Luminal thrombotic occlusions associated with non-significant atherosclerosis are commonly observed in patients with critical lower limb ischemia, which suggests the possibility of thromboembolic disease as a great contributor to ischemia. This was particularly verifiable in infrapopliteal vessels, thus showing a possible mechanism of progression from peripheral vascular disease to critical ischemia, as well as a...
Taking into account a simple 12-lead electrocardiography performed immediately after transcatheter aortic valve implantation (TAVI), removing the temporary pacemaker immediately is safe in patients without right bundle branch block who are in sinus rhythm with PR interval <240 ms and QRS interval <150 ms. In cases of atrial fibrillation, a QRS interval <140 ms also reassures the decision...
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...
There are plenty of clinical studies assessing the use of angioplasty for en la peripheral artery disease with restenosis rates as high as 40% and 60% at 6 and 12 months. Drug coated balloons have significantly raised primary patency, but they have mostly been tested in short lesions with mild calcification and no total occlusions. This...
Peripheral vascular diseases affect over 20% of the population and can affect up to 30% of people with cardiovascular risk factors. The most important treatment points include modification of risk factors, exercise, optimal medical treatment, and timely revascularization. Given its lower risk of peri-procedural complications (when compared to surgery), endovascular therapy is generally the first...
Original Title: Zilver PTX Post-Market Surveillance Study of Paclitaxel-Eluting Stents for Treating Femoropopliteal Artery Disease in Japan 12-Month Results. Reference: Hiroyoshi Yokoi et al. J Am Coll Cardiol Intv. 2016;9(3):271-277. This multicenter prospective study carried out in Japan assessed the paclitaxel eluting stent Zilver PTX in an unselected real world population very different to...
Original Title: Acute Limb Ischemia and Outcomes With Vorapaxar in Patients with Peripheral Artery Disease: Results From TRA2°P-TIMI 50. Reference: Marc P. Bonaca et al. Circulation. 2016 Mar 8;133(10):997-1005. Patients with peripheral artery disease have a high risk of acute limb ischemia, an event that may result in the loss of the affected limb. This...
Initial therapy for intermittent claudication has been historically the gear train, however, especially in recent years; the number of peripheral angioplasties has increased, proving highly effective for this condition. The aim of this study was to compare the clinical effectiveness of endovascular revascularization plus exercise versus exercise alone in patients with intermittent claudication. The study...
Original title: Comparative effectiveness of endovascular and surgical revascularization for patients with peripheral artery disease and critical limb ischemia. Reference: W. Schuyler Jones et al. American Heart Journal 2014. Epub ahead of print. Critical limb ischemia is the most severe condition affecting patients with peripheral vascular disease. Mortality, morbidity, and costs associated with this condition are...
Severe persistent calcification of the coronary arteries has been associated with different factors, such as advanced age, hypertension, dyslipidemia, smoking, and kidney failure, among others, and continues to be one of the challenges to stent implantation because of it impact on device advancing, drug release and adequate positioning. Intravascular lithotripsy (IVL) is a technique that...