Issue

  • Issue Number: 
    6

    I’d bet the majority of the VDM readership (and Medicine at large) would rank cardiac surgery (CS) amongst the top and most-respected specialties — and for good reasons. For many years, heart surgeons have been some of the busiest and best-paid physicians in the country. Their work is often linked to “miraculous cures” and “great saves”…. After all, only the brain can compete with the heart to inspire awe and capture everyone’s imagination. They have been, one might say, “almost alone in that small high place reserved for those chosen to be at the top.”

    Now, fast forwa

  • Issue Number: 
    6

    The management of vascular diseases traditionally encompasses the diagnosis and treatment of arterial, venous, and lymphatic disorders. Indeed, these principles are incorporated into the original mission statement of The Society of Vascular Surgery,1 while standard textbooks of vascular surgery or diseases include venous and lymphatic disorders, along with arterial disease. For most vascular surgeons, however, the diagnosis and treatment of arterial occlusive and aneurysmal disease is their principal focus for many reasons. They are, in essence, arterial surgeons, who, by definition

  • Issue Number: 
    6

    Introduction
    In patients with polytrauma, injuries are treated after they are prioritized based on their severity. Some injuries, if managed conservatively, may result in delayed complications. We present a patient with a fractured clavicle who presented with a related complication 2 months later. The management of the case is also discussed.

    Case Study
    A 40-year-old male was brought to the emergency services department with multiple injuries sustained during a fall from a two-wheeler while under the influence of alcohol.

    His sensorium was initally obtunde

  • Issue Number: 
    6

    Introduction
    The profession of cardiothoracic surgery is facing many challenges. The forces affecting cardiac surgeons today are similar to those that affected vascular surgeons 5 to 7 years ago. Cardiologists and vascular surgeons have developed catheter-based skill sets that are being used to treat cardiovascular disease with less invasive approaches. Cardiac surgeons are now at a crossroads and many are learning these minimally invasive techniques. The future of cardiothoracic surgery will be determined by the net result of five unique forces: (1) a decrease in referrals for coronar

  • Issue Number: 
    6

    Introduction
    CMI is caused by atherosclerosis in more than 90% of the cases. Nonatheromatous conditions include: median arcuate ligament compression syndrome (compression of celiac artery by diaphragmatic crus), Takayasu arteritis, dysplastic lesions, thromboangiitis obliterans, and radiation-induced vascular injury.1–4 The disease generally presents in patients over 60 years and the incidence is three times higher in women.5 Approximately half of the patients with CMI have significant coronary artery disease and peripheral vascular disease.6,2

    The

  • Issue Number: 
    6

    Golzarian et al have done a nice job in reviewing mesenteric artery stenting for chronic mesenteric ischemia (CMI), and have noted it to be a rare disorder, with an incidence of 1 in 100,000. This statistic may be true, but it brings back memories of the “rare” incidence of renal artery stenosis (RAS) of 1% that I was taught 30 years ago while in medical school. We now know that RAS is one of the most common diseases treated by endovascular stenting. I suspect CMI will become analogous to RAS in regards to enhanced awareness, diagnosis, and treatment, especially with the recent improvemen

  • Issue Number: 
    6

    Introduction
    Post-thrombotic syndrome (PTS) is a common complication of acute deep vein thrombosis (DVT).1 PTS commonly causes chronic, lifestyle-limiting symptoms such as limb heaviness/fatigue, swelling, and pain, with a minority of patients developing significant venous claudication, stasis dermatitis, and skin ulceration.2 Catheter-directed thrombolysis (CDT) refers to a family of image-guided endovascular techniques in which a thrombolytic drug is delivered directly into the venous thrombus through a catheter embedded in the thrombosed vein.3 In modern

  • Issue Number: 
    6

    Introduction
    Over the last decade, there has been remarkable progress in the percutaneous management of coronary artery disease (CAD) as an established alternative to coronary artery bypass surgery. When compared to dilatation of coronary lesions with balloons, the scaffolding properties of stents have resulted in increased safety and predictable results, with reduced rates of acute closure and late restenosis. Recently, the addition of antiproliferative agents on the surface of the metal stents (drug-eluting stents) has been shown to markedly attenuate the vascular responses of neoint

  • Issue Number: 
    6

    Percutaneous treatment of chronic total occlusions (CTOs) of coronary arteries represents one of the greatest technical challenges in interventional cardiology. Although CTOs are present in approximately one quarter of patients with angiographically documented coronary artery disease (CAD), these lesions represent only 15% of percutaneous interventions (PCIs) performed.1 Thus, patients with CTO have historically been denied PCI in favor of either continued medical therapy or referral for coronary artery bypass graft surgery (CABG). Several studies of patients with CTO have demonstr


Digital Supplements

Using Advanced Technology to
Treat Occluded Below-the-Knee Arteries


This clinical case update was supported through an unrestricted educational grant from Terumo Medical Corporation.


Superior Mesenteric Artery Revascularization and
Retrograde Visualization


This clinical case update was supported through an unrestricted educational grant from Terumo Medical Corporation.

CME Showcase

"Diabetic Peripheral Neuropathy"

Upcoming Accredited Webcast

Release Date: December 22, 2008

Expiration Date: December 22, 2009

This activity is supported by an educational grant from PamLabs.
This activity is sponsored by the North American Center For Continuing Medical Education (NACCME).

To register for this Webcast, visit www.naccme.com/program/n-558/



LUMEN 2009 - THE SYMPOSIUM ON OPTIMAL TREATMENTS FOR ACUTE MI

Live Symposium

Date: February 26-28
Location: Loews Miami Beach Hotel
Miami Beach, Florida 33139
Phone: (305) 604-1601
Toll Free: 1-877-563-9762

This activity is sponsored by the North American Center for Continuing Medical Education.

CARDIAC PET: Optimizing CAD Patient Management with Diagnostic Confidence


A Complimentary CME Accredited Lunch Symposium

Date: Friday, September 12, 2008
12:00 pm - 1:15 pm
Location: Hynes Convention Center
900 Boylston Street, Room 304
Boston, MA 02115

This activity is supported by an educational grant from Bracco Diagnostics Inc.


REVIEW OUR OTHER
CARDIOLOGY BRANDS

Check out our other resources for healthcare professionals of all specialties.

  • CathLab Digest
  • Journal of Invasive Cardiology
  • EP Lab Digest
  • Cath Lab Basics