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…
Aortic Aneurysms Treated with Endologix AFX Require Special Followup
An FDA document recently published reminds doctors and patients of the need of annual follow up of abdominal aortic aneurysm patients receiving Endologix AFX endoprostheses, with imaging, and for life. The reason behind this recommendation is the risk of type III leaks. In 2019, the FDA had alerted us against this issue after finding a…
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…
SOLACI PERIPHERAL | 4th Clinical Case: Thoracic Aortic Dissection in Patient with Complex Arch
A new clinical case to keep learning with colleagues! Today, we present a Thoracic Aortic Dissection in Patient with Complex Arch. This is the 4th case for SOLACI Peripheral, which continues its mission: to deepen knowledge exchange among Latin American interventional cardiologists. Tell us what you think about this case using the comments section in this…
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…
Virtual ACC 2020 | VOYAGER PAD: Rivaroxaban Superior to Aspirin in Preventing Events
In patients with peripheral artery disease undergoing revascularization, the combination of rivaroxaban (Xarelto) and low doses of aspirin are superior to aspirin alone in the prevention of acute low limb ischemic events, amputation, cardiovascular events and strokes. The outcomes of VOYAGER PAD add to the COMPASS outcomes, showing the combination of therapies can benefit risk…
New European Guidelines on the Management of Lower Limb Acute Ischemia
Clinical practice guidelines are usually tedious and, frankly, while a lot of people make an enormous effort to write them, they are ultimately read in full by just a few. These new European Guidelines on the Management of Lower Limb Acute Ischemia represent a special team effort, since they include physicians, cardiologists, surgeons, and interventionists,…
Felling Reassured with Paclitaxel Coated Devices in Peripheral Artery Disease
This big analysis shows rapid absorption of paclitaxel coated devices for PCI in femoropopliteal territory, which reassures us about its alleged association to increased mortality. In fact, survival, amputation-free survival and cardiovascular events rate resulted better with paclitaxel coated devices in the treatment of chronic limb ischemia. This study emphasizes the difference that might exist…
Drug-Coated Balloons vs. Conventional Angioplasty Below the Knee
This meta-analysis is an update on the role of drug-coated balloons in the treatment of infrapopliteal arterial disease, a difficult pathology for all strategies. The primary endpoint of this meta-analysis was treated lower limb salvage at 12 months. The secondary endpoints included survival at 12 months, amputation free survival, restenosis, and target lesion repeat revascularization rate. This…
Angioplasty in Long Femoropopliteal Lesions Offers Reasonable Results
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…