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Editor's Corner
The New VDM
pg. A1
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At the dawn of a new decade, it is with pleasure and a sense of excitement that I write the first Corner editorial of 2010 to introduce a new format for Vascular Disease Management as it becomes an online-only publication. We are confident this will enhance the journal’s relevance and reach in a most significant way. The most salient advantages of such evolution can be listed as follows:
• The number of issues will double (beginning immediately) from 6 to 12 per year, making it a monthly journal;
• A much-increased capacity to expand c
Medical Imaging in the XXI Century: Too much of a good thing?
Many of us have come to depend on (even demand) the kind of exquisite imaging depicted in Figure 1. Contemporary management of aortic diseases is changing dramatically as it goes through a revolution of sorts, propelled — in a large measure — by the ability to visualize the vascular anatomy with a degree of definition and refinement we would not have thought possible a decade ago. Add to this the remarkable developments in the endovascular technology field and one can explain easily the near-incredible transformation in all the cardiovascular specialties.
We now use this imaging capabi
Type II Endoleaks After EVAR: A Continuing Dilemma
author:
Frank J. Criado
Editor-in-Chief
Vascular Surgery and Endovascular Intervention; Union Memorial Hospital/MedStar Health,
Baltimore, Maryland
frank.criado@medstar.net
Endoleaks have been at the center of developments with endovascular aneurysm repair (EVAR) from the outset — even before the term had been coined.1 The definition is rather simple: persistent (or recurrent) blood-flow perfusion of the aneurysm sac after endograft implantation. Type I (stent-graft seal failure at a proximal or distal fixation site) and type III (from graft holes or modular component sepa
Optimal Management of Acute DVT Demands Referral to a Vascular Specialist
The situation is a bit counter intuitive, but probably not unique: widely-acknowledged progress in diagnostic methodology, leading to…less than optimal management for some patients! Can this be true?
Consider the following: patients with acute deep vein thrombosis (DVT) most often present to the emergency department, or other medical/surgical services, that have in place sophisticated and well-validated protocols and guidelines to determine whether the patient should be classified at a high or low suspicion. The physician can then (easily) obtain confirmation (or exclusion) of the diagnos
On the death of King George II in 1760: Aortic Dissection in Perspective
“On the 25th of October he [King George II] rose as usual at six, and drank his chocolate; for all his actions were invariably methodic. A quarter after seven he went into a little closet. His German valet de chambre in waiting heard a noise, and running in, found the King dead on the floor.”1 Nichols was directed to open and embalm the royal body. What he found (and meticulously described2) was the first clear account of the condition we now know (after Laennec) as aortic dissection (AD): “...the pericardium was found distended with a quantity of coagulated blood, nearly a pint...; the
Endograft Repair in the Thoracic Aorta: Poised to Grow!
The article by Halawa et al on thoracic stent-grafts1 serves as an appropriate platform for this issue’s Editor’s Corner. Arguably, 2008 was the “coming-out” year for these technologies, as two additional endograft devices received FDA approval. We now have a total of three commercially available and “off-the-shelf” thoracic devices (Table 1). While treatment of aneurysms in the descending aorta represents the approved on-label indication (Figure 1), physicians — no doubt — will also use them off-label in the management of patients with a host of other similarly serious patholo
Update on Carotid Stenting: What Went Wrong?
Frank J. Criado, Editor-in-Chief
Vascular Surgery and Endovascular Intervention; Union Memorial Hospital/MedStar Health, Baltimore, Maryland
frank.criado@medstar.net
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“… the procedure is expected to greatly reduce the demand for a common operation in which surgeons slice open the neck and scrape the carotids clean from earlobe to collarbone”.
“The shift to angioplasty has drawn fervent opposition from surgeons who question angioplasty’s long-term effectiveness and safety…They also stand to lose a major source of income…”1
Going below the knee: Not without challenges
By all accounts, leg ischemia caused by below-the-knee (BTK) arterial occlusive arterial lesions is an important and frequent form of atherosclerotic vascular disease. Until the recent past, BTK revascularization was long considered a “sacred domain” of surgical (bypass) treatment — with little if any room left for catheter-based therapy. We know better today.1 The BTK territory, in fact, can be appropriately thought of today as one of the most promising frontiers in the entire endovascular field when the potential for growth and patient benefit are taken into account.
Balloon angiop
On the Nature of Turf Wars: Disruptive Technologies Did It!
When offered the position of Editor-in-Chief at VDM, I was told that I would have a great deal of freedom to generate my imprint on this publication, and a few privileges; perhaps a little glamour as well. I was also given the “power” to over-rule (if necessary) manuscript reviewers and make some decisions of my own — provided they were rational and based on compelling reasons. Well, I finally found something worthy of such a stance!
The article by Baerlocher, et al. on uterine artery embolization was submitted to VDM and put through the usual peer-review process. The assigned revie
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