Background: Evidence is lacking about the effectiveness of risk reduction interventions in patients with asymptomatic peripheral arterial disease.
Background: Inferior vena caval filters (IVCFs) may prevent recurrent pulmonary embolism (PE). Despite uncertainty about their net benefit, patterns of use and outcomes of these devices in contemporary practice are unknown.
Background: In patients with symptomatic peripheral artery disease with a history of limb revascularization, the optimal antithrombotic regimen for long-term management is unknown.
Background: Patients with peripheral artery disease (PAD) are at heightened risk of acute limb ischemia (ALI), a morbid event that may result in limb loss. We investigated the causes, sequelae, and predictors of ALI in a contemporary population with symptomatic PAD and whether protease-activated receptor 1 antagonism with vorapaxar reduced ALI overall and by type.
Patients who have a blood clot in their leg, referred to as deep vein thrombosis (DVT), are at risk of the clot breaking off and traveling toward the lung. It gets to the lung via the big vein in the abdomen (Figure 1), called the inferior vena cava (IVC). The traveling clot is called an embolus. Once it reaches the lung (after having passed through the right chambers of the heart) and becomes lodged in the lung, it is called a pulmonary embolism (PE). A filter can be inserted into the IVC (Figure 1) to catch and trap a traveling clot, preventing it from reaching the lung. Such filters used to be called Greenfield filters, but a variety of differently shaped filters now exist, so a more generic and better term is IVC filter. Filters can be nonremovable and thus are permanent, or they can be removable and thus can be left in for only a few weeks or months.
A 39-year-old woman (gravida 2, para 1-0-0-1) with no medical history developed acute, tearing chest pain radiating to her back, which reached maximal intensity within minutes of onset. She was then 31 weeks into an uncomplicated pregnancy with no evidence of pre-eclampsia or systemic hypertension. Routine prenatal care was pursued throughout the pregnancy, and testing for HIV infection and syphilis was negative. Vital signs on presentation to her local emergency department were notable for a blood pressure of 129/55 mm Hg and troponin I levels that were undetectable (<0.04 ng/mL) on serial evaluations.
Background: One issue that remains critical is where and when failure occurs, whether simple restenosis or occlusion to the lesion, and how best to treat these failures, particularly when an endoprosthesis is already in place because of its use at the index procedure. One of the earliest questions of revascularization has been answered through the Mild to Moderate Intermittent Claudication (MIMICS) trial where revascularization of the iliac/femoropopliteal segments had a better outcome with either absolute walking distance, ischemic claudication distance, or simple ankle-brachial index at 1- and 2-year durations. Interestingly, this trial did not delineate angioplasty or stenting in the form of revascularization, but only that it occurred and was better than medical therapy and exercise.
Drug-eluting stents (DES) are the default strategy for superficial femoral artery (SFA) intervention in 2015 because they have been evaluated in a large number of patients over a long follow-up period with outcomes superior to other treatment options. No other therapy can make that claim.
Background: This randomized controlled trial evaluated clinical durability of Zilver PTX, a paclitaxel-coated drug-eluting stent (DES), for femoropopliteal artery lesions. Outcomes compare primary DES versus percutaneous transluminal angioplasty (PTA), overall DES (primary and provisional) versus standard care (PTA and provisional Zilver bare metal stent [BMS]), and provisional DES versus provisional BMS.
Background: Evidence that vena cava filters (VCFs) are beneficial is limited.
Background: Contemporary outcomes of percutaneous transluminal angioplasty for the treatment of infrapopliteal atherosclerotic lesions are not well characterized. Hence, a systematic review and meta-analysis was performed to determine the safety and effectiveness of this approach in patients with advanced below-the-knee arterial disease.
Revascularization for critical limb ischemia (CLI), the most advanced form of peripheral artery disease, is the only treatment that has shown to reduce amputations.
Background: Endovascular management is important for the treatment of primary Budd–Chiari syndrome, which is caused by inferior vena cava (IVC) obstruction. The aims of this study were to compare long-term outcomes of endovascular management for primary Budd–Chiari syndrome patients with membranous obstruction of IVC (MOVC) and segmental obstruction of IVC (SOVC) and explore the optimal endovascular strategy for these conditions.
Background: Endovascular infrapopliteal treatment of patients with critical limb ischemia using percutaneous transluminal angioplasty (PTA) and bail-out bare metal stenting (BMS) is hampered by restenosis. In interventional cardiology, drug-eluting stents (DES) have shown better patency rates and are standard practice nowadays. An investigator-initiated, multicenter, randomized trial was conducted to assess whether DES also improve patency and clinical outcome of infrapopliteal lesions.
Background: There are limited data on femoropopliteal artery stent thrombosis (ST), which is a serious adverse outcome of peripheral artery interventions.
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