Infrapatellar articles

Subutilización del tratamiento médico en enfermedad vascular periférica

Optimal Medical Treatment Under-used in Vascular Peripheral Disease

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 y enfermedad vascular periférica: viejas drogas con nueva evidencia

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

balon farmacologico

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

Nuevas estrategias en el territorio femoropoplíteo

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

ACC 2020 Virtual | Sub-análisis del COMPASS: la diabetes aumenta el beneficio del rivaroxaban más AAS

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

Los balones farmacológicos pasaron la prueba del tiempo en territorio femoropoplíteo

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

isquemia crítica de miembros inferiores

New European Guidelines on the Management of Lower Limb Acute Ischemia

Clinical practice guidelines are usually tedious and, frankly, while a lot of people make an enormous effort to write them, they are ultimately read in full by just a few. These new European Guidelines on the Management of Lower Limb Acute Ischemia represent a special team effort, since they include physicians, cardiologists, surgeons, and interventionists,

Los balones farmacológicos pasaron la prueba del tiempo en territorio femoropoplíteo

Drug-Coated Balloons vs. Conventional Angioplasty Below the Knee

This meta-analysis is an update on the role of drug-coated balloons in the treatment of infrapopliteal arterial disease, a difficult pathology for all strategies. The primary endpoint of this meta-analysis was treated lower limb salvage at 12 months. The secondary endpoints included survival at 12 months, amputation free survival, restenosis, and target lesion repeat revascularization rate. This

doble antiagregacion plaquetaria sexo

We Should Indicate More than 6 Months of DAPT in Lower Limb Disease

Courtesy of Dr. Carlos Fava. Advanced peripheral vascular disease is frequently associated with cardiovascular events and amputation. It has been proven that mono-antiplatelet therapy (MAPT) offers some benefit (with either aspirin or clopidogrel), but there are scarce data on the role of dual antiplatelet therapy (DAPT) in these patients. Researchers analyzed 404 patients who received MAPT for

Mejorando los resultados luego de la revascularización de miembros inferiores

Improved Outcomes after Lower Limb Revascularization

Operator ability combined with improved and diverse devices for lower limb revascularization has clearly increased in the last decade. However, is this technical feasibility we did not use to have translating into better clinical outcomes for patients, or is it simply inflating our interventionist egos? This study aims at answering the question above by identifying