Advanced stages of peripheral artery disease cause significant limitations in patients, such as critical limb ischemia (CLI), which manifests with resting pain and gangrene or ulcers of difficult resolution. Uncontrolled progression of this pathology might lead to major amputation, reduced life expectancy and increased healthcare costs. Prior research on infrapopliteal territory have shown contradicting results.…
TCT 2023 The LIFE-BTK Trial
This was a randomized study including 261 patients treated with infrapatellar percutaneous transluminal angioplasty.173 of these patients received an everolimus bioresorbable scaffold while the remaining 88 were treated with balloon angioplasty. The efficacy primary end point was limb salvage and primary patency rates at 12 months and the safety primary end point was freedom from…
BASIL-2: Revascularization of Infra-Popliteal Territory in Patients with Critical Lower Limb Ischemia
Results of infrapopliteal territory revascularization in critical limb ischemia. Compared against the general population, patients suffering from critical lower limb ischemia (CLI) not only experience seriously limited quality of life, but also face a significant higher risk of death and amputation. Specifically, the optimal treatment for these patients remains uncertain. This uncertainty was sparked by…
Watch again our Webinar on Lower Limb Angioplasty: LATAM Peripheral Registry
Watch again our Webinar on “Lower Limb Angioplasty: LATAM Peripheral Registry ” on our Youtube account. The event was held on May 12th, 2021.
Optimal Medical Treatment Under-used in Vascular Peripheral Disease
Less than half of patients undergoing endovascular revascularization for peripheral artery disease to their lower limbs are discharged with optimal medical treatment. Their traditional risk factors are predictors of a more comprehensive treatment; however, women, patients with higher risk of thrombosis, and those more likely to lose a lower limb, are far from being treated…
Diabetes and Peripheral Vascular Disease: Old Drugs, New Evidence
This paper, recently published in JAHA, showed that patients with type 2 diabetes mellitus exhibiting lower-limb vascular disease benefit from combining cilostazol and clopidogrel. Treatment for at least 6 months with clopidogrel (75 mg/QD) plus cilostazol (100 mg/BID) significantly reduces ischemic events—including stroke, infarction, and death from vascular causes—compared with clopidogrel monotherapy. Adding cilostazol reduces ischemic events, but that…
Drug-Coated Balloons in Critical Ischemia: The Paradigm of Randomized Evidence vs. Logbooks
This research, which included thousands of patients treated for chronic inferior limb ischemia with drug-coated balloons, did not show an association between said devices and the increased mortality observed in some randomized trials. The long-term evidence from plenty of real-world patients contradicts what has been shown in randomized trials, leaving an information gap. Endovascular revascularization…
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…
Virtual ACC 2020 | VOYAGER PAD: Rivaroxaban Superior to Aspirin in Preventing Events
In patients with peripheral artery disease undergoing revascularization, the combination of rivaroxaban (Xarelto) and low doses of aspirin are superior to aspirin alone in the prevention of acute low limb ischemic events, amputation, cardiovascular events and strokes. The outcomes of VOYAGER PAD add to the COMPASS outcomes, showing the combination of therapies can benefit risk…
Virtual ACC 2020 | COMPASS Sub-Analysis: Diabetes Increases the Benefit of Rivaroxaban Combined with AAS
In patients with stable coronary or peripheral artery disease, diabetes increases the benefit of combining low doses of rivaroxaban and aspirin vs. aspirin alone. This analysis was pre-specified in the COMPASS protocol and was presented virtually for the ACC 2020 and simultaneously published in Circulation. Patients with diabetes, showed numerically greater reduction in terms of…
Drug-Coated Balloons in Infrapopliteal Disease: Much Ado About Nothing
The revascularization of tibial arteries in patients with critical lower limb ischemia using drug-coated balloons vs. conventional angioplasty resulted in comparable long-term outcomes in terms of both safety and efficacy. Paclitaxel exposure was not related to a higher risk of amputation or all-cause mortality at 5 years (which is the good news for much questioned drug-coated…