Mehdi Shishehbor2012-10-05
Drug-Coated Balloon Angioplasty in Femoropopliteal CTOs: Intraluminal or Subintimal?
Patients with peripheral vascular disease often experience femoropopliteal compromise. It is estimated that approximately 50% of lesions in this area are chronic total occlusions (CTO). Even though success rate has improved for peripheral CTO treatments, long term clinical and technical outcomes have not been fully determined yet. Prior research has looked into stenting outcomes in...
Low vs High Dose Drug Coated Balloons in Femoropopliteal Territory
The use of drub coated balloons (DCB) in the treatment of femoropopliteal artery disease has grown. Studies on first generation high dose DCB (HD-DCB) have shown benefits, which has led to their recommendation by current guidelines. However, there have been reports of secondary effects caused by paclitaxel and its excipients. Second generation low dose DCB...
Primary vs Secondary Retrograde Approach in CTO: Differences
Successful chronic total occlusion procedures are on the rise, especially in high volume centers, seeing as they count on more sophisticated materials and different techniques, such the retrograde approach. However, the significant increase of success rate with this technique has also brought along an increase in associated complications. The aim of this study was to...
Clinical Results of IVUS-Guided Drug-Eluting Stent Implantation in Femoropopliteal Disease
Endovascular treatment of femoropopliteal lesions has become the first-line treatment due to the development of devices that decrease the restenosis rate. Recently, the IMPERIAL study showed greater patency at 1 year and greater freedom from clinically guided revascularization at 2 years in favor of the ELUVIA stent (paclitaxel-eluting fluoropolymer, FP-DES) compared with the ZILVER PTX...
IN.PACT Global: Follow Up of Real-Life Patient in Femoropopliteal Territory
Drug coated balloons (DCB) emerged as an innovative treatment approximately 10 years ago. Since then, numerous randomized studies have shown their effectiveness and benefit in femoropopliteal territory, and even though the use of paclitaxel coated balloons has been called into question, a retrospective study including 168,553 patients was able to show paclitaxel coated balloons were...
Large Differences between Focal and Diffuse Patterns of Stable CAD
PCI is far more successful at reducing ischemia when treating focal stable coronary artery disease (CAD). However, there were no differences in symptoms between both types of CAD. Physiological assessment with pressure wire pullback can be used to distinguish focal vs diffuse CAD, even though the relevance of this distinction has not been looked at...
Contralateral Occluded Carotid Defines Revascularization Strategy
A significative lesion to the carotid artery in addition to contralateral carotid occlusion is an obvious factor of high risk for a revascularization procedure. However, this might be true for surgery but not for carotid artery stenting according to this recent publication in JACC. The presence of contralateral carotid occlusion has been established as high...
The Transradial Approach Continues to Be the Best for Primary PCI
The transradial approach has been associated to lower mortality and bleeding rates in patients receiving primary PCI for ST elevation MI. This had been called into question by the recent SAFARI-STEMI, but after including its outcomes in a new meta-analysis, the scales tilted slightly in favor of the transradial approach vs. the transfemoral. The transradial...
How to Determine Optimal Balloon Size in Below-the-Knee Angioplasty
Unlike the coronary and femoral arteries, calcification of medial layers in infrapatellar arteries prevents positive remodeling and expansion capacity to maintain vessel lumen. Long term patency of endovascular treatment is suboptimal despite the coated balloons, atherectomy devices and stents. Standard angiographies only show vessel lumen far from its real dimension given the severe thickening of...