Purpose: To determine whether endovascular repair (EVAR) offers a survival advantage over open repair (OAR) with ruptured abdominal aortic aneurysms (RAAA). Vascular and Endovascular Surgery 44(8) 645-649. Copyright The Author(s) 2010.
The purpose of this analysis was to characterize the progression of coronary atherosclerosis in patients with concomitant peripheral arterial disease (PAD). Journal of the American College of Cardiology. Vol. 57, No. 10, 2011. Copyright © 2011 by the American College of Cardiology Foundation. Published by Elsevier Inc. ISSN 0735-1097.
Subintimal angioplasty (SA) has evolved into a viable revascularization procedure for complex lower extremity lesions. Although patency rates are lower than those for autogenous bypass, limb salvage rates are comparable. This study reviewed the 8-year experience of SA in a single center. Vascular and Endovascular Surgery 44(8) 633-637. Copyright The Author(s) 2010.
Women have a lower chance of surviving elective open abdominal aortic repair. The reasons for this are not clear. Endovascular repair has clearly reduced early and midterm morbidity and mortality for patients with large abdominal aortic aneurysms (AAAs). However, most patients are male. It is unclear whether there has been any reduction in elective morbidity for females or what the extent of that reduction has been. We prospectively analyzed outcomes for elective endovascular aneurysm repair (EVAR) in women at our center and compared results with those for elective open surgery and emergent open and endovascular repair. Presented at the Thirty-seventh Annual Meeting for the New England Society for Vascular Surgery, Rockport, Me, September 23-26, 2010. Copyright © 2012 by the Society for Vascular Surgery. All rights reserved.
Peripheral arterial disease is a condition characterized by progressive arterial narrowing, which affects patients’ quality of life. The purposes of this study were to (1) establish the feasibility of obtaining peripheral fractional flow reserve (pFFR) in the peripheral vascular circulation, (2) demonstrate an association between baseline pFFR and peak systolic velocity (PSV) measured by duplex ultrasound, and (3) correlate postintervention pFFR with future restenosis using the change in PSV over time as a surrogate. Copyright 2011 Wiley Periodicals, Inc. Journal of Interventional Cardiology. Vol. 25, No. 1, 2012
Purpose: To report preliminary experiences with the treatment of aortic aneurysm sac abscesses following prior endovascular aortic aneurysm repair (EVAR) using computerized tomography (CT)-guided percutaneous drainage. Vascular and Endovascular Surgery 44(8) 701-707. Copyright The Author(s) 2010.
Failure of arteriovenous fistula (AVF) maturation is attributed to impaired vein remodeling. The purpose of this study is to identify whether vein matrix metalloproteinase (MMP) expression and activity is associated with AVF maturation. Patients with renal insufficiency undergoing surgery had their vein segments harvested and snap-frozen at time of AVF construction. Vascular and Endovascular Surgery 44(8) 674-679. Copyright The Author(s) 2010
A Systematic Review and Meta-Analysis of Comparative Studies. The purpose of this study was to determine whether thoracic endovascular aortic repair (TEVAR) reduces death and morbidity compared with open surgical repair for descending thoracic aortic disease. Journal of the American College of Cardiology Vol. 55, No. 10, 2010. Copyright © 2010 by the American College of Cardiology Foundation ISSN 0735-1097/10. Published by Elsevier Inc.
A status report on thoracic endovascular aortic repair. Endovascular developments have changed the entire field of thoracic aortic surgery in a profound and irreversible manner. The true beginnings can be traced back to the first stent graft procedure for repair of a descending thoracic aortic aneurysm (TAA) performed by Dake et al in 1992. Looking back, it was almost inevitable then that endovascular solutions for the thoracic aorta would emerge after the landmark procedure for treatment of an abdominal aortic aneurysm (AAA) by Parodi and associates in 1990 and Volodos’ first-ever endovascular aortic repair in 1986.
C ritical limb ischemia (CLI) patients present a wide variety of challenges to the interventional physician’s ability to treat their disease. Many have lesions in multiple anatomies, up to and including widespread cardiovascular disease. Lifestyle modification directions are often ignored or unable to be carried out due to the very nature of the symptoms, and recurrent disease poses a new set of obstacles upon later presentations. Although sustaining long-term, durable results is a constant goal, CLI therapy can be difficult to even initiate. Target vessel and lesion access and crossing are some of the most significant obstacles faced when treating this population, with each case featuring unique anatomical and disease-related issues. At least 10% to 15% of patients with complex infrainguinal occlusive PAD cannot be crossed with simple antegrade or retrograde femoral approaches. If the therapy cannot be successfully delivered to the lesion, there is simply no chance of limb salvage. Fortunately, emerging techniques and anatomy-specific technologies are providing interventionalists with new pathways via alternate access sites. Retrograde tibiopedal access is increasingly being used for patients in whom other access attempts have failed or are simply not possible due to their disease. This supplement looks at the anatomy through which tibiopedal access is gained; offers tips on patient selection, procedural steps, pitfall avoidance, and imaging options; and provides illustrative cases employing this technique. Case images on cover courtesy of Aravinda Nanjundappa, MD, RVT
The introduction of endovascular aortic repair (EVAR) revolutionized the care of patients with abdominal aortic aneurysms (AAAs). Since then, additional studies have confirmed that procedure-related morbidity and mortality rates are significantly reduced with EVAR versus open repair. Since the first generation of endografts, progressive improvements in materials, fixation mechanisms, and delivery system profiles, as well as increased ease of use and expanded indications, have resulted in new technologies and improvements in preexisting technologies that initially proved to be flawed. In this article, we detail the various EVAR technologies that are currently or will soon be available. Endovascular Today march 2012
Internal carotid artery stenting (CAS) has become an increasingly tenable alternative to carotid endarterectomy for occlusive disease in high-risk patients. Although CAS is advantageous in several respects relative to endarterectomy, both show risk for embolic stroke. Despite the absence of any form of embolic protection during initial CAS experiences, the potential for embolism during wire manipulation of the plaque with continuous antegrade blood flow is intuitively evident. SEPTEMBER 2011 I SUPPLEMENT TO ENDOVASCULAR TODAY
Campeau first described the use of radial artery access for coronary angiography in 1989. Subsequently, Kiemeneij and Laarman performed the first coronary intervention using this approach in 1993. In many Asian and European countries, radial access is the default approach for coronary angiography and intervention. Worldwide, it is estimated that 20% of interventional procedures are performed via the radial artery. If the United States is excluded, 29% of procedures use radial access. In North America, 50% of procedures in Canada are performed radially compared to the United States where only < 2% of procedures in 2008 were transradial. ENDOVASCULAR TODAY I JANUARY 2012
As the practice of carotid artery stenting (CAS) has grown over the past decade, along with a greater acquired experience with the procedure and equipment, and rapid improvement in outcomes, the natural progression of the field is to look for further opportunities to refine the technique and improve the technology so as to create an even safer and therefore more effective stroke-preventative procedure. SUPPLEMENT TO ENDOVASCULAR TODAY I SEPTEMBER 2011
The Carotid Revascularization Endarterectomy Versus Stent Trial (CREST) was initiated under the support of the National Institutes of Health and the National Institute of Neurological Disorder and Stroke to compare the efficacy of carotid artery stenting (CAS) to carotid endarterectomy (CEA) for the revascularization of extracranial stenoses of the internal carotid artery in patients with standard surgical risk. CREST was the largest study of its kind and was adequately powered to uncover significant differences in the results of both procedures. This prospective, randomized, parallel, two-arm, multicenter trial included 2,502 patients and examined the composite primary endpoint of myocardial infarction (MI), stroke, or death during the periprocedural period plus any ipsilateral stroke within 4 years after randomization. SUPPLEMENT TO ENDOVASCULAR TODAY I SEPTEMBER 2011
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