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Vascular Disease Management - ISSN: 1553-8036 - Volume 4 - Issue 4 - July 2007 | |
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| Jinnette Abbott, MD and David Williams, MD |
Endovascular specialists are increasingly facing the
challenges of treating peripheral arterial chronic
total occlusions (CTOs). The two primary issues
concerning these lesions are the ability to safely
achieve initial angiographic success and the longterm
durability of therapy. The advent of new techniques
and devices, including re-entry catheters, has
increased the crossing success rates for even the most
difficult CTOs. Although more effective ways of
maintaining vessel patency are needed, nitinol stents
have improved immediate outcomes and become the
mainstay of therapy. This article will review the percutaneous
treatment of peripheral CTOs.
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| 1Robert S. Dieter, MD, RVT, 1Ali Morshedi-Meibodi, MD, 2Aravinda Nanjundappa, MD, RVT |
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| Joe Huang, MD, Takao Ohki, MD, PhD |
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Stent-Graft Placement in Popliteal Artery Aneurysms:
Midterm Results |
| Reza Ghotbi, MD, Agamemnon Sotiriou, MD, Sylvia Schönhofer, MD, Dimitrios Zikos, MD,
Kerstin Schips, MD, Wolfgang Westermeier, MD |
Purpose. We sought to determine the selection criteria,
midterm durability and need for reintervention
after stent-graft placement in symptomatic popliteal
artery aneurysms (PAA).
Methods. Twenty-four patients (22 males and 2
females, mean age 58 years), with a combined 27
aneurysms, underwent an elective stent-graft repair of
symptomatic popliteal artery aneurysms between January
1999 and December 2003. When an essential
branch would be blocked by an endograft, thrombosed
aneurysms and aneurysms were excluded from the
study. The commercially available stent-graft Viabahn
(W.L. Gore & Associates, Inc., Flagstaff, Arizona) was
used in all cases. The primary endpoint was defined as
a successful exclusion after a 2-year period. Exclusion
success was assessed using duplex ultrasound and spiral
computed tomography.
Results. The primary technical success rate was 100%.
In-hospital mortality was 0%. Two central leaks required
reintervention. There were 2 stent-graft occlu
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Is Carotid Stenting of Complicated Plaques Safe? |
| Gianluca Faggioli, MD, Monica Ferri, MD, Mauro Gargiulo, MD, Antonio Freyrie, MD,
Francesca Fratesi, MD, 1Lamberto Manzoli, MD, MPH, 2Cristina Rossi, MD, Andrea Stella, MD |
Background. Specific plaque characteristics, such as
ulcers and subocclusive lesions, may increase the complication
rate in carotid stenting (CAS) procedures, however,
few data have been published in this regard.
Aim. Our goal was to investigate the risk of technical
failure and neurological symptoms in complicated and
uncomplicated plaques after CAS.
Methods. From January 2005 to March 2007, all
patients submitted to CAS were divided into two groups
depending on plaque morphology: complicated plaque
patients (ComP) (plaques with ulcers diameter > 2 mm and
plaques determining subocclusive stenosis [i.e., > 99%]);
the rest being uncomplicated plaques (UnComP). The two
groups were compared in terms of baseline characteristics,
preoperative neurological symptoms, cerebral computed
tomography, type of arch, presence of stenosis or occlusion
of the contralateral carotid, type of stent and protection
system, and technical and clinical outcome. Differences
across groups in t
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