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…
Asymptomatic Carotid Artery Stenosis: Do We Have All the Answers?
Advancements in therapies to reduce the impact of stroke in asymptomatic carotid artery stenosis have been hard to come by over the last decade. Several points of disagreement among published randomized trials prevented their information from being integrated into daily clinical practice. However, over the past 5 years, there has been some alignment, allowing for this…
How to Predict Events in Order to Decide Whether to Revascularize Symptomatic Carotid Artery Stenosis
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…
New Tools to Define Intervention in Asymptomatic Carotid Disease
This meta-analysis included 14 studies and compared the uptake of fluorodeoxyglucose (18F-FDG) according to positron emission tomography (PET)/computed tomography (CT) in symptomatic versus asymptomatic patients, demonstrating a significantly higher uptake in patients with symptomatic lesions. While PET/CT imaging of atheroma is a tool under investigation, with limited applicability in clinical practice, in a relatively close future,…
Latest articles about peripheral vascular diseases
1) Efficacy of Micromesh-Covered Stents in Carotid Artery Stenting Most literature, old and recent, associates carotid artery stenting with a higher rate of stroke (although minor) when compared with carotid endarterectomy during the acute period. However, 30-day outcomes of angioplasty and surgery are comparable. Read more 2) Multivessel Disease and Severe Carotid Stenosis: How to Proceed Myocardial revascularization surgery (CABG) is…
Endarterectomy vs. Stenting in Asymptomatic Carotid Artery Stenosis
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…
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…