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01 mayo 2021

Optical Frequency Domain Images of 3 Unique Femoral Artery Stents at 5 Months After Implantation

Jun Yoshimura, Masayoshi Kimura, Nariko Ikemura, and Takahisa Sawada

Introduction A wide variety of stents for the superficial femoral artery (SFA) are currently available, including drug-eluting stents, interwoven stents, and covered stents. In using these stents, reduction of restenosis and stent thrombosis are the major concerns. Pathological studies have indicated that an uncovered coronary stent strut is the best morphometric predictor of late stent thrombosis (1). Optical frequency domain imaging (OFDI) provides detailed information on stent strut coverage, similar to that from scanning electron microscopy. We report on OFDI performed 5 months after implantation of 3 different SFA stents.

17 enero 2020

Endovascular Versus Surgical Revascularization for Acute Limb Ischemia

Dhaval Kolte, Kevin F. Kennedy, Mehdi H. Shishehbor, Shafiq T. Mamdani, Lars Stangenberg, Omar N. Hyder, Peter Soukas and Herbert D. Aronow

Abstract Background: The optimal revascularization strategy for acute limb ischemia (ALI) remains unclear, and contemporary comparative effectiveness data on endovascular versus surgical revascularization are lacking.

15 enero 2020

Absence of Long-Term Benefit of Revascularization in Patients With Intermittent Claudication

Henrik Djerf, Johan Millinger, Mårten Falkenberg, Lennart Jivegård, Mikael Svensson and Joakim Nordanstig

Abstract Background: The long-term benefit of revascularization for intermittent claudication is poorly understood. The aim of this study was to investigate the long-term effectiveness and cost-effectiveness compared with a noninvasive approach.

07 febrero 2020

Mortality After Paclitaxel Coated Balloon Angioplasty and Stenting of Superficial Femoral and Popliteal Artery in the Vascular Quality Initiative

Daniel J. Bertges, Art Sedrakyan, Tianyi Sun, Mohammad H. Eslami, Marc Schermerhorn, Philip P. Goodney, Adam W. Beck, Jack L. Cronenwett and Jens Eldrup-Jorgensen

Abstract Background: To compare mortality after treatment of superficial femoral-popliteal artery disease with paclitaxel and nonpaclitaxel devices using a multicenter vascular registry.

15 enero 2021

2021 ACC/AHA/SVM/ACP Advanced Training Statement on Vascular Medicine (Revision of the 2004 ACC/ACP/SCAI/SVMB/SVS Clinical Competence Statement on Vascular Medicine and Catheter-Based Peripheral Vascular Interventions)

Mark A. Creager, Naomi M. Hamburg, Keith D. Calligaro, Ana I. Casanegra, Rosario Freeman, Phyllis A. Gordon, Heather L. Gornik, Esther S.H. Kim, Nicholas J. Leeper, Geno J. Merli, Khusrow Niazi, Jeffrey W. Olin, Rene Quiroz, Elona Rrapo Kaso, Suman Wasan, Andrew R. Waxler, Christopher J. White, Khendi White Solaru and Marlene S. Williams

Preamble Since publication of its first Core Cardiovascular Training Statement (COCATS) in 1995,1 the American College of Cardiology (ACC) has defined the knowledge, experiences, skills, and behaviors expected of clinical cardiologists. Subsequent revisions have moved toward competency-based training based on the 6-domain competency structure promulgated by the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties and endorsed by the American Board of Internal Medicine (ABIM). The ACC has taken a similar approach to describe the aligned general cardiology lifelong learning competencies that practicing cardiologists are expected to maintain. Many hospital systems now use the 6-domain structure as part of medical staff privileging, peer review, and professional competence assessments.

04 diciembre 2020

Self-Expandable Nitinol Stents for the Treatment of Nonmalignant Deep Venous Obstruction

Tim Sebastian, Suvetha Gnanapiragasam, David Spirk, Rolf Peter Engelberger, Laura Moeri, Corrado Lodigiani, Robert Kreuzpointner, Stefano Barco and Nils Kucher

Background: Angioplasty with stent placement is a therapeutic option for patients with acute thrombotic, postthrombotic, and nonthrombotic obstruction of the iliofemoral veins or inferior vena cava. Previous studies of steel-alloy stents described variable patency rate across indications.

14 agosto 2020

Discharge Prescription Patterns for Antiplatelet Therapy Following Lower Extremity Peripheral Vascular Intervention

Nikhil Singh, Li Ding, Gregory A. Magee, David M. Shavelle, Vikram S. Kashyap and Parveen K. Garg

Background: Despite current guidelines suggesting a benefit for dual antiplatelet therapy (DAPT) following peripheral vascular intervention (PVI), there are limited data on antiplatelet prescribing patterns post-procedure. We attempted to determine variables associated with DAPT prescription following lower extremity PVI.

12 octubre 2020

Association of Disease Progression With Cardiovascular and Limb Outcomes in Patients With Peripheral Artery Disease

Jennifer A. Rymer, Hillary Mulder, Dennis I. Narcisse, Frank Rockhold, William R. Hiatt, F. Gerry Fowkes, Iris Baumgartner, Jeffrey S. Berger, Brian G. Katona, Kenneth Mahaffey, Lars Norgren, Juuso I. Blomster, W. Schuyler Jones and Manesh R. Patel

Background: Patients with peripheral artery disease have a high risk of future cardiovascular disease events and mortality. Little is known about the changes in symptom classification over time in patients with peripheral artery disease and the association of changes in symptom classification with subsequent cardiovascular disease events.

12 octubre 2020

Use of Natural Language Processing to Improve Identification of Patients With Peripheral Artery Disease

E. Hope Weissler, Jikai Zhang, Steven Lippmann, Shelley Rusincovitch, Ricardo Henao and W. Schuyler Jones

Background: Peripheral artery disease (PAD) is underrecognized, undertreated, and understudied: each of these endeavors requires efficient and accurate identification of patients with PAD. Currently, PAD patient identification relies on diagnosis/procedure codes or lists of patients diagnosed or treated by specific providers in specific locations and ways. The goal of this research was to leverage natural language processing to more accurately identify patients with PAD in an electronic health record system compared with a structured data–based approach.

07 octubre 2020

Contemporary Review of Antithrombotic Therapy in Peripheral Artery Disease

Connie N. Hess and Marc P. Bonaca

Abstract Patients with peripheral artery disease (PAD) are at heightened risk for ischemic events related to atherothrombosis. Antithrombotic therapies can reduce the risk of atherothrombotic events but increase bleeding. Importantly, there is growing appreciation of the heterogeneity in risk profile and effect of antithrombotic therapies in different populations, including those with PAD. Further, patients with PAD are at risk for not only major adverse cardiovascular events but also major adverse limb events, and the drivers of risk for each are different. Within PAD populations, data from trials may be difficult to interpret due to differences among the studies with regards to patient population, clinical settings, and outcomes examined. The acute setting of peripheral revascularization which involves plaque rupture and endothelial disruption confers very high risk of major adverse limb events early postprocedure. Among patients with chronic PAD for whom the goal of antithrombotic therapy is secondary prevention, concomitant coronary artery disease, particularly with prior myocardial infarction, is associated with greatest risk for major adverse cardiovascular events, while prior peripheral revascularization or amputation is associated with greatest risk for major adverse limb events. Understanding of the potential impact of clinical setting and patient risk profile is important to guide evidence-based decisions regarding antithrombotic therapy in patients with PAD. In this article, we provide a contemporary review of data supporting the use of antithrombotic therapy in PAD, as well as a clinical framework for analysis and translation of these data into practice, highlighting areas in need of further investigation.

09 marzo 2021

Treatment of Varicose Veins Affects the Incidences of Venous Thromboembolism and Peripheral Artery Disease

Shyue-Luen Chang, Sindy Hu, Yau-Li Huang, Mei-Ching Lee, Wen-Hung Chung, Chun-Yu Cheng, Yen-Chang Hsiao, Chee Jen Chang, Shu Ru Lee, Su-Wei Chang and Yu-Wen Wen

Background: Varicose veins are a common problem worldwide. Although it was reported that varicose veins have cosmetic and symptomatic effects and can also lead to an increased risk of incident deep venous thrombosis, pulmonary embolism, and peripheral artery disease, whether varicose vein treatment prevents those serious complications is unknown.

10 enero 2022

Increasing the Efficiency of Mechanical Thrombectomy Procedures for Deep Vein Thrombosis

Alexander Misono

Deep vein thrombosis (DVT) obstructs lower extremity venous outflow, often leading to acute and long-term reduction in quality of life.1,2 In fact, up to 40-50% of DVT patients experience chronic symptoms related to post-thrombotic syndrome (PTS).3-6 Fortunately, endovascular techniques to treat DVT are now available.7,8 One device designed specifically to treat DVT is the ClotTriever System (Inari Medical), which has shown promising results.

19 septiembre 2017

CIRCULATION. Stellarex Drug-Coated Balloon for Treatment of Femoropopliteal Disease

Prakash Krishnan , Peter Faries , Khusrow Niazi , Ash Jain , Ravish Sachar , William B. Bachinsky , Joseph Cardenas , Martin Werner , Marianne Brodmann , J. A. Mustapha , Carlos Mena-Hurtado , Michael R. Jaff , Andrew H. Holden , Sean P. Lyden , Mark Mewissen , Barry Katzen , Aravinda Nanjundappa , Matheen A. Khuddus , Jason Ricci , Dennis Fry , Mehdi Shishehbor , Christopher Bosarge , Richard Kovach , Mark Goodwin , Mohammad Laiq Raja , Guy Mayeda , Jasvinder Sandhu , Oscar Rosales , William Crowder , David Paolini , John Henretta , Pratik Desai , Naim Farhat , Edward Kang , Gary Ansel , Mohammad Ghani , William Miller , Christopher Pollock , Ethan Korngold , John F. Angle , Greg Schultz , Todd Gensler , Louis Lopez , James Park , Georges Al-Khoury , Charles Joels and Christopher Metzger

Background: Drug-coated balloons (DCBs) are a predominant revascularization therapy for symptomatic femoropopliteal artery disease. Because of the differences in excipients, paclitaxel dose, and coating morphologies, varying clinical outcomes have been observed with different DCBs. We report the results of 2 studies investigating the pharmacokinetic and clinical outcomes of a new DCB to treat femoropopliteal disease.

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