Volume 4 - Issue 4 - July/August 2007

Percutaneous Revascularization of Peripheral Chronic Total Occlusion — Which Patients, Why, and How?

1Aravinda Nanjundappa, MD and 2Robert S. Dieter, MD

Recanalization of peripheral arterial total occlusion in lower extremities plays a pivotal role to improve claudication symptoms and limb salvage. Coronary chronic total occlusion (CTO) recanalization has recently gathered controversy with the publication of the occluded artery trial (OAT). However, in peripheral vasculature, specifically in the superficial femoral artery (SFA), occlusion predominates stenosis. The predominance of occlusion is due to limited collaterals, namely the profunda femoris artery and the diffuse nature of the disease.2 The constant endothelial injury, d

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Key words:

The GlideWire Supremacy: 20 Years and Counting

Frank J. Criado

The idea for this editorial emerged in my mind while reviewing the article “A Comparison of Interventional Guidewires in a Canine Model” by Huang et al. The authors set out to test three different wires in the setting of an in vivo experiment. They used some of the most common maneuvers interventionists perform with guidewires in the course of endovascular procedures. Not surprisingly, the study showed the superiority of the GlideWire. I thought it was reassuring — at least to me!

And now the rest of the story; and it’s all personal. As a vascular surgeon da

continue reading
Key words:

Is Carotid Stenting of Complicated Plaques Safe?

Gianluca Faggioli, MD, Monica Ferri, MD, Mauro Gargiulo, MD, Antonio Freyrie, MD,
Francesca Fratesi, MD, 1Lamberto Manzoli, MD, MPH, 2Cristina Rossi, MD, Andrea Stella, MD

Introduction

The risk of embolization during CAS may be influe

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Key words:

A Comparison of Interventional Guidewires in a Canine Model

Joe Huang, MD, Takao Ohki, MD, PhD

Introduction

Guidewires are a fundamental component of any cardiac and vascular interventional procedure. These interventions may include coronary angioplasty, carotid stenting, endovascular aortic aneurysm repair (EVAR), superficial femoral artery (SFA) stenting, and inferior vena cava (IVC) filter placement. Numerous options exist for the guidewire available to interventionalists and surgeons. These guidewires vary in design and physical properties, and thus are not identical in their capabilities. While there have been evaluations of individual guidewires,1–9

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Key words:

Carotid Artery Stenting — Do EPDs Level the Playing Field?

1Robert S. Dieter, MD, RVT, 1Ali Morshedi-Meibodi, MD, 2Aravinda Nanjundappa, MD, RVT

Carotid artery stenting (CAS) has variably fallen in and out of favor. Some have argued that CAS should be reserved for those patients who are at highest risk, not only for endartectomy (CEA), but if only treated medically. Unfortunately, none of the current trials or registries has been adequately designed to allow for equal comparison between the three treatment strategies — surgery, stenting, and medical therapy. Recent randomized trials comparing CAS and CEA contain significant methodological flaws and are thus inadequate for definitive comparisons, though they are thought provoking

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Key words:

Stent-Graft Placement in Popliteal Artery Aneurysms: Midterm Results

Reza Ghotbi, MD, Agamemnon Sotiriou, MD, Sylvia Schönhofer, MD, Dimitrios Zikos, MD,
Kerstin Schips, MD, Wolfgang Westermeier, MD

The popliteal artery aneurysm is the most common peripheral aneurysm, accounting for 70–80%. It is found mainly in male patients,10-12 with 50% of all cases being bilateral.13 The pathogenesis is often atherosclerotic, however, generalized dilatation and elongation of other arteries, such as the abdominal aorta, suggest a systemic abnormality.14 Mechanical stresses like hypertension, which is present in many patients15,16 and the fixation of the vessel at the adductor hiatus can contribute to aneurysm formation in the popliteal artery. Non-

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Key words:

A Single-Center Experience with Simultaneous IVC Filter Placement during Gastric Bypass

Jeffrey Indes, MD, Jeffrey Wang, MD, Frank Veith, MD, Evan Deutsch, MD, Larry Scher, MD

Introduction

 

In recent years, increasing numbers of patients are choosing the option of gastric bypass for weight reduction. In 2004, 121,055 bariatric procedures were performed, a nine-fold increase compared to 1998, when 13,386 bariatric procedures were done.1 This increase in bariatric procedures corresponds to an increase of national inpatient hospital costs by more than eight times, excluding physician costs, from $147 million in 1998 to $1.26 billion in 2004.2 With the number of bariatric procedures expected to rise in the ensuing ye

continue reading
Key words:

Percutaneous Treatment of Peripheral Arterial Chronic Total Occlusions: Device Options and Clinical Outcomes

Jinnette Abbott, MD and David Williams, MD

Introduction

The number of percutaneous revascularization procedures performed for symptomatic peripheral arterial disease (PAD) has significantly increased over the past several years.1 Traditionally, the use of percutaneous techniques were limited to certain anatomic subsets, such as stenosis or focal occlusions, with surgical treatment preferred for more extensive disease.2 More recently, endovascular specialists are facing the challenges of treating commonly- encountered peripheral chronic total occlusions (CTOs). Furthermore, unlike the co

continue reading
Key words:
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Volume 4 - Issue 4 - July/August 2007

Percutaneous Revascularization of Peripheral Chronic Total Occlusion — Which Patients, Why, and How?

1Aravinda Nanjundappa, MD and 2Robert S. Dieter, MD

Recanalization of peripheral arterial total occlusion in lower extremities plays a pivotal role to improve claudication symptoms and limb salvage. Coronary chronic total occlusion (CTO) recanalization has recently gathered controversy with the publication of the occluded artery trial (OAT). However, in peripheral vasculature, specifically in the superficial femoral artery (SFA), occlusion predominates stenosis. The predominance of occlusion is due to limited collaterals, namely the profunda femoris artery and the diffuse nature of the disease.2 The constant endothelial injury, d

continue reading
Key words:

The GlideWire Supremacy: 20 Years and Counting

Frank J. Criado

The idea for this editorial emerged in my mind while reviewing the article “A Comparison of Interventional Guidewires in a Canine Model” by Huang et al. The authors set out to test three different wires in the setting of an in vivo experiment. They used some of the most common maneuvers interventionists perform with guidewires in the course of endovascular procedures. Not surprisingly, the study showed the superiority of the GlideWire. I thought it was reassuring — at least to me!

And now the rest of the story; and it’s all personal. As a vascular surgeon da

continue reading
Key words:

Is Carotid Stenting of Complicated Plaques Safe?

Gianluca Faggioli, MD, Monica Ferri, MD, Mauro Gargiulo, MD, Antonio Freyrie, MD,
Francesca Fratesi, MD, 1Lamberto Manzoli, MD, MPH, 2Cristina Rossi, MD, Andrea Stella, MD

Introduction

The risk of embolization during CAS may be influe

continue reading
Key words:

A Comparison of Interventional Guidewires in a Canine Model

Joe Huang, MD, Takao Ohki, MD, PhD

Introduction

Guidewires are a fundamental component of any cardiac and vascular interventional procedure. These interventions may include coronary angioplasty, carotid stenting, endovascular aortic aneurysm repair (EVAR), superficial femoral artery (SFA) stenting, and inferior vena cava (IVC) filter placement. Numerous options exist for the guidewire available to interventionalists and surgeons. These guidewires vary in design and physical properties, and thus are not identical in their capabilities. While there have been evaluations of individual guidewires,1–9

continue reading
Key words:

Carotid Artery Stenting — Do EPDs Level the Playing Field?

1Robert S. Dieter, MD, RVT, 1Ali Morshedi-Meibodi, MD, 2Aravinda Nanjundappa, MD, RVT

Carotid artery stenting (CAS) has variably fallen in and out of favor. Some have argued that CAS should be reserved for those patients who are at highest risk, not only for endartectomy (CEA), but if only treated medically. Unfortunately, none of the current trials or registries has been adequately designed to allow for equal comparison between the three treatment strategies — surgery, stenting, and medical therapy. Recent randomized trials comparing CAS and CEA contain significant methodological flaws and are thus inadequate for definitive comparisons, though they are thought provoking

continue reading
Key words:

Stent-Graft Placement in Popliteal Artery Aneurysms: Midterm Results

Reza Ghotbi, MD, Agamemnon Sotiriou, MD, Sylvia Schönhofer, MD, Dimitrios Zikos, MD,
Kerstin Schips, MD, Wolfgang Westermeier, MD

The popliteal artery aneurysm is the most common peripheral aneurysm, accounting for 70–80%. It is found mainly in male patients,10-12 with 50% of all cases being bilateral.13 The pathogenesis is often atherosclerotic, however, generalized dilatation and elongation of other arteries, such as the abdominal aorta, suggest a systemic abnormality.14 Mechanical stresses like hypertension, which is present in many patients15,16 and the fixation of the vessel at the adductor hiatus can contribute to aneurysm formation in the popliteal artery. Non-

continue reading
Key words:

A Single-Center Experience with Simultaneous IVC Filter Placement during Gastric Bypass

Jeffrey Indes, MD, Jeffrey Wang, MD, Frank Veith, MD, Evan Deutsch, MD, Larry Scher, MD

Introduction

 

In recent years, increasing numbers of patients are choosing the option of gastric bypass for weight reduction. In 2004, 121,055 bariatric procedures were performed, a nine-fold increase compared to 1998, when 13,386 bariatric procedures were done.1 This increase in bariatric procedures corresponds to an increase of national inpatient hospital costs by more than eight times, excluding physician costs, from $147 million in 1998 to $1.26 billion in 2004.2 With the number of bariatric procedures expected to rise in the ensuing ye

continue reading
Key words:

Percutaneous Treatment of Peripheral Arterial Chronic Total Occlusions: Device Options and Clinical Outcomes

Jinnette Abbott, MD and David Williams, MD

Introduction

The number of percutaneous revascularization procedures performed for symptomatic peripheral arterial disease (PAD) has significantly increased over the past several years.1 Traditionally, the use of percutaneous techniques were limited to certain anatomic subsets, such as stenosis or focal occlusions, with surgical treatment preferred for more extensive disease.2 More recently, endovascular specialists are facing the challenges of treating commonly- encountered peripheral chronic total occlusions (CTOs). Furthermore, unlike the co

continue reading
Key words:
Back to top