Look around you. We are literally “surrounded” by innovation, less-invasive endovascular techniques and devices… “New paradigms” emerge every couple of years, perhaps more often! Many such new technologies and therapies can be classified as disruptive (see VDM editor’s corners from the September/October 2005 and November/December 2005 issues). They tend to emerge rapidly as new options or alternatives to traditional standards of care. Enthusiasts are quick to proclaim that a new standard of care has arrived! But, has it really…?

The article “Most Thoracic Aneurysms and Tho

Introduction
As interventional technologies have evolved over the years, the use of intravascular stents to revascularize stenotic carotid arteries and reduce the incidence of stroke has been the topic of heated discussion within the clinical community. While the U.S. Food and Drug Administration (FDA) approved the first carotid stent system in the United States in 2004,¹ this decision served only to inflame this debate, rather than quench it. There are several facets to this difference in opinion, and while many of them are not unique to carotid stenting, it is indeed rare

Thoracoabdominal aortic aneurysm (TAAA) repair is one of the most extensive operations undertaken by a surgeon. The size of the incision, as well as the number of organ systems that are at considerable risk during the procedure, places TAAA repair among one of the most major procedures the human body can tolerate. Fortunately, methods of organ protection (particularly for the spinal cord) have been developed to reduce these risks. We have built upon these techniques, resulting in an operative strategy that has improved outlook for our patients. We will give a brief history of the treatment of

In this issue of VDM, Shammas has presented several algorithms regarding treatment of the spectrum of acute and chronic lower extremity ischemia with the emphasis refreshingly placed primarily on thrombus, platelets and “clot” management. I have referred to this as “endopharmacotherapy” in treating critical limb ischemia (CLI), and consider this tool just as important in achieving limb salvage as any of the recent novel device technologies we are now adding to our CLI “toolbox”.¹ Endopharmacotherapy may even be more important when considering that ultimate limb loss ofte

Introduction
This case presents a patient scheduled to receive a femorofemoral bypass graft in conjunction with aortomonoiliac endograft. Initially, the patient was to undergo an endovascular stent graft repair for his abdominal aortic aneurysm and occluded iliac artery; however, the decision was made to recanalize the long segment occlusion and convert him to a standard bifurcated endograft. Significant literature has been published concerning monoiliac stent grafts, but there have been no reported cases of recanalizing a chronic total occlusion of the iliac with subsequent bi-limb st