Last year was eventful in the vascular and endovascular world. Regulatory approval (in the United States) of carotid stenting and thoracic aortic endografting was — clearly — among the most salient developments. Their likely enormous impact is only beginning to be felt. Rapid expansion and further refinements in both fields are sure to take place in the new year and beyond.

Technological innovation in a number of areas will continue to occupy most of our attention in 2006. There are many exciting areas that will undoubtedly capture headlines in the near future, such as nano-technology

Stenting of the renal artery is now the procedure of choice in treating obstructive atherosclerotic renal artery disease. Unfortunately, restenosis remains the Achilles’ tendon of this percutaneous therapy, and ranges from 15–25%.¹ Several predictors of restenosis following stenting of the renal arteries have been suggested, including small vessel size^1,2 (typically < 4.5 mm), length of stented segment,² time to evaluate for restenosis,^1,3 smoking,¹ the use of gold-coated stents³ and bilateral renal artery disease.³

Introduction
The natural history of atherosclerotic renal artery stenosis is characterized by progression, causing hypertension and chronic renal failure (RF). Up to 21% of patients with renal stenosis reducing luminal diameter by more than 60% progress to occlusion within 2 years. Renal stenosis is responsible for renal failure in 15% of adult patients who begin dialysis each year.^1–3

Renal angioplasty⁴ with renal artery stenting (RAS)^5–8 has become the procedure of choice in the treatment of stenosis. The technical success and low complication

Introduction
Patent foramen ovale (PFO) is more prevalent in patients with cryptogenic stroke (CS) than in individuals with a stroke of known cause, suggesting that “paradoxical embolus” (i.e., the migration of a venous thrombus across the PFO to the systemic circulation) may be the etiology of stroke in some patients.¹
Currently, secondary prevention of recurrent CS in patients with PFO includes medical therapy with oral antiplatelet and anticoagulant medications or PFO closure (percutaneous or surgical). The majority of the PFO closures are now done percutaneously due

Vascular complications arising during or after percutaneous access of the femoral artery have decreased over the past decade, but still present a problem in some cases. The use of vascular closure devices for femoral artery access management has allowed early ambulation and improved patient satisfaction with a safety profile that is equivalent, or in some circumstances better, than is observed with manual compression. Striving to achieve complication-free vascular access is a goal of all practicing physicians. The sharing of information relevant to better access techniques and uncommon complic