VASCULAR DISEASE MANAGEMENT
July 2015, Vol. 12, No. 7
Gender Differences in Patients who Undergo Endovascular Revascularization for Peripheral Arterial Disease
Michael S. Lee, MD; Seung Woon Rha, MD
From UCLA Medical Center and Korea University Guro
ABSTRACT: Objective: Peripheral arterial disease (PAD) can be treated with percutaneous transluminal angioplasty (PTA). Data comparing the outcomes of females to males with PAD who undergo PTA is limited. We compared the clinical outcomes of male and female patients with PAD who underwent PTA. Methods: In a single center, prospective registry, the outcomes of 239 consecutive patients who underwent PTA for symptomatic PAD stratified by gender were analyzed. The primary endpoint was restenosis at 8 months. The secondary end points were repeat PTA, target lesion revascularization, target extremity revascularization, and amputation at a follow-up of 2 years. Results: Female patients were older (69.5 ± 11.1 vs 65 ± 11.6 years of age, P=.04) and had a trend toward a higher percentage of diabetic foot wound (58.1% vs 44.5%, P=.076) and PTA of tibial artery lesions (63.6% vs 53.8%, P=.064). Females had higher incidence of major hematoma (≥4 cm; 18.1% vs 8.1%, P=.033). No significant differences were observed between females and males for binary restenosis at 8 months and clinical events at 2 years. Conclusions: Female patients were older and had trends toward a higher percentage of diabetic foot wound as the initial diagnosis for PTA and PTA of tibial artery lesions. Despite having a higher incidence of major hematoma, females who underwent PTA had no significant differences in restenosis and 2-year clinical outcomes. PTA represents a viable treatment option for female patients with symptomatic PAD.
Venous Insufficiency: The Changing Paradigm in Vascular Disease
Robert Coronado, MD
From Northern Heart & Vascular Institute Inc., Redding, California
ABSTRACT: Venous insufficiency is the most prevalent vascular disorder in medicine today. It has been documented in sculptures uncovered in Greece that date back several centuries B.C. Up until a little over a decade ago, medicine had at best offered venous stripping as the only approach to the definitive treatment of venous insufficiency. This treatment proved to be anything but definitive. Despite significant advancement in its treatment options, venous insufficiency remains the most prevalent yet underdiagnosed vascular disorder today. It is estimated that over 30 million Americans suffer from symptomatic venous insufficiency, yet fewer than 2 million actually seek treatment. To put this in perspective, venous vascular disease is 5 times as prevalent as peripheral arterial disease and 2.5 times as prevalent as coronary artery disease. The following case study aims to better elucidate venous insufficiency and this underdiagnosed as well as misdiagnosed condition.
EXCITE ISR Data Revealed by Craig Walker, MD, at NCVH
By Jennifer Ford
VISION Trial Data Discussed at NCVH Meeting
By Jennifer Ford
* Articles are subject to change at the editor’s discretion.