Cath Lab Digest

ABSTRACT: Purpose. Internal iliac artery occlusion can be an intentional or inadvertent complication of endovascular aneurysm repair, especially repair of abdominal aortic aneurysms (EVAR). Several studies have reported on side effects experienced by patients as a result of bilateral internal iliac artery occlusion, with buttock claudication and erectile dysfunction being the most frequent. A low incidence of serious side effects, including colonic and spinal cord ischemia, have been reported. In our study, we add the experience of 7 patients who underwent bilateral internal iliac artery occlusion at our institution in conjunction with endovascular repair of aneurysms of the abdominal aorta or common iliac arteries. Methods. A retrospective chart review was performed on patients who received embolization or experienced inadvertent occlusion of both internal iliac arteries. Patients were also contacted by phone and were asked about their experience with the procedures. Data regarding the incidence and severity of side effects as experienced by patients were compared to that obtained from published studies. Results. Between May 2000 and May 2010, 7 patients underwent procedures resulting in bilateral occlusion of the internal iliac arteries. Four of 7 patients (57%) experienced initial buttock claudication following the procedures; of these, claudication resolved by 18 months in 2 of 4 patients. Two of 7 patients (29%) reported experiencing new-onset impotence following the embolization procedures. There were no incidences of colonic or spinal cord ischemia. Conclusions. Bilateral internal iliac artery occlusion appears to have an acceptable incidence of side effects, with buttock claudication being the most common negative symptom.

Few studies report the use of conservative management in the treatment of acute upper limb ischemia (AULI). A retrospective series is presented from a hospital where a conservative approach is used primarily. Methods. A retrospective analysis of patients treated for AULI in our hospital over a 10-year period was carried out. Results. In our series of 17 patients with AULI, 1 was treated surgically and 16 were treated conservatively with anticoagulation as the primary therapy. Fourteen of 16 patients deemed suitable for conservative therapy were treated successfully (88%). Two patients required surgery after a period of failed conservative management, leading to full resolution of symptoms. This was comparable to published reports using embolectomy as the primary management. Conclusions. In selected patients conservative anticoagulation management (with a low threshold for intervention) is a viable alternative to surgical intervention as a first-line therapy in AULI.

Abstract

We report on our center’s clinical experience which supports the view that the new TIF Pinnacle sheath offers superior performance and enhanced safety. The complication rate was essentially nil and the use of closure devices was obviated altogether. However, these conclusions should be tempered by the limited nature of the study, mainly, the absence of a control patient subset, the potential built-in bias related to case selection and observation of outcomes, and its small size.

VASCULAR DISEASE MANAGEMENT 2010;7:E168–E170

Abstract

Objective. We sought to report the successful intracranial placement of the Solitaire FR device (ev3, Inc., Irvine, California), a self-expanding stent-platform-based thrombectomy device that is fully recoverable after deployment, effecting complete recanalization of soft and firm clots in a canine stroke model.

Methods. Soft and firm clots were introduced in the target vessel to occlude the vessels completely in a mongrel dog. The clot was crossed with a SilverSpeed guidewire (ev3) and over the wire with a Rebar microcatheter (

Comparison of Doppler Ultrasound, Photoplethysmographic, and Pulse-Oximetric Calculated Pressure Indices To Detect Peripheral Arterial Occlusive Disease

authors:
Usman Jaffer, MD, Mohammed Aslam, MD, Nigel Standfield, MD

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Abstract

Objectives. Doppler ankle-brachial pressure index (ABI) is considered the non-invasive screening test of choice to detect peripheral arterial disease (PAD). Photoplethysmography (PPG) and pulse oximetry (PO) are also suitable alternatives; however, correlation and validation are yet to be e