Infrapatellar articles

Mejorando los resultados luego de la revascularización de miembros inferiores

Improved Outcomes after Lower Limb Revascularization

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

The Importance of Tibial Artery Patency in the Rechanneling of the Femoral Artery

After rechanneling occluded superficial femoro-popliteal arteries, interventional physicians are left with the question of how to proceed with infrapopliteal disease. This work (soon to be published in Eur J Vasc Endovasc Surg) shows us the importance of achieving patency in tibial arteries so as to obtain better mid-term outcomes. The gist is that, after an

Programas de ejercicios en la enfermedad vascular periférica

Exercise Programs in Peripheral Artery Disease

Programmed exercises are recommended as initial management strategy for patients with peripheral artery disease (PAD). Most exercise programs include supervised treadmill walking twice or three times a week in a strategic facility (such as a gym). PAD patients often give up on these programs seeing as they might find it difficult to keep to a

isquemia crítica de miembros inferiores

Frailty: What Happens When We Are Too Late in Critical Lower Limb Ischemia

This condition, now “trending” among patients undergoing transcatheter aortic valve replacement (TAVR), has expanded to almost all patients we treat, always with the same outcome: the prognosis is bad, so bad that it might warrant making the difficult decision of not going forward. The association between frailty and bad prognosis is easy to see and

HIV and Peripheral Artery Disease: Acknowledging the Association

The role of human immunodeficiency virus (HIV) in the development of vascular disease (specifically peripheral artery disease) remains unclear. Is the virus per se the direct cause of this disease or is it a consequence of dyslipidemia, one of the adverse effects of antiretrovirals? This study looked into the effect of HIV infection on peripheral

Mortality in Peripheral Vascular Disease Drops Due to Revascularization

This cohort study shows that, from 2006 to 2015, the overall survival rate increased and the risk of major amputation decreased following lower limb revascularization. These population observations indicate that outcomes after lower limb revascularization have improved during the assessed period, and so have the centralization and specialization of interventional services. The availability and diversity

What’s New in the European Guidelines on Peripheral Arterial Disease

Since the last version of the European guidelines on the diagnosis and treatment of peripheral arterial disease in 2011, there have been many trials and registries that warrant guideline adjustments in many aspects. The first novelty is the teamwork that gave way to these guidelines, which were written in collaboration with the European Society of

Apuntar a la lesión parece el secreto de la isquemia crítica

Lesion Targeting Seems to Be the Secret in Critical Ischemia

Ulcers that do not heal, thus threatening the integrity of a lower limb in patients with critical ischemia, is a main concern. Sometimes, despite successful revascularization, major amputation cannot be prevented. The anatomical description of angiosomes started in the 70s as a way of optimizing tissue grafts. Angiosomes are basically blocks of tissue that include

What is the effect of statins on amputations, and survival in peripheral vascular disease?

The prevalence of peripheral arterial disease is between 15% and 20% of patients older than 65 years and its severity is greatly underestimated. In fact, annual mortality is higher in patients with peripheral arterial disease (8.2%) than in those after acute myocardial infarction (6.3%). Despite the above, medical advice and efforts to modify risk factors

Isquemia crítica de miembros inferiores: las re-hospitalizaciones frecuentes muestran la magnitud del problema

Critical ischemia in the lower limbs: Frequent Readmissions show the magnitude of this problem

Readmissions at 6 months in patients with critical ischemia in the lower limbs occur in about 50% of all cases and most of them are unplanned.   This truly alarming number is cause for further concern when taking into account that only part of these readmissions are related to vascular problems. Many are caused by comorbidities

Isquemia crítica de miembros inferiores: el blush de la herida

Critical Limb Ischemia: Wound Blush Is the Most Important Objective

The aim of this study was to find the optimal angiographic endpoint for infrapopliteal interventions to be able to predict wound healing.   Evidence shows acceptable patency and successful limb salvage in patients with critical limb ischemia after infrapopliteal intervention. However, the optimal angiographic endpoint remains unclear. Is it enough to restore flow in one

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