This prospective study analyzed patients with critical lower limb ischemia (due to complex, multiple lesions in several places) who were treated uniformly with common femoral artery endarterectomy combined with angioplasty to improve inflow and/or outflow. This hybrid treatment, which must be carried out by a team, can be greatly beneficial for this high-risk patient group...
This study sought to randomly compare the double-layer Roadsaver stent (Terumo) with the single-layer Carotid Wallstent device (Boston) in association with either distal filter-like embolic protection device FilterWire (Boston) or proximal protection device Mo.Ma (Medtronic) in patients with lipid-rich carotid plaques. This is a very interesting work because there are no head-to-head simultaneous comparisons between...
Courtesy of Dr. Carlos Fava. Around half the treated lesions in peripheral disease are femoropopliteal lesions. Long lesions are among the challenges faced: they are associated with higher mortality and morbidity, and revascularization in that setting always entails some degree of difficulty. Nowadays, with the development of nitinol stents and more operator experience, angioplasty is becoming...
Courtesy of Dr. Carlos Fava. Peripheral vascular disease in lower limbs is on the rise. Antegrade recanalization is associated with amputation and death, and therefore contraindicated. For a while we have been using the retrograde access when classic revascularization is not possible. Even though there is evidence in favor of this access, it is just...
This work shows the safety of carotid artery stenting within 14 days of a stroke and, so far, this is the largest series of symptomatic patients published by an institution. The exact moment to conduct this procedure after an acute stroke is still controversial, although most publications so far have favored early endarterectomy over early angioplasty....
Current models are not reliable when it comes to predicting events after carotid revascularization in acute patients. Peri-procedural events seem to be particularly hard to predict. The development of models that can be externally validated is essential for the decision-making process in patients with high event rates, both during the procedure or while the case...
The recent publication of several reports on risk of cataract, left sided brain tumors, subclinical atherosclerosis and chromosome damage among interventional cardiologists has raised increasing concerns about radiation exposure in the cath lab. Recognizing these risks has created a demand of these new forms of protection. Unfortunately, these have mainly been focused on the main operator,...
The comparative efficacy and safety of carotid stenting vs. endarterectomy in asymptomatic carotid stenosis patients remains controversial and, what is worse, consensus seems unlikely in the near future. Given the lack of definite evidence, several meta-analyzis and systematic reviews have been produced in an attempt to shed some light on this matter. This study included all...
Courtesy of Dr. Carlos Fava. The incidence of peripheral vascular disease is clearly increasing, progressing towards critical ischemic claudication and amputation. Angioplasty is currently the treatment of choice for these pathologies. Several times, an implanted stent ends up cracking due to extensive calcification, increasing the rate of restenosis and worsening critical ischemia. Technological development on drug-eluting...
Recent randomized studies have shown that the rates of combined peri-procedural events for carotid artery stenting and carotid endarterectomy are similar. While the final numbers are similar, the actual events are different: more infarction events for endarterectomy and more stroke (particularly minor stroke) events for carotid artery stenting. The reduction of these rates of stroke has been the aim of...