In-Stent Restenosis in the SFA Remains a Significant Unresolved Problem
While it is true that devices and techniques have evolved considerably over the past several years, and endovascular treatment has been propelled to first-line therapy in most cases today, there is no doubt that in-stent restenosis (ISR) remains a significant and largely unresolved issue.
Endostaples Have Arrived: Will They Become Important Tools in the Hands of Aortic Interventionists?
Last month, Aptus Endosystems, Inc. announced that it received 510(k) clearance from the U.S. Food and Drug Administration for the company’s endostapling system, which will now be known as the HeliFX aortic securement system, for use during endovascular aneurysm repair (EVAR). According to the company, the device’s helical anchor technology enables independent endograft fixation and is designed to “duplicate” surgical sutures performed during operative repair of abdominal aortic aneurysms.
Will drug-eluting stents for the SFA prove to be game-changer (over BMS devices) and at what price?
Cook Medical announced that the company’s Zilver PTX drug-eluting stent for treating peripheral artery disease in the superficial femoral artery (SFA) has received a positive recommendation from the FDA’s Circulatory System Devices Panel of the Medical Devices Advisory Committee. The panel members voted unanimously to recommend approval of the device on the basis of its safety, efficacy, and acceptable risk profile. This important achievement will ultimately lead to FDA approval to commercialize the Zilver PTX stent in the United States, according to Cook Medical.
Should we continue to screen patients for asymptomatic carotid artery stenosis?
I was in Taipei last week where I participated in the 2011 Congress of the Asian Society for Vascular Surgery. I had the privilege of taking part in a session on carotid artery disease and my chosen topic for presentation was, “Carotid screening on asymptomatic patients: Should this practice end?”
Drug-Eluting Balloons Below the Knee: A Better Mouse-Trap?
In a recent issue of JACC (Journal of the American College of Cardiology), Schmidt et al published an interesting clinical study on the use of drug-eluting balloon angioplasty for treatment of long-lesion infrapopliteal arterial occlusive disease.1 There were 104 patients and 109 limbs treated; critical ischemia was the indication for intervention in the vast majority (82.6%). The device used was the IN.PACT Amphirion paclitaxel-eluting balloon catheter (Medtronic, Minneapolis, Minnesota).
IVC Filter Placement: Too Much of a Good Thing?
More than 200,000 IVC filters were inserted in the U.S. in 2010, which is an enormous number that represents exponential growth when compared with previous decades. Such “sea-change” can be explained on the basis of several factors, including the general evolution of medical practice in this country. But principally, it is a reflection of newer and better IVC filter technologies and devices – particularly, the promise of retrievability.
Stenting the Common Femoral Artery: Another Myth Debunked?
In vascular surgery circles, the common femoral artery (CFA) ranks only second to the carotid artery to exemplify the goodness and lasting qualities of reconstructive open surgery: “No endovascular therapy for this baby!”
Renal Artery Stenting (RAS): A bit of good news at last…?
In a recent issue of the Journal of Vascular Surgery, Modrall et al1 published a paper on a retrospective clinical study of predictors of a favorable blood pressure (BP) response to RAS. The patient cohort was comprised of 149 patients receiving RAS between the years 2000 and 2008. The bottom-line results (in a multivariate analysis) pointed to 3 pre-operative clinical variables that may turn out to be useful predictors of a favorable BP response to RAS: 4 or more anti-hypertensive medications, diastolic BP ≥90 mm Hg, and clonidine use.
TMI, The Internet, & How Information Can Impede Decision-Making
No one would dispute that the information age is upon us. And its impact can be felt everywhere including – naturally – our daily practices, patient management and decision-making processes. Sounds good…? Think again.
Life after CREST: Impact on my carotid practice
A little over a year has passed since the CREST trial results were first announced (in February 2010). A great deal of information has been presented and published since then, and it would be most appropriate to acknowledge that this was a landmark trial. Some experts have gone as far as advancing the label of “the essence of evidence-based medicine” to describe its unique and history-making nature.
