Volume 5 - Issue 2 - March/April 2008
Editor's Corner »
New Therapies 2008: Can the public be protected without stifling innovation in the process?
Last September 15th and 16th, as a member of the IAGS (International Andreas Gruentzig Society), I felt privileged for the opportunity to participate in an absolutely unique and most inspiring event: a trip to Zürich, Switzerland to celebrate the 30th anniversary of Andreas Gruentzig’s first coronary angioplasty. As if going to the same hospital where it all happened on September 16, 1977 and gathering in the same auditorium where some of the first-ever live demonstration courses took place (Figure 1) were not enough, we were presented with an even greater surprise: the chance to meet Andre
Original Contribution »
Effects of Percutaneous Closure of Patent Foramen Ovale on Atrial Fibrillation
Introduction
Atrial arrhythmias are known to be associated with atrial septal defects (ASDs). The surgical closure of ASDs can also eliminate atrial arrhythmias, and on some occasions, can induce new arrhythmias. In many cases, the arrhythmias, which are present before defect closure, continue to persist. Atrial arrhythmias are a source of significant morbidity and mortality, and there is a need to decrease the incidence of postoperative arrhythmias, both new-onset after surgery and the persistence of preexisting arrhythmias.1 On the other hand, there is some suggestion that
Original Contribution »
Catheter-Directed Thrombolysis and Percutaneous Thrombectomy for Acute Arterial Ischemia in Children
Introduction
Acute arterial ischemia is defined as the sudden decrease in blood flow to a tissue bed due to an embolism or thrombosis, resulting in a potential threat to the viability of the area.1 The intravascular administration of thrombolytic agents originated in the 1960s for the treatment of pulmonary embolism. Thrombolysis by selective catheter infusion for vascular occlusion entered the mainstream during the 1970s.2 Thrombolytic agents have been successfully employed to dissolve the occluding thrombus, reconstitute blood flow and improve the status of the
Clinical Review »
Primary Simultaneous Kissing Stent Deployment of Anomalous Looped Circumflex Artery During Acute Myocardial Infarction (With Sta
Case Illustration
A 60-year-old man with a history of cardiac arrest 16 years prior presented via ambulance with substernal pressure of 2 hour duration. An electrocardiogram revealed prominent ST-segment elevation in the inferolateral and apical leads. His blood pressure was 138/73 mmHg, and his heart rate was 53 beats per minute. He had received an aspirin in the ambulance, and intravenous nitroglycerine, heparin, and eptifibatide were initiated in the emergency room.
The medical history was significant for a cardiac arrest that occurred 16 years prior. The patient believed cardia
Clinical Review »
Management of Femoropopliteal Occlusive Disease in the Endovascular Era
Introduction
Chronic lower-extremity ischemia affects approximately 10% of patients over the age of 70, with the total number of affected patients exceeding 10 million. Within this group, only a fraction of patients have symptoms consistent with intermittent claudication, and even fewer of these ultimately present to a physician with complaints related to their arterial disease. In addition to the functional limitations caused by pain with walking, many patients fear limb loss as an ultimate complication and outcome. However, it is imperative that physicians emphasize how unlikely an
Case Study and Review »
Power-Pulse Spray and Angiojet Thrombectomy in Massive Inferior Vena Cava and Bilateral Lower Extremity Deep Venous Thrombosis
Introduction
Venous thromboembolism (VTE) encompasses both pulmonary embolism (PE) and deep venous thrombosis (DVT) and is a grossly underdiagnosed disease spectrum associated with high mortality and morbidity. It is surprising that despite the vast advances in the interventional field, no significant changes have occurred on a wide scale in the approach to this entity over the last half century, with the mainstay of treatment remaining heparin and chronic warfarin therapy.
We present a 52-year-old man with massive bilateral DVT extending into the inferior vena cava (IVC) who under
Commentary »
The Power-Pulse Spray Technique in Complex Venous Thrombotic Disease: A Multidisciplinary “Call to Action”
In this issue of Vascular Disease Management, Sharifi et al, obviously cardiologists, did a nice job treating their patient and identifying a great clinical need, an aggressive endovascular interventional mindset and treatment for venous thrombotic disease (VTD). They are to be congratulated for their “call to action” for more cardiologists becoming involved with treating VTD. This “call to action” has gone out before and must also be repeated to all surgical and radiology specialists and to all multidisciplinary healthcare providers who treat or manage vascular disease, includi
Feature »
Agreement of Community-Performed Ankle Brachial Pressure Indices (ABPI) with Vascular Laboratory Performed Assessment
Introduction
The ankle brachial pressure index (ABPI) is the ratio of the highest ankle systolic pressure to the highest brachial systolic pressure. An accurate ABPI measurement is fundamental to the community management of suspected peripheral arterial occlusive disease (PAOD). It is a cheap test that provides hard evidence of vascular disease. Using a threshold ratio of 0.9, sensitivity equals 95% and specificity equals 100%, compared to an angiogram.1
This study investigates the correlation and agreement of general practitioner (GP)-performed ABPI measurements in the c
