Courtesy of Dr. Carlos Fava. Delaying or failing to heal trophic wounds in critical limb ischemia (CLI) changes quality of life, delays rehabilitation and is associated to infections and amputation. Pedal artery revascularization with angioplasty would speed up recovery and improve CLI wound healing. The study analyzed 257 patients with de novo infrapopliteal…
Carotid Revascularization After Stroke: When Should It Be Performed?
In 2006, the American Heart Association guidelines recommended that carotid revascularization be performed within 2 weeks of stroke based on data from 2 randomized trials on carotid endarterectomy. This study aimed to determine whether the time between the event and revascularization has decreased after these guidelines were issued, and the proportion of patients receiving some sort of revascularization (endarterectomy…
Inferior Vena Cava Filters in Recurrent Thromboembolism: Yes or No?
Courtesy of Dr. Guillermo Migliaro. At present, there is no clear evidence in favor of inferior vena cava filters (IVC) for patients developing recurrent symptomatic venous thromboembolism (VTE), and the existing guideline recommendations from the different societies are contradicting. The aim of this study was to assess the effectiveness of these devices in patients…
When to Intervene a Symptomatic Carotid Stenosis?
Guidelines recommend that carotid endarterectomy be performed within two weeks of stroke in patients with symptomatic carotid stenosis. Because a Swedish registry study showed patients treated within the first days after a transient ischemic attack or stroke are at increased risk of death and perioperatory stroke, this study aims at verifying this risk in…
Bioresorbable Scaffolds: Promising in Peripheral Territory
Bioresorbable Vascular Scaffolds (BVS) could change the paradigm of peripheral angioplasty according to several small studies suggesting these everolimus eluting devices could significantly improve symptoms in patients with intermittent claudication. [plain] Three year outcomes of the ESPRIT I trial, presented at VIVA 2016 (held in Las Vegas) showed there were no new events between…
Paclitaxel Drug Coated Balloon in Femoral: Effective at Long Term?
In patients with symptomatic peripheral vascular disease, the paclitaxel coated balloon showed superior efficacy at 3 years compared to the conventional balloon, in addition to very good results at one year when tested in the real world outside strict trial inclusion/exclusion criteria. Both the IN.PACT SFA trial and the IN.PACT SFA global registry showed…
AAA Screening in Men Over 65 Reduces Mortality
Systematic screening for abdominal aortic aneurysm (AAA) targeting all men over 65 years old (not just those presenting risk factors) was associated with a drop in the mortality rate specific for this disease, according to the Swedish Nationwide Screening Program. While 667 men were examined for AAA, the number of patients who required treatment to prevent…
Patients with Resistant Hypertension: Nearly 50% doesn’t take medication
The DENERHTN trial (Renal Denervation for Hypertension) confirmed the efficacy of renal denervation in addition to antihypertensive standard care in patients with resistant hypertension. This study reports the influence of adherence to treatment to control blood pressure. It included 106 patients with resistant hypertension after four week treatment with indapamide 1.5 mg/day, ramipril 10…
Carotid PCI at Long Term: Effective in Stroke Prevention?
There are no data outside controlled studies, neither are there long term outcomes, on carotid artery stenting. This study was designed to assess the long term effectiveness of carotid stenting to prevent strokes in a large number of real life patients. This registry included prospective data with a strict follow up protocol on 901…
BVS: Safe and Effective in the Infrapatellar Area
Courtesy of Dr. Carlos Fava. Drug-eluting stents (DES) have shown mid-term benefit in lesions below the knee (BTK) by reducing the rate of acute occlusion and restenosis in type A and B lesions. However, failure to recover the self-regulatory functions of the local vessel could hinder future revascularization. Drug-eluting bioresorbable scaffolds (BVS) could be a solution to this problem.…
Angiosome: Is It Feasible in Critical Limb Ischemia?
Courtesy of Dr. Carlos Fava. Critical limb ischemia (CLI) accompanied by tissue loss entails high risk of amputation. At present, there is substantial evidence in favor of revascularization by PCI according to the angiosome concept, but the feasibility of this treatment remains unclear. 161 compromised limbs were analyzed in 160 patients with foot…