April 14, 2013—At the Society of Interventional Radiology’s 38th Annual Scientific Meeting in New Orleans, Louisiana, a study was presented evaluating the use of drug-eluting stents (DES) in the treatment of critical leg ischemia (CLI) to prevent amputation. In the retrospective study of 107 patients with CLI treated with DES, 90% showed patency at 6 months and 70% at 2 years. All patients in the study who were treated in the early stages of CLI were able to avoid amputation.
A meta-analysis of studies comparing the performance of drug-eluting stents vs. bare metal stents in the treatment of infrapopliteal artery disease has demonstrated favourable one-year results with drug-eluting stents. According to the study, published in the Journal of Endovascular Therapy, patients treated with drug-eluting stents had increased patency rates and freedom from target lesion revascularisation.
The first-in-man experience with a new branched thoracic aortic arch stent graft was performed on 11 April 2013 at the Carolinas HealthCare System’s Sanger Heart & Vascular Institute, Charlotte, USA. The procedure with the Medtronic Valiant Mona device, designed with a branch to preserve the left subclavian artery (LSA), was led by Frank Arko.
The UK National Institute for Health and Care Excellence (NICE) has issued final draft guidance recommending rivaroxaban (Xarelto, Bayer Healthcare) as a clinically and cost-effective option for treating pulmonary embolism and preventing recurrent deep vein thrombosis and pulmonary embolism after acute pulmonary embolism in adults. The draft guidance has been issued to consultees for appeal and published on the NICE website for information.
Bard Peripheral Vascular, a subsidiary of C R Bard, announced on 3 April 2013 the launch of the Love Your Limbs awareness campaign, a new Bard-sponsored initiative intended to raise awareness of critical limb ischaemia, its precursor, peripheral artery disease, and limb amputation awareness and prevention.
Biotronik has announced positive 12-month results from the BIOLUX P-I study, demonstrating excellent clinical outcomes for the Biotronik Passeo-18 Lux paclitaxel-eluting balloon. BIOLUX P-I is a randomised controlled study investigating the safety and performance of the Passeo-18 Lux drug-eluting device (n=30), versus an uncoated Passeo-18 angioplasty catheter (n=30), for the treatment of lesions in the femoropopliteal segment up to 200mm in length. Patients were enrolled at five centres in Germany and Austria.
Drug-eluting stents can keep clogged leg arteries open, preventing amputation of the leg, suggests research being presented at the Society of Interventional Radiology’s 38th Annual Scientific Meeting in New Orleans, USA (13–18 April 2013).
Biotronik (Lake Oswego, OR) announced 12-month results from the BIOLUX P-I study of the company’s Passeo-18 Lux paclitaxel-releasing balloon. According to the company, BIOLUX P-I is a randomized controlled study investigating the safety and performance of the Passeo-18 Lux device versus the uncoated Passeo-18 percutaneous transluminal angioplasty (PTA) catheter for the treatment of lesions in the femoropopliteal segment up to 200 mm in length. The study enrolled 60 patients, randomized 1:1, at five centers in Germany and Austria.
Ali Khoynezhad, MD, et al have published results from the RESCUE trial in the Journal of Vascular Surgery (2013;57:899-905). RESCUE is a prospective, nonrandomized, multicenter trial using the Medtronic Valiant Captivia stent graft (Medtronic, Inc., Minneapolis, MN) to evaluate the early outcomes of patients undergoing thoracic endovascular aortic repair for blunt thoracic aortic injuries.
Despite evidence supporting the benefit of supervised exercise in intermittent claudication, there is a worldwide scarcity of funds for programmes. Experts were united in their frustration that there is a global lack of funding despite the rhetoric of the need to focus more on prevention.
After listening to the latest data for the Zilver PTX drug-eluting peripheral stent, 81% of delegates at yesterday’s stent data session voted against the motion that “plain old balloon and bare metal stents reign supreme in the superficial femoral artery”.
Cordis launched the Smart Flex Self-Expanding Stent System at CX35. The device belongs to a new generation of self-expandable stents for peripheral indications and, according to the company, is “fully connected and yet flexible.”
The latest updates on devices for abdominal aortic aneurysms, and a discussion on the impact of going low profile so as not to compromise on device performance, formed the mainstay of a session yesterday. There were presentations on the latest results from promising new low profile devices including the Treovance abdominal stent graft (Bolton Medical), which is being launched at CX35
The management of type II endoleak provoked a whole host of opinions among experts at CX35 yesterday. Are type II endoleaks benign, or not? Are “dangerous” type II endoleaks really misdiagnosed type I or type III endoleaks? Do type II endoleaks need treatment (and how), or is leaving them akin to “leaving a baby on a railway line”? Experts taking part in a panel discussion about the management of type II endoleaks following endovascular aneurysm repair (EVAR) did not agree
The incidence of thoracic aortic aneurysms is estimated to be as high as six cases per 100,000 person-years, and replacement of the ascending aorta accounts for the majority of cardiothoracic aortic procedures. Aneurysms and dissections of the ascending aorta are still mainly treated operatively with cardiopulmonary bypass. Ascending aortic aneurysms with normal sinuses and aortic annulus require only replacement of the ascending aorta from the sinotubular ridge to the origin of the innominate artery with a Dacron tube graft.
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