Cath Lab Digest

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

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

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

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

The FDA announced approval of the first thoracic endograft device (Gore TAG) on March 23, 2005. It signaled the true beginning of a new era in endovascular therapy, and the unmistakable 'message' that thoracic aortic surgery is about to be transformed in a dramatic and irreversible fashion.

Thoracic aortic diseases, such as aneurysms, dissection, and others, share in common several important features - a relatively high incidence and high lethal potential, among others! Open surgical repair has been the acknowledged standard of care for decades, but it is far from ideal because of continuin