The Outback® Re-Entry Catheter (LuMend, Inc., Redwood City, CA) (Figures 2A–B) is a single lumen catheter designed to facilitate access and positioning of a guide wire within the peripheral vasculature, from a remote vascular entry site. A control knob, a rotating hemostasis valve (RHV), a catheter shaft with a distal nosecone, and a distal guide tip comprise the major element of the device. The distal curved tip cannula consists of a controllable nitinol sharp needle, activated via the proximal end of the catheter and used to puncture the true lumen of a vessel, under controlled fluorosc

Dr. Cates, you’ve been involved in helping the cardiology and vascular surgery societies develop credentialing guidelines for carotid artery stenting (CAS). How did these medical societies come together?

The societies felt it was important to take a role in helping define credentialing guidelines for CAS. Because this new procedure involves different anatomy and complications and because multiple specialists will be performing the procedure, a consistent set of guidelines will help to ensure the best patient care. So, the Society for Cardiovascular Angiography and Interventions (S

Introduction
Despite technologic advances in noninvasive vascular imaging (CTA, MRA), arch and carotid arteriography continues to play an essential role in the planning of surgical and endovascular interventions, and still is the gold standard for brachiocephalic and vertebral imaging. Endovascular treatment of carotid artery stenosis has become an accepted modality in a sub-group of patients who are “high risk” for carotid endarterectomy. At some point in the future, this may become the standard of care. As carotid, subclavian and vertebral interventions are more widely utilized,

INTRODUCTION
An early and accurate diagnosis of peripheral atherosclerosis (renal, abdominal and aortoiliac localizations) is of paramount importance for global management and prognosis due to its major additional mortality impact in patients with known coronary artery disease^1-2, especially those who are candidates to coronary or cardiac revascularization (CAD).^3-4 We sought to retrospectively evaluate the role of the invasive cardiologist in the diagnosis and management of clinically relevant significant subclavian artery stenosis (SAS) and abdominal vessel sten

As new technologies and procedures are introduced, the question of what’s best for the patient is extremely important. Physicians must be clear about why they want to offer alternatives to the standard of care. Is there really no other option for the patient? Is the new device or procedure the safest and most efficacious approach? And what about wanting to be “first on the block” to try a new treatment? While it is clear medical technology cannot advance if clinicians aren’t willing to try new approaches, we must evaluate every patient individually and ask ourselves, is this the