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Clinical Review
Catheter-Directed and Pharmacomechanical Thrombolysis for the Treatment of Acute Iliofemoral Deep Venous Thrombosis
Introduction
The majority of physicians treat patients with iliofemoral deep venous thrombosis (DVT) with anticoagulation alone, despite a growing body of evidence that these patients suffer more severe postthrombotic morbidity and higher recurrence rates than patients with infrainguinal DVT. Although there have been enormous advances in anticoagulation therapy (e.g., low-molecular-weight heparins, pentasaccharides, and direct thrombin inhibitors), these agents serve to limit the progression of thrombosis and, with proper duration of therapy, reduce recurrence. However, anticoagulant
Why Thrombosis Prophylaxis Fails
author affiliations:
From the Division of Vascular Surgery, NorthShore University Health System, Evanston, Illinois, Northwestern University Feinberg School of Medicine, Chicago, Illinois, and the Robert R. McCormick School of Bioengineering Northwestern University, Evanston, Illinois.
The author discloses no conflicts of interest regarding the content herein.
Manuscript submitted November 11, 2008, provisional acceptance given January 12, 2009, final version accepted January 30, 2009.
Address for correspondence: Joseph A. Caprini, MD, MS, FACS, Louis Biegler Professor of
Laser Venous Interventions
author affiliations:
From the Academic Vascular Surgical Unit, Hull Royal Infirmary, E. Yorks, United Kingdom.
Disclosure: Dr. Carradice and Dr. Chetter disclose that Diomed (Cambridge, U.K.) provided research grants (50% of a research nurse’s salary over a 12-month period) to facilitate trials at Hull Royal Infirmary, but had no involvement or influence in the drafting, or decision to publish this or any other paper.
Manuscript submitted September 12, 2008, provisional acceptance given December 2, 2008, accepted December 11, 2008.
Address for correspondence: Daniel Carr
Optimal Strategy in Lower Extremity Peripheral Percutaneous Interventions: An Interventionalist’s Perspective
author affiliations:
From the Midwest Cardiovascular Research Foundation, Davenport, Iowa.
Disclosure: Supported by the Nicolas and Gail Shammas Research Fund at the Midwest Cardiovascular Research Foundation (MCRF). MCRF has received research grants from ev3 and Foxhollow.
Manuscript submitted December 4, 2008 and accepted January 9, 2009.
Address for correspondence: Nicolas W. Shammas, MS, MD, Cardiovascular Medicine PC, 1236 E. Rusholme, Davenport, IA 52803 E-mail: shammas@mchsi.com
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Abstract
Peripheral artery disease
The Aortic Arch: Markers, Imaging, and Procedure Planning for Carotid Intervention
Author:
Christos D. Liapis, MD, Efthimios D. Avgerinos, MD, Achilles Chatziioannou, MD
Author Affiliations:
From the University Hospital Attikon, Department of Vascular Surgery, Athens, Greece.
Correspondence: Christos D. Liapis, MD, University Hospital Attikon, Department of Vascular Surgery, 1 Rimini Street, Chaidari, Athens 12462, Greece. E-mail: liapis@med.uoa.gr.
Manuscript submitted September 15, 2008, provisional acceptance given, November 5, 2008, accepted November 13, 2008.
Disclosure: The authors report no financial relationships or conflicts of inte
Comparisons Between Thoracic Stent Grafts — How Do We Know Which Stent Graft to Select?
Author:
Mustafa Halawa, MD, Benjamin Patterson, MD, Peter Holt, MD, Matt Thompson, MD, Ian M. Loftus, MD
Author Affiliations:
From St. George’s Vascular Institute, London, England.
Correspondence: Ian Loftus, MD, St. George’s Vascular Institute, St. George’s Hospital, Blackshaw Road, London, England SW170QT
Manuscript submitted September 12, 2008, provisional acceptance given October 15, 2008, and accepted November 6, 2008.
Disclosure: The authors report no financial relationships or conflicts of interest regarding the content herein.
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Drug-Eluting Stents and Drug-Coated Balloons in Peripheral Interventions
Author Affiliations:
From the Department of Angiology, Herz-Zentrum Bad Krozingen, Bad Krozingen, Germany (TZ) and the Department of Diagnostic and Interventional Radiology, University Tuebingen, Germany.
Correspondence: Dr. Thomas Zeller, Herz-Zentrum Bad Krozingen, Südring 15, D-79189 Bad Krozingen, Germany. E-mail address: thomas.zeller@herzzentrum.de.
Manuscript submitted July 17, 2008, provisional acceptance given August 18, 2008, manuscript accepted September 5, 2008.
Disclosure: The authors report no financial relationships or conflicts of interest regarding the content
Why Drug-Eluting Stents May Not Work for Most Patients with Leg Ischemia Caused by Below-Knee Arterial Occlusive Disease
Although the use of stents is common in other peripheral vessels, the application of stents remains highly controversial in the infrapopliteal bed (BTK). In general, infrapopliteal stent implantation is reserved for cases with a suboptimal outcome after PTA (i.e., > 50% residual stenosis, flow-limiting dissection). The fear that early thrombosis and late luminal loss due to intimal hyperplasia may lead to suboptimal long-term patency rates explains the reluctance on implanting stents in these small-diameter vessels. In the effort to optimize stent outcomes, coronary drug-eluting stent (DES) te
Re-establishing Macro Vascular Flow and Wound Healing: Beyond the Vascular Intervention
Introduction
Since approximately 70% of wounds treated at outpatient wound centers in the United States are lower extremity venous ulcerations, we will use a leg ulcer as case study for the purposes of this article. A 65-year-old Caucasian female presents to the wound center with a 10 x 8 cm wound just above the medial malleoli. The wound has been present for 2 years and is slowly increasing in size. The skin surrounding the wound is hyperpigmented and the soft tissue is firm on palpation. The ankle circumference is 16 cm, while the mid-calf circumference is 3
Long-Term Safety and Economic Impact of Drug-Eluting Stents
Drug-eluting stents (DES) were designed to prevent neointimal proliferation via the controlled release of antiproliferative agents. Two such DES have been approved for use in the United States. The sirolimus-eluting Cypher stent (SES, Cordis Corporation, Miami Lakes, Florida) and paclitaxel-eluting TAXUS stent (PES, Boston Scientific Corporation, Natick, Massachusetts) were approved for use after randomized controlled clinical trials demonstrated their superiority over bare-metal stents (BMS) at reducing restenosis rates and the need for repeat revascularization. Months afte
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CME Showcase
"Diabetic Peripheral Neuropathy"
Upcoming Accredited Webcast Release Date: December 22, 2008 Expiration Date: December 22, 2009 This activity is supported by an educational grant from PamLabs. To register for this Webcast, visit www.naccme.com/program/n-558/ |
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