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 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...
SOLACI PERIPHERAL | 5th Clinical Case: Abdominal Aortic Aneurysm with Hostile Neck
New clinical case from SOLACI PERIPHERAL! This time, we present a case featuring an abdominal aortic aneurysm with hostile neck. With this, we wrap up an intense year during which we published 5 clinical cases to deepen and stimulate the exchange between Latin American interventionist colleagues. Tell us what you think about this case using...
The Key We Are Overlooking in Peripheral Vascular Disease
To change the prognosis of peripheral vascular disease patients, a referral for supervised exercise is paramount. This should be a cultural change, not only an individual recommendation. A physically active lifestyle reduces the risk of cardiovascular events and functional impairment in patients with peripheral vascular disease. The novelty of this work (forthcoming in Eur J...
Evidence or Theory? Antiaggregation Scheme after Peripheral Vascular Intervention
Antiaggregation indication after peripheral intervention (PVI) can vary up to 50% depending on center, operator, and procedure. This highlights the huge variation in indication and the scarce evidence there is on this matter. Most cardiologists would like to simply transfer the information from the coronaries to the superficial femoral, but we can confirm this does...
ESC 2020 | Rivaroxaban Might Reduce Cardiac Cerebral and Peripheral Events
Adding rivaroxaban to the standard treatment might reduce events incidence in lower limbs, heart, and brain, in patients with peripheral vascular disease undergoing revascularization. These new data resulted from the analysis of the VOYAGER PAD subgroups and were presented at the virtual ESC 2020. The COMPASS study had reached similar conclusions using 2.5 mg rivaroxaban...
Antiaggregation vs. Anticoagulation after Peripheral PCI
The truth is this question has no clear answer and what with do with peripheral stenting is transfer the evidence we have on coronary stenting, given the lack of standards and poor reporting on antithrombotic therapy outcomes in randomized studies on endovascular intervention. Heterogeneity is worse when it comes to venous territory. Some time ago...
Repeat Revascularization Is Not Benign, at Least in Left Main Disease
After the “EXCEL scandal” at the end of last year, study investigators have been publishing explanations and sub-studies that were planned from the beginning, but which can still be interpreted as explanations. This sub-study states that revascularization was more common in the angioplasty arm, but only revascularizations performed on the target lesion, regardless of the...
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...
Safety of Paclitaxel-Coated Balloons in Peripheral Vascular Disease
Everybody keeps wondering whether drug-coated balloons can actually increase mortality. If that is the case, there is an even harder question in need of an answer: what would be the physiopathology for such increase in mortality? As a lukewarm message, the US Food and Drug Administration recommended a special informed consent form when these devices...