAD patients, and also review potential therapies for arterial stiffness and endothelial dysfunction that could improve functional performance in PAD. Recent studies suggest that measures of arterial function, such as arterial stiffness and endothelial function, are associated with exercise performance in the setting of PAD. These studies have provided new insights into (1) the pathophysiology of functional impairment in PAD, (2) mechanisms of strategies known to be effective such as walking programs, and (3) potential new therapeutic interventions for improving functional performance. Thus, therapies aimed at arterial ‘de-stiffening’ and improving endothelial function (such as aerobic exercise, statins and angiotensinconverting enzyme inhibitors)may improve functional performance in patients with PAD; however, further investigations are needed. Published online before print March 29, 2011, doi: 10.1177/1358863X11400935. Vascular Medicine June 2011 vol. 16 no. 3 203-211. Copiryght © The Author(s) 2011
Occlusive disease of the renal arteries poses a major problem. Most cases result from atherosclerotic disease, and the prevalence of incidental renal artery disease detected during imaging studies for symptomatic coronary, aortic, and peripheral vascular disease ranges from 14% to >35%, increasing with age.1 Although many (perhaps most) of these lesions produce only minor hemodynamic effects, it has long been recognized that when some “critical” level of occlusion is breached, poststenotic renal blood flow and glomerular filtration rate (GFR) fall, especially after lowering systemic arterial pressure. In some cases, kidney function can recover after restoring blood flow with either endovascular or surgical revascularization. Several prospective, randomized trials have examined whether the loss of renal function due to atherosclerotic renal artery stenosis can be managed best by medical therapy alone or would further benefit from renal revascularization.2,3 The study reported by Madder and colleagues4 in this issue of Circulation: Cardiovascular Interventions directly challenges whether conventional criteria for estimating GFR and directional trends in such trials are valid. This matter is important for physicians serious about considering renovascular disease. Circulation: Cardiovascular Interventions. 2011; 4: 213-215 doi: 10.1161. Copyright © American Heart Association. All rights reserved. Print ISSN: 1941-7640. Online ISSN: 1941-7632.
The objective of this paper is to describe outcomes of endovascular therapy in patients with symptomatic common femoral artery (CFA) lesions. Symptomatic atherosclerotic disease of the common femoral artery is an uncommon clinical entity, and there is no consensus regarding the suitability of catheter-based therapy. We reviewed the records of 26 consecutive patients treated with catheter-based therapy for symptomatic CFA lesions between 1994 and 2009. Angiographic success and procedure success were obtained in all vessels and in all patients. At 1 year, 100% (16/16) of the claudication patients and 70% (7/10) of the critical limb ischemia (CLI) patients maintained clinical success. The ankle– brachial index (ABI) significantly improved from a baseline of 0.47 ± 0.18 to 0.77 ± 0.18 (p < 0.001) after the procedure. At their most recent clinic visit (31 months ± 14 months), clinical success was maintained in 100% of the claudication patients and in 70% (7/10) of the CLI patients. During the follow-up period, femoral vascular access for an unrelated procedure was obtained through the CFA stent. In conclusion, patients with symptomatic CFA atherosclerotic disease obtained excellent clinical outcomes with angioplasty with stenting. We found that angioplasty with stenting of the CFA did not preclude future CFA vascular access. Our data suggest that catheter-based therapies should be considered as an option to open surgery in selected patients with symptomatic CFA disease. Vascular Medicine April 2011 vol. 16 no. 2 109-112 doi: 10.1177/1358863X11404280. Copiryght © The Author(s) 2011.
Innominate and subclavian artery lesions run a wide spectrum of disease manifestation and treatment options. Since the first surgical treatment, multiple variances have been attempted with the desire to maintain high long-term patency rates while reducing perioperative morbidity and mortality. The advent of endovascular procedures in the 1970s provided the opportunity to seek alternative treatment options, but the fear of serious neurologic sequela stalled the adoption of these new techniques. The advancement in endovascular techniques and technology, along with proven clinical success and decreased morbidity and mortality, has led to their adoption as the first-line treatment. Seminars in Vascular Surgery Volume 24, Issue 1 , Pages 31-35, March 2011. Copiryght © 2011 Elsevier Inc. All rights reserved.
Background: The evolution and correlation between the aortic neck and distally located iliac necks after endovascular treatment of abdominal aortic aneurysms (AAAs) was studied. Journal of Vascular Surgery Volume 55, Issue 1 , Pages 24-32, January 2012. Copyright © 2012 by the Society for Vascular Surgery.
Background—In this study, we report the late outcomes of a large, decade-long single-center thoracic endovascular aortic repair experience. Circulation. 2011; 123: 2938-2945 Published online before print June 6, 2011, doi: 10.1161. Copyright © 2011 American Heart Association, Inc. All rights reserved. Print ISSN: 0009-7322. Online ISSN: 1524-4539.
Background: Superior mesenteric artery (SMA) syndrome is a rare condition, which results in compression of the third portion of the duodenum by a narrow-angled SMA against the aorta. We report a case of a patient treated for chronic mesenteric ischemia, who developed an SMA-like syndrome as a result of the compression of the duodenum between an SMA stent and an inferior mesenteric artery (IMA) stent. Annals of Vascular Surgery Volume 26, Issue 1 , Pages 107.e1-107.e4, January 2012. Copiryght © Annals of Vascular Surgery Inc. Published online: August 26, 2011.
Although rare, pathologies of the aortic arch vessels can result in devastating sequelae. This article will address two of these pathologies, fibromuscular dysplasia and arterial dissection, along with diagnosis and treatment options. Seminars in Vascular Surgery Volume 24, Issue 1 , Pages 36-43, March 2011. Copiryght © 2011 Elsevier Inc. All rights reserved.
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