Free Journal
Journal
of Endovascular Therapy
ISES (International Society of Endovascular
Specialists
http://www.isesonline.org/med_links.html
Peripheral Overview Archive 2000-2001
TCT 2002 Abstracts
Full text journal article Apr 2002
Vascular
Surgery for Peripheral Arterial Disease
Some PAD patients require prompt intervention to prevent morbidity and mortality;
vascular surgery fulfills this need.
Iliac-Femoro-Popliteal Archive 1989-2001
TCT 2002 Meeeting Coverage
| The PELA Trial | J. R. Laird |
TCT 2002 Expert Presentations
| PELA Trial - Peripheral Excimer Laser Angioplasty | J. R. Laird |
TCT 2002 Presentations
PELA:
Disappointing results with laser angioplasty in severe peripheral vascular
disease
with slides / A randomized trial has shown no difference in procedural
success, patency, or the need for reintervention between laser angioplasty and
balloon angioplasty alone in long occlusive lesions in the superficial femoral
artery. However, the researchers aren't giving up on the laser yet.
PELA
Trial: Peripheral Excimer Laser Angioplasty
Excimer laser angioplasty for the treatment of SFA stenosis is as effective
as standard PTA and may reduce the need for stenting.
Full text journal article Jan 2002
Current
Options in the Diagnosis and Management of Acute Limb Ischemia
Effective and comprehensive management of acute limb ischemia is vital.
Encouraging
results with FGF-1 for critical limb ischemia
with slide / Final results of a phase 1 trial of fibroblast growth
factor 1 (FGF-1), the largest to date in patients with critical limb ischemia,
are sufficiently encouraging that investigators will begin a randomized trial of
this strategy. The plasmid was well tolerated with encouraging initial clinical
results, the lead researcher noted, and these results lay the groundwork for a
randomized, double-blind, placebo-controlled trial due to start next week.
XIVth
World Congress of Cardiology. [ May 09, 2002 ]
Bone-marrow
cell transplantation improves limb ischemia
Tateishi-Yuyama E et al.
Lancet 2002;360:427-35. [ Aug 08, 2002 ]
with slide / Results of the TACT trial showed that injecting
bone-marrow mononuclear cells into ischemic limbs improved several measures of
ischemia, including ulcer healing. Patients themselves reported less pain, and
amputation procedures were canceled.
Femoropopliteal
arteries: immediate and long-term results with a Dacron- covered stent-graft
Ahmadi R, et al.
Radiology 2002;223:345-50.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11997536
http://radiology.rsnajnls.org/cgi/content/full/223/2/345
http://radiology.rsnajnls.org/cgi/content/abstract/223/2/345
Implantation of Dacron-covered stent-grafts for treatment of femoropopliteal
lesions leads to high early and late restenosis rates, with a considerable rate
of complications, such as fever and pain.
Intravascular
ultrasound scanning improves long-term patency of iliac lesions treated with
balloon angioplasty and primary stenting
Buckley CJ, et al.
J Vasc Surg 2002;35:316-23.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11854730
http://www.mosby.com/scripts/om.dll/serve?action=searchDB&searchDBfor=art&artType=abs&id=a119755&target=
Balloon
angioplasty and primary stenting of symptomatic aortoiliac occlusive lesions is
a durable treatment option. Long-term follow-up of treated patients shows
outcomes that are comparable with direct surgical intervention. IVUS
significantly improved the long-term patency of iliac arterial lesions treated
with balloon angioplasty and stenting by defining the appropriate angioplasty
diameter endpoint and adequacy of stent deployment.
Intra-aortic
balloon pump placement following aorto-iliac angioplasty and stent placement
Colyer WR, Jr., et al.
Catheter Cardiovasc Interv
2002;55:163-8.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11835640
Angioplasty
or stenting to facilitate IABP placement in patients with peripheral vascular
disease is safe and effective.
Iliac
artery stenosis causing post-renal transplant hypertension: successful
management by percutaneous angioplasty and stent implantation
Mullasari AS, et al.
J Invasive Cardiol
2002;14:212-3.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11923579
Case
report of a 61-year-old renal transplant recipient with native bilateral iliac
artery stenoses and coronary artery disease. He presented with severe
hypertension and was managed successfully with angioplasty and stenting of
native iliac arteries.
Early
results of external iliac artery (EIA)
stenting combined with common femoral artery
endarterectomy
Nelson
PR, et al.
J Vasc Surg 2002;35:1107-13.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12042720
http://www.mosby.com/scripts/om.dll/serve?action=searchDB&searchDBfor=art&artType=abs&id=a124374&target=
EIA stenting as an adjunct to CFA endarterectomy/patch angioplasty allows for
more localized surgery than conventional bypass. This approach also allows a
better interface between the stent and endarterectomy than staged preoperative
stenting. Technical success and early patency rates are excellent.
Abdominal Aortic Aneurism (AAA) Archive 1989- 2001
Links
Summaries of important articles from major peer-reviewed journals
| Results of the ADAM Study | F. Lederle | NEJM 2002; 346:1437-1444 |
| Editorial Comment: Detection and Management of Small Aortic Aneurysms | NEJM 2002; 346:1484-1486 | |
| Long-Term Outcomes: Repair vs Surveillance of Small AAAs | NEJM 2002; 346:1445-1452 |
Screening
for aortic aneurysms is cost effective
Scott A et al.
Lancet 2002; 360:1531-1539;
Buxton M et
al; Greenhalgh R et al.
BMJ 2002;325:1135-1138 and 1123-1124. [ Nov 14, 2002 ]
with slide / UK researchers provide convincing evidence this week that
ultrasound screening of men over 65 years of age could substantially reduce
death from ruptured aortic aneurysms and that this type of screening program
would be cost effective.
News Ago 2002
Endovascular Aneurysm
Repair Feasible in Community Setting
Early results show the AneuRx device works as well as in a university setting,
but long-term study is neededed.
A
useful endovascular technique for treating modular limb disconnection in a
bifurcated stent-graft
Brouard R, et al.
J Endovasc Ther
2002;9:124-8.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11958316
http://journals.allenpress.com/jrnlserv/?request=get-abstract&issn=1526-6028&volume=9&issue=1&page=124
A hydrophilic guidewire is introduced via a homolateral femoral access and
passed through the thrombosed iliac extension. Once the errant graft limb is
recanalized, wire exchange for an extra stiff guidewire facilitates passage of
an angioplasty balloon into the stent. Inflated under low pressure, the balloon
is used to push the thrombosed limb retrograde into the aneurysm sac. With the
aortoiliac axis restored, a new covered stent can be deployed.This approach is
one of several that may be used to treat a type III endoleak arising from a
disconnected and occluded stent- graft limb. It avoids the bleeding
complications of thrombolysis and restores the aortoiliac axis so that another
stent-graft may be implanted to re-exclude the aneurysm
Propranolol
for small abdominal aortic aneurysms: results of a randomized trial
Propanolol Aneurysm Trial Investigators
J Vasc Surg 2002;35:72-9.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11802135
http://www.mosby.com/scripts/om.dll/serve?action=searchDB&searchDBfor=art&artType=abs&id=a121308&target=
Patients with AAAs do not tolerate propranolol well, and the drug did not
significantly affect the growth rate of small AAAs.
Endovascular
abdominal aortic aneurysm (AAA) repair since the FDA approval. Are we going too
far?
Adelman MA, et al.
J Cardiovasc Surg (Torino)
2002;43:359-67.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12055568
Although we have been able to offer endovascular AAA repair to a larger
number of patients since FDA approval, endovascular management of increasingly
complex proximal necks and increased iliac artery disease appears to have
increased the incidence of attachment site endoleaks. Although many of these
leaks have been successfully managed with adjunctive endovascular procedures,
their increasing incidence is worrisome and suggests that we may need to
re-evaluate current inclusion criteria for using this technology. Although
difficult access issues have been handled with adjunctive procedures, the
presence of a short, angulated proximal neck may be difficult to overcome, and
may not be well suited for endovascular repair with the currently available
devices.
Cost
of routine screening for carotid and lower extremity occlusive disease in
patients with abdominal aortic aneurysms
Axelrod DA, et al.
J Vasc Surg 2002;35:754-8.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11932675
http://www.mosby.com/scripts/om.dll/serve?action=searchDB&searchDBfor=art&artType=abs&id=a121568&target=
Routine noninvasive diagnostic testing for the identification of
asymptomatic CAS and PVOD in patients with AAA may not be justified.
Preoperative screening is more clearly indicated for patients with AAAs who have
clinical evidence suggestive of CAS or PVOD.
Treatment
of type 2 endoleaks after endovascular repair of abdominal aortic aneurysms:
comparison of transarterial and translumbar techniques
Baum RA, et al.
J Vasc Surg 2002;35:23-9.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11802129
http://www.mosby.com/scripts/om.dll/serve?action=searchDB&searchDBfor=art&artType=abs&id=a121068&target=
The transarterial embolization of inferior mesenteric arteries for the
repair of type 2 endoleaks is ineffective and should not be performed. Direct
translumbar embolization of the endoleak is effective in the elimination of type
2 leaks and should be the therapy of choice when aggressive endoleak management
is indicated.
Causes
and outcomes of open conversion and aneurysm rupture after endovascular
abdominal aortic aneurysm repair: can type II endoleaks be dangerous?
Buth J, et al.
J Am Coll Surg
2002;194:S98-102.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11800362
Abdominal
aortic aneurysm: overview of stent-graft devices
Criado FJ, et al.
J Am Coll Surg
2002;194:S88-97.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11800360
Potential
impact of therapeutic warfarin treatment on type II endoleaks and sac shrinkage
rates on midterm follow-up examination
Fairman RM, et al.
J Vasc Surg
2002;35:679-85.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11932662
http://www.mosby.com/scripts/om.dll/serve?action=searchDB&searchDBfor=art&artType=abs&id=a121570&target=
Warfarin treatment is not associated with an increase in the incidence rate
of early or delayed postoperative endoleaks. However, the rate of reduction in
maximum aneurysm sac diameter after aortic endografting is slower in patients
who undergo therapeutic warfarin therapy at 1-year follow-up examination, a
statistically significant difference from the control group. In addition, type
II endoleaks may be less likely to undergo spontaneous thrombosis in patients
who undergo warfarin therapy.
Failure
of endovascular aortoaortic tube grafts: a plea for preferential use of
bifurcated grafts
Faries PL, et al.
J Vasc Surg
2002;35:868-73.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12021700
http://www.mosby.com/scripts/om.dll/serve?action=searchDB&searchDBfor=art&artType=abs&id=a123684&target=
Endovascular aortoaortic tube grafts are vulnerable to failure even when
initial exclusion of the aneurysm is successful. A significant association is
seen between distal neck length and eventual failure. Because of the propensity
toward eventual failure, the use of aortoaortic tube grafts in the infrarenal
aorta cannot be recommended for typical fusiform aneurysms, even when an
adequate distal neck appears to be present.
Emergency
Endograft Placement for Recurrent Aortocaval Fistula After
Conventional AAA Repair
Gandini R, et al.
J Endovasc Ther
2002;9:208-11.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12010102
http://journals.allenpress.com/jrnlserv/?request=get-abstract&issn=1526-6028&volume=9&issue=2&page=208
Endograft treatment of vascular lesions in the acute setting is becoming
more common as our experience with the devices grows. Endovascular repair of
primary aortocaval fistulas appears to be an efficacious and minimally invasive
means of dealing with these lesions in AAA patients.
Patient
selection for endovascular abdominal aortic aneurysm repair
Green RM.
J Am Coll Surg
2002;194:S67-73.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11800357
Abdominal
aortic endografting: fixation and sealing
Greenberg RK.
J Am Coll Surg
2002;194:S79-87.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11800359
Ruptured
abdominal aortic aneurysm.
Time for a new approach
Hinchliffe RJ, et al.
J Cardiovasc Surg (Torino)
2002;43:345-7.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12055566
Percutaneous
repair of abdominal aortic aneurysms using the AneuRx stent graft and the
percutaneous vascular surgery device
Howell M, et al.
Catheter Cardiovasc Interv
2002;55:281-7.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11870928
Complete percutaneous endoluminal AAA repair is feasible using the Perclose
technique. CFAs with sheaths up to 22 Fr can be safely and successfully accessed
and repaired percutaneously using this technique. This method provides secure
hemostasis and reduces the invasiveness of procedures requiring large-bore
sheaths.
Emergent
Repair of a Ruptured Abdominal Aortic Aneurysm Using an AneuRx Stent-Graft
Kumar V, et al.
J Endovasc Ther
2002;9:194-7.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12010099
http://journals.allenpress.com/jrnlserv/?request=get-abstract&issn=1526-6028&volume=9&issue=2&page=194
The AneuRx stent- graft can be successfully applied for the treatment of a
ruptured AAA in emergency situations.
Rupture
rate of large abdominal aortic aneurysms in patients refusing or unfit for
elective repair
Lederle FA, et al.
Jama 2002;287:2968-72.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12052126
The rupture rate is substantial in high-operative- risk patients with AAA of
at least 5.5 cm in diameter and increases with larger diameter.
Percutaneous
femoral arterial closure in AAA endograft: advantages and disadvantages
Londero HF.
Catheter Cardiovasc Interv
2002;55:288.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11870929
Detection
of endoleak with enhanced ultrasound imaging: comparison with biphasic computed
tomography
McWilliams RG, et al.
J Endovasc Ther 2002;9:170-9.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12010096
http://journals.allenpress.com/jrnlserv/?request=get-abstract&issn=1526-6028&volume=9&issue=2&page=170
Ultrasound scanning with or without contrast enhancement was not as reliable
as CT in diagnosing type II endoleak. CT imaging remains our surveillance
modality of choice.
The
incidence and natural history of type I and II endoleak: a 5-year follow-up
assessment with color duplex ultrasound scan
Parent FN, et al.
J Vasc Surg
2002;35:474-81.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11877694
http://www.mosby.com/scripts/om.dll/serve?action=searchDB&searchDBfor=art&artType=abs&id=a121848&target=
color duplex ultrasound (CDU) scan is effective in the identification of the
type of endoleak, the delineation of the vessel involved, and the hemodynamic
information not available with any other testing method. Endoleaks have a
dynamic natural history characterized by a variable onset with changing branch
vessel involvement and spectral flow patterns. Periodic long-term endograft
surveillance with CDU scanning is necessary for following existing endoleaks and
for detecting new ones. Corroboration of these findings in larger multicenter
prospective trials will be needed to determine whether CDU scan analysis of
endoleaks would be predictive of long-term success in endovascular AAA repair.
Ten-year
experience with endovascular therapy in aortic aneurysms
Parodi JC, et al.
J Am Coll Surg
2002;194:S58-66.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11800356
The
evolution of Z stent-based stent-grafts for endovascular aneurysm repair: a
life-table analysis of 7.5-year followup
Resch T, et al.
J Am Coll Surg
2002;194:S74-8.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11800358
Enhanced stent-graft design has improved the probability of stent-graft
success after endovascular abdominal aortic aneurysm repair. Better technical
skills and increased use of intraoperative adjunctive procedures may also have
contributed to improved results.
Expansion
rates and outcomes for the 3.0-cm to the 3.9-cm infrarenal abdominal aortic
aneurysm
Santilli SM, et al.
J Vasc Surg
2002;35:666-71.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11932660
http://www.mosby.com/scripts/om.dll/serve?action=searchDB&searchDBfor=art&artType=abs&id=a121572&target=
AAAs of 3.0 cm to 3.9 cm expanded slowly, did not rupture, and rarely had
operative repair or expanded to more than 5.0 cm in our study of male patients.
Expansion rates and the incidence rate of operative repair are more common in
the 3.5-cm to 3.9-cm AAA when compared with the 3.0-cm to 3.4-cm AAA.
Aortic
neck angulation predicts adverse outcome with endovascular abdominal aortic
aneurysm repair
Sternbergh WC, 3rd, et al.
J Vasc Surg 2002;35:482-6.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11877695
http://www.mosby.com/scripts/om.dll/serve?action=searchDB&searchDBfor=art&artType=abs&id=a119506&target=
On the basis of the data of this study, great caution should be exercised in
recommending EAAA repair for patients with aortic neck angulation >or=40
degrees.
TCT 2002 Expert Presentations
Images
in cardiovascular medicine. Flash pulmonary edema heralding renal artery
stenosis
Basaria S, et al.
Circulation 2002;105:899.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11854134
http://www.circulationaha.org/cgi/content/full/105/7/899
Treatment
of renal artery fibromuscular dysplasia with balloon angioplasty: a prospective
follow-up study
Birrer M, et al.
Eur J Vasc Endovasc Surg
2002;23:146-52.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11863332
Although restenosis rate after PTRA in fibromuscular dysplasia is as high as
in non-ostial atherosclerotic lesions, there remains a considerable higher
therapeutic effect. Profound pressure response and recurrent arterial
hypertension with restenosis support the high probability of a renovascular
origin of arterial hypertension in this young and otherwise healthy population
compared to patients with atherosclerotic renal artery lesions.
Transradial
renal artery angioplasty and stenting
Braunlich S, et al.
J Invasive Cardiol
2002;14:147-9.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11870270
This case demonstrates the feasibility of the radial approach to treat
severe renal artery disease safely with PTRAS. Comparison with femoral and
brachial arterial access sites is beyond the scope of this paper, but the
cardiac literature has demonstrated the safety and efficacy of transradial
artery access. With refinement of the endovascular equipment, the radial
approach could become an attractive alternative entry site for renal artery
interventions.
Renal
artery stenting for renal insufficiency in solitary kidney in 26 patients
Chatziioannou A, et al.
Eur J Vasc Endovasc Surg
2002;23:49-54.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11748948
Renal stenting results in improvement or stabilisation of renal function in
the majority of the patients with solitary kidneys and renal artery stenosis,
presenting with renal insufficiency. Because best outcome was observed mainly in
those patients with not progressed renal insufficiency, intervention should be
focused on that group.
Multicenter
Palmaz stent renal artery stenosis revascularization registry report: four-year
follow-up of 1,058 successful patients
Dorros G, et al.
Catheter Cardiovasc Interv
2002;55:182-8.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11835644
Renal artery stent revascularization, in the presence of normal or mildly
impaired renal function, had a beneficial effect on blood pressure control and
on renal function (through stabilization or improvement). Survival was adversely
effected by renal dysfunction despite adequate revascularization. Perhaps early
diagnosis of renal artery stenosis and adequate revascularization prior to the
onset of renal dysfunction could beneficially impact blood pressure control,
preserve or prevent deterioration of renal function, and improve patient
survival.
Usefulness
of 3-dimensional reconstructed images of renal arteries using rotational digital
subtraction angiography
Endo H, et al.
J Urol 2002;167:2046-8.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11956435
3-D images of renal arteries obtained with rotational DSA are considered
acceptable for clinical use.
Renovascular
hypertension: problems in evaluation and management
Kloner RA, et al.
Chest 2002;121:964-8.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11888983
http://www.chestjournal.org/cgi/content/full/121/3/964
Endovascular
stent placement for management of total renal artery occlusion in a child
Liang CD, et al.
J Invasive Cardiol
2002;14:32-5.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11773693
The combination of balloon angioplasty and stent placement allowed
reestablishment of perfusion and salvage of a severely threatened kidney. His
blood pressure improved after the procedure and returned to normal 3 months
later. The patient has remained free of symptoms for 12 months without
medication.
Percutaneous
management of renal artery aneurysm with a stent-graft
Liguori G, et al.
J Urol 2002;167:2518-9.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11992072
Angiography
for renal artery stenosis: no additional impairment of renal function by
angioplasty
Lufft V, et al.
Eur Radiol 2002;12:804-9.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11960230
In this study using sensitive methods to detect changes of renal function
and tubular toxicity no additional renal function impairment in DSA with
angioplasty for RAS compared with DSA alone could be demonstrated. Our data
suggest that angioplasty performed for RAS has a beneficial effect on renal
function.
3D
MR angiography of renal arteries: comparison of volume rendering and maximum
intensity projection algorithms
Mallouhi A, et al.
Radiology 2002;223:509-16.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11997561
http://radiology.rsnajnls.org/cgi/content/full/223/2/509
http://radiology.rsnajnls.org/cgi/content/abstract/223/2/509
The volume rendering (VR) technique of renal MR angiography enabled more
accurate detection and quantification of renal artery stenosis than did maximum
intensity projection (MIP), with significantly improved vascular delineation.
Munneke GJ, et al.
J Vasc Interv Radiol
2002;13:327-31.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11875094
http://www.jvir.org/cgi/content/full/13/3/327
http://www.jvir.org/cgi/content/abstract/13/3/327
CBA for potential use in renal artery in-stent restenosis and other
peripheral neointimal hyperplasia is discussed.
Duplex
ultrasonographic study of the renal arteries before and after renal artery
stenting
Napoli V, et al.
Eur Radiol 2002;12:796-803.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11960229
Doppler US represents a feasible and reliable technique in the detection of
renal artery stenosis and in- stent restenosis, although laboratory-specific
threshold values are required to improve its accuracy.
Morphologic
and functional magnetic resonance imaging of renal artery stenosis: a
multireader tricenter study
Schoenberg SO, et al.
J Am Soc Nephrol
2002;13:158-69.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11752033
http://www.jasn.org/cgi/content/full/13/1/158
http://www.jasn.org/cgi/content/abstract/13/1/158
A combined morphologic and functional MR examination significantly reduces
interobserver variability and offers reliable and reproducible grading of renal
artery stenosis based on stenosis morphology and hemodynamic changes. It can be
considered a safe and noninvasive alternative for diagnostic DSA in cases that
do not require assessment of intrarenal vessels.
Noncoronary
transradial angioplasty with coronary equipment: a less invasive technique
Sharma GL, et al.
Catheter Cardiovasc Interv
2002;55:197-205.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11835647
Preliminary experience of noncoronary interventions via the transradial
approach using coronary equipment with 100% technical and clinical success. Nine
noncoronary interventions were performed in seven patients (five renal, two
celiac, one mesenteric and subclavian angioplasty each). The advantage of this
approach is that it limits arterial wall damage as well as potential distal
embolization by the use of small guiding catheters and 0.014" guidewires.
The only limitation of this approach for noncoronary interventions is the
guiding catheter length in tall patients and the unavailability of large
coronary balloons for subclavian, celiac, and renal interventions. With the
miniaturization of equipment and improvements in technique, this approach will
also become an excellent alternative for noncoronary interventions.
Unilateral
stent implantation for renal function in bilateral atherosclerotic renovascular
hypertension--a case report
Takakuwa H, et al.
Angiology 2002;53:349-52.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12025924
Renal angioplasty or stenting should be attempted in bilateral
atherosclerotic renovascular hypertension with renal insufficiency, even though
it may only be successful unilaterally
Renal
artery stenosis: a cardiovascular perspective
Vashist A, et al.
Am Heart J 2002;143:559-64.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11923791
http://www.mosby.com/scripts/om.dll/serve?action=searchDB&searchDBfor=art&artType=abs&id=a120769&target=
Revascularization of a stenosed renal artery is associated with preservation
of renal function and better control of hypertension, unstable angina, and
congestive heart failure. Because atherosclerotic RAS is associated with
generalized atherosclerosis, aggressive risk factor modification and
antiplatelet therapy are integral in the management of RAS regardless of the
revascularization strategy.
Incidental renal artery stenosis among a
prospective cohort of hypertensive patients undergoing coronary angiography.
Rihal CS, Textor SC, Breen JF, McKusick MA, Grill DE, Hallett JW, Holmes DR
Jr.
Mayo Clin Proc 2002 Apr;77(4):309-16
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=11936924
The prevalence of incidental renal artery stenosis among hypertensive patients
undergoing coronary catheterization is significant. Therefore, screening
abdominal aortography should be considered in these patients to better define
their risk of cardiovascular complications
Editorial
Screening
for renal artery stenosis: is it justified?
Zierler RE.
Mayo Clin Proc
2002;77:307-8.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11936923
Subclavian
artery angioplasty for the treatment of angina using a double balloon technique
to protect a left internal mammary artery graft
Jones RD, et al.
Eur Radiol
2002;12:908-10.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11960246
Percutaneous transluminal angioplasty (PTA) has proven to be a safe and
effective method of treating subclavian stenosis with technical success rates
ranging from 83 to 100%. This technique, however, can result in distal
embolisation. In the presence of a previous internal mammary bypass graft this
may prove catastrophic, especially when that graft provides the dominant supply
to the heart. Clearly any technique of reducing the risk of graft embolisation
is valuable in this small subgroup of patients. The deployment of a double
balloon to protect the left internal mammary artery graft to prevent this
potentially fatal event has not been described previously.
Free Journal (one year after publication)
AHA 2002 Meeting Coverage
SAPPHIRE:
Carotid stenting superior to endarterectomy in high-risk patients
with slides / A randomized comparison of carotid endarterectomy with
carotid stenting using distal protection has shown the interventional procedure
cut 30-day rates of death, MI, and stroke by more than half.
SAPPHIRE:
Stenting and Angioplasty with Protection in Patients at High Risk for
Endarterectomy
Carotid stenting with distal protection significantly reduces the combined
incidence of death/stroke/MI compared with CEA. Individual components show trend
in favor of stenting approach.
News Nov 2002
Carotid
Artery Stenting With Capture Device Superior to Endarterectomy
Preliminary data presented here Tuesday at the American Heart Associations
Scientific Sessions 2002 indicate that the rate of major adverse events after
carotid artery stenting using a capture device is about half that of
conventional carotid endarterectomy.
News Nov 2002
Gli stent carotidei con
sistemi di protezione sembrano essere superiori alla endarterectomia
Tra le novità presentate alle Scientific Sessions 2002 dell'American Heart
Association che potrebbero, nei prossimi anni, far cambiare atteggiamento e
indicazioni terapeutiche, vi sono i risultati dello studio SAPPHIRE (Stenting
and Angioplasty with Protection in Patients at HIgh Risk for Endarterectomy).
TCT 2002 Abstracts
TCT 2002 Meeting Coverage
| Peripheral Vascular Symposium: Carotid Interventions | K. Mathias G. S. Roubin S. S. Iyer |
ACC 2002 Meeting Coverage
| Carotid Interventions |
Abstract
Percutaneous
transluminal angioplasty and stenting for carotid artery stenosis
A Cochrane Review Abstract: Evidence Based Medicine reviews based primarily on
meta-analysis of controlled clinical trials.
Education in Heart
Carotid artery surgery for people with existing coronary artery disease
Ian Lane and John Byrne
Heart 2002;87 86-90
http://www.heartjnl.com/cgi/content/full/87/1/86
Patients requiring coronary revascularisation with symptomatic carotid disease
that fulfil the indications for surgery should undergo carotid endarterectomy.
In the absence of randomised trials, asymptomatic patients should be managed
recognising the high stroke risk associated with carotid stenosis of over 80%
and carotid occlusion. There is a need for randomised trials to clarify the need
for carotid endarterectomy at the time of coronary artery surgery.
Multicenter
evaluation of carotid artery stenting with a filter protection system
Al-Mubarak N, et al.
J Am Coll Cardiol
2002;39:841-6.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11869850
Carotid artery stenting with filter protection is technically feasible and safe.
Early clinical outcomes appear to be favorable and need to be confirmed in a
larger comparative study.
Carotid
artery stenting for stenosis following revascularization or cervical irradiation
Alric P, et al.
J Endovasc Ther
2002;9:14-9.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11958319
http://journals.allenpress.com/jrnlserv/?request=get-abstract&issn=1526-6028&volume=9&issue=1&page=14
CAS is a safe alternative to conventional surgery in patients with carotid
artery stenosis following surgical revascularization or cervical irradiation
provided preoperative testing excludes stenoses at risk for embolism.
Outcome
of extracranial cervicocephalic arterial dissections: a follow- up study
Gonzales-Portillo F, et al.
Neurol Res 2002;24:395-8.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12069289
Cervicocephalic arterial dissections (CCAD). The short- and long-term
outcome are usually favorable with either anticoagulant or platelet
antiaggregant therapy. A medical initial approach to the management of
extracranial CCAD is recommended for most patients.
Prospective
comparative study of two cerebral protection devices in carotid angioplasty and
stenting
Grego F, et al.
J Cardiovasc Surg (Torino)
2002;43:391-7.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12055572
CAS may protect against postoperative procedure-related neurological events.
Common and specific disadvantages were observed in both systems showing they
were not close enough to the ideal device.
Benefits
of cerebral protection during carotid stenting with the PercuSurge GuardWire
system: midterm results
Henry M, et al.
J
Endovasc Ther 2002;9:1-13.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=11958312
This study yielded a favorably low rate of periprocedural embolic events
comparable with standard CAS series. Protection devices may play an important
role in future carotid interventions and expand the applicability of the
procedure. Randomized studies (surgery versus CAS with and without cerebral
protection) are awaited.
Carotid
stenting without angioplasty
Men S, et al.
Can J Neurol Sci
2002;29:175-9.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12035841
In this case of severe carotid stenosis, the use of a self-expanding stent
alone, without balloon angioplasty, resulted in excellent anatomic and
hemodynamic improvement.
Review
Angioplasty
& stenting in the carotid?
Pope W.
Rn 2002;65:54-9; quiz 60.
http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&dopt=r&uid=12087600
TCT 2002 Meeting Coverage
| Thoracic Aorta Stent Grafts | F. Criado |
| Endovascular Strategies For Dissection Thoracic Aortic Aneurysms | M. Drake |
TCT 2002
Expert PresentationsSummaries of important articles from major peer-reviewed journals
| Angiogenesis For Patients With Limb Ischaemia By Autologous Transplantation Of Bone-Marrow Cells | E. Tateishi-Yuyama | Lancet 2002; 360: 427-35 |
Abstract
Percutaneous
transluminal angioplasty and stenting for vertebral artery stenosis
A Cochrane Review Abstract: Evidence Based Medicine reviews based primarily on
meta-analysis of controlled clinical trials.