Tag Archives: Intermitent claudication

Subutilización del tratamiento médico en enfermedad vascular periférica

Optimal Medical Treatment Under-used in Vascular Peripheral Disease

Optimal Medical Treatment Under-used in Vascular Peripheral Disease

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 y enfermedad vascular periférica: viejas drogas con nueva evidencia

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

balon farmacologico

Drug-Coated Balloons in Critical Ischemia: The Paradigm of Randomized Evidence vs. Logbooks

This research, which included thousands of patients treated for chronic inferior limb ischemia with drug-coated balloons, did not show an association between said devices and the increased mortality observed in some randomized trials.  The long-term evidence from plenty of real-world patients contradicts what has been shown in randomized trials, leaving an information gap. Endovascular revascularization

Continuar con la actividad física luego de un IAM reduce la mortalidad

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

Seguridad de los balones con paclitaxel en enfermedad vascular periférica

Consensus on How to Conduct Follow-Up in Peripheral Vascular Disease

Peripheral vascular disease involves multiple areas and, therefore, can have very different presentations (from complete lack of symptoms to disabling symptoms). Depending on clinical presentation, general condition, anatomical localization, and lesion extension, revascularization can be indicated alongside optimal medical treatment. In 2017, guidelines with indications for revascularization were published; however, maintaining long-term patency can be

Tasa de stroke post cirugía vs angioplastia coronaria en un análisis de más de 10.000 pacientes

Angioplasty vs. Surgery in Lower Limb Ischemia

This analysis of data from an already published study, “Bypass Versus Angioplasty in Severe Ischemia of the Limb (BASIL-1),” confirms the superiority of bypass over balloon angioplasty, with or without stenting, in patients with chronic lower limb ischemia who require a femoropopliteal intervention. While analyzed interventions took place between 1999 and 2003 (a fact subject

Efecto a largo plazo de los balones liberadores con bajas dosis de paclitaxel

New FDA Updates on Paclitaxel Device Outcomes

A new FDA letter confirms late mortality signal with paclitaxel eluting stents and paclitaxel coated balloons in peripheral territory. Even though this recently published letter confirms data, there are no new recommendations on the use of these devices. After careful consideration of their own analyzis outcomes and a 2-day discussion of an advisory panel especially

Continuar con la actividad física luego de un IAM reduce la mortalidad

Supervised Exercise and Revascularization for Intermittent Claudication

The combination of optimal medical treatment plus angioplasty plus supervised exercise seems to be the first line of treatment for patients with intermittent claudication, in terms of maximum walking distance and best quality of life. This combination requires a multidisciplinary team for the best possible results. The aim of this study was to conduct a

Mejorando los resultados luego de la revascularización de miembros inferiores

Improved Outcomes after Lower Limb Revascularization

Operator ability combined with improved and diverse devices for lower limb revascularization has clearly increased in the last decade. However, is this technical feasibility we did not use to have translating into better clinical outcomes for patients, or is it simply inflating our interventionist egos? This study aims at answering the question above by identifying

Efecto a largo plazo de los balones liberadores con bajas dosis de paclitaxel

Mortality and Paclitaxel Devices, Data Are Aligning

5 years ago, several prospective randomized studies confirmed paclitaxel coated balloons were safe and effective in femoropopliteal territory. However, a recently published meta-analysis of heterogeneous studies including both paclitaxel coated balloons and drug eluting stents has linked these devices to mortality. In addition, higher doses were associated to higher mortality, both at 2 and 5

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