VASCULAR DISEASE MANAGEMENT
June 2015, Vol. 12, No. 6
Can’t See the Forest for the Trees: Transcollateral Crossing of Chronic Total Occlusions
Vinayak Subramanian, BS1; George L. Adams, MD, MHS2
From 1Department of Biomedical Engineering, North Carolina State University, Raleigh, NC, and 2Rex Hospital, University of North Carolina Health System, Raleigh, NC
ABSTRACT: Chronic Total Occlusions (CTOs) remain a significant clinical challenge in the treatment of peripheral artery disease. Successful treatment of CTOs is largely dependent on the skill level, patience, and experience of the interventionalist and is associated with a success rate between 34% and 91%. A transcollateral approach can be taken to cross and treat complex lesions that are untreatable using traditional techniques. This paper is focused on the techniques and tools required for successfully using the transcollateral approach to cross CTOs in the peripheral artery tree.
Case Files With Dr. George
Delayed Venous Stent Migration Presenting as Pulmonary Embolism and Managed With Retrieval Using a Snare and Ultrasound-Enhanced Catheter-Directed Thrombolysis
Rajeev Mareddy, DO; Jon C. George, MD
From the Division of Interventional Cardiology and Endovascular Medicine, Deborah Heart and Lung Center, Browns Mills, New Jersey
ABSTRACT: A 37-year-old female with history of multiple deep venous thromboses, status post temporary inferior vena cava filter placement and removal, and stent deployment to right popliteal vein, presented with progressively worsening shortness of breath and right leg swelling. Upon admission, the patient was found to have had pulmonary embolism with delayed venous stent migration to the right pulmonary artery greater than 1 year following initial stent implantation. Stent retrieval was performed using a snare device and residual clot burden managed using ultrasound accelerated catheter directed thrombolysis with significant improvement.
Former Patient’s Philanthropic Gift Seeds Vascular Training Center
By Jennifer Ford
* Articles are subject to change at the editor’s discretion.