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Target Audience: Physicians, nurses, and technologists.
This activity is supported by an educational grant from Terumo Medical Corporation.

Clinical Review

Venous Laser Updates: New Wavelength or New Fibers?




VOLUME: 7 PUBLICATION DATE: Mar 03 2010
Issue Number: 
3 (March 2010)
Lowell S. Kabnick, MD, FACS, FACPh



Introduction

Since the introduction of endovenous lasers (EVL) in the early 2000s, procedure methodologies, as well as device technologies, have evolved extensively in the endeavor to improve treatment outcomes. As each novel parameter has been studied, new data have enabled the venous ablation community to acquire an enhanced understanding of the laser’s mechanism of action. The primary subject matter in EVL studies has routinely included one or a combination of the following: laser fiber vein-wall contact,1,2 linear endovenous energy density (LEED),3,



Cardiogenic Shock: From Reperfusion to Revascularization and Hemodynamic Support




VOLUME: 7 PUBLICATION DATE: Feb 02 2010
Issue Number: 
2 (February 2010)



Amar R. Chadaga, MD, Jamil B. Dihu, MD, Timothy A. Sanborn, MD



Abstract

Cardiogenic shock represents the most ominous challenge of acute myocardial infarction (AMI), with an incidence of 8–9% and a mortality rate approaching 50%. The majority of cases of cardiogenic shock are secondary to AMI complicated by left ventricular failure leading to refractory hypoperfusion and hypotension. Placement of an intra-aortic balloon pump (IABP) and primary percutaneous coronary intervention (PCI), particularly in young patients, remain the America



Management of Common Femoral Artery and Bifurcation Diseases




VOLUME: 7 PUBLICATION DATE: Jan 01 2010
Issue Number: 
Volume 7 - Issue 1 - January 2010
Mallik Thatipelli, MD, RVT, FSVM, FACPh, FACC and Sanjay Misra, MD*

pg. E27 - E30

__________________________

Introduction and Epidemiology

Isolated atherosclerotic involvement of the common femoral artery (CFA) and its bifurcation are rare and reports consisting large patient series are unavailable. The CFA is usually involved as a continuum with the atherosclerosis of the proximal (iliac) or distal (femoro-popliteal) arterial segments. CFA and its bifurcation are critical segments of the lower-limb arterial tree, exemplified by the development of acute and limb-threatening ischemia when it is occluded with a thrombotic or thrombo-



Impact of Technique and Device Selection on Clinical Outcomes in Carotid Artery Stenting




VOLUME: 7 PUBLICATION DATE: Jan 01 2010
Issue Number: 
Volume 7 - Issue 1 - January 2010
Muhammad Raza, MD*, Bilal Ayub, MD§, Firas Alani, MD£, Mrinalini Meesala, MD*, Daniel Gzesh, MD*, Sheldon Goldberg, MD*, Daniel J. McCormick, DO*

pg. E20 - E26

_________________________

Introduction

Each year about 780,000 people experience a new or recurrent stroke, accounting for 17% of cardiovascular deaths.1 Approximately 80% of strokes are caused by focal cerebral ischemia and the remaining 20% are caused by hemorrhage.2 Almost 20% of ischemic strokes result from carotid artery stenosis.3,4 Various options for the management of carotid artery stenosis include medical therapy, carotid artery endarterectomy (CEA) and carotid artery stenting (CAS). CEA has been established as a gold-standard treatment for ca



Intracranial Stent-assisted Revascularization for Acute Ischemic Stroke




VOLUME: 6 PUBLICATION DATE: Nov 06 2009
Issue Number: 
11/12 (Nov/Dec 2009)
Sabareesh K. Natarajan, MD, MS,* Yuval Karmon, MD,* Adnan H. Siddiqui, MD, PhD,* Elad I. Levy, MD,*,§ L. Nelson. Hopkins, MD*

From *University at Buffalo, State University of New York, Buffalo, New York and §Millard Fillmore Gates Hospital, Kaleida Health; Departments of Neurosurgery & Radiology and Toshiba Stroke Research Center, Buffalo, New York.

Manuscript submitted July 29, 2009, provisional acceptance given August 17, 2009, accepted September 9, 2009.

Correspondence: L. Nelson Hopkins, MD, University at Buffalo, State University of New York, Neurosurgery, 3 Gates Circle, Buffalo, NY 14209. E-mail: lnhbuffns@aol.com

Disclosures: Dr. Hopkins receives research support from Toshiba; serves as a consultant



IVC Filters: Indications and Evidence




VOLUME: 6 PUBLICATION DATE: Nov 06 2009
Issue Number: 
11/12 (Nov/Dec 2009)
Neil J. Rane, MD and Raman Uberoi, MD

Abstract

The role of anticoagulants in the treatment of venous thrombo-embolic disease is well established. The use of inferior vena cava filters as a second line treatment is increasing, most recently with the popularity of of retrievable filters. However, the indications and evidence for their safety and efficacy are not clear-cut. There are few absolute indications. The majority of evidence originates from single-center series studying a preferred few genres of filters. Generalizability and meta-analysis are difficult. Important questions remain to be answered, particularly regard



Bare-Metal Versus Drug-Coated Intracoronary Stents in Clinical Practice: Are There Guidelines?




VOLUME: 6 PUBLICATION DATE: Sep 01 2009
Issue Number: 
Volume 6 - Issue 5 - September/October 2009
Srihari S. Naidu, MD

Introduction

The development of bare-metal stents (BMS) and optimal post-procedure antiplatelet therapy in the mid 1990s resulted in marked reductions in acute and subacute stent thrombosis, bleeding complications, negative remodeling, and acute vessel recoil, and a consequent dramatic rise in procedural success. Yet, intermediate-term outcomes remained hampered by restenosis from aggressive neointimal hyperplasia. The advent of drug-coated stents, which impede the growth of neointima while maintaining the strengths of BMS, heralded their widespread utilization to approximately 90% o



Does Microparticle Size Affect Bland Embolization Outcomes of Local Treatment for Liver Malignancies?




VOLUME: 6 PUBLICATION DATE: Sep 01 2009
Issue Number: 
Volume 6 - Issue 5 - September/October 2009
Guido Bonomo, MD, Lorenzo Monfardini, MD, Paolo Della Vigna, MD, Gianluigi Orgera, MD, Vittorio Pedicini, MD, Franco Orsi, MD

Introduction

Treatment options for primary liver tumors (i.e., hepatocellular carcinoma or HCC) and metastatic liver neoplasms have increased in the past decade in response to the incidence of these tumors; HCC is the most common primary liver cancer, while liver tumors are the sixth most common cancer and the third most common cause of cancer-related death globally.1,2 The incidence of liver cancer in the United States and Western Europe is increasing.3,4 Liver metastases from colorectal cancer (CRC) develop in 50% of patients.5

While liver resection remains the gold standard in



Gene Therapy in Critical Limb Ischemia




VOLUME: 6 PUBLICATION DATE: Aug 01 2009
Issue Number: 
Volume 6 - Issue 4 - July/August 2009


authors:
1Hong H. Keo, MD, 2Alan T. Hirsch, MD, 1Iris Baumgartner, MD, 3Sigrid Nikol, MD,
2Timothy D. Henry, MD

________________________________

Abstract

Critical limb ischemia (CLI) represents the most severe stage of atherosclerotic lower extremity peripheral artery disease (PAD), and CLI prevalence is expected to increase as the population ages. The current standard of care for CLI relies on direct revascularization, either by endovascular techniques or open surgical approaches, as there are few effective medical treatments for this condition. Therapeutic angi



Interventional Treatment Options for Small Saphenous Varicose Veins




VOLUME: 6 PUBLICATION DATE: Aug 01 2009
Issue Number: 
Volume 6 - Issue 4 - July/August 2009


authors:
Caroline D. Rodd, MD, FRCS, Alison M. Young, MBBS, Jonothan J. Earnshaw, DM, FRCS

___________________________

Introduction

Varicose veins are common, and affect nearly a third of adults in Western societies. Although women present more frequently for treatment, Lee et al observed a significantly higher age-adjusted prevalence of varicose veins in men (40% vs. 32% in women).1 Patients present with a variety of symptoms that they attribute to their varicose veins, including pain, heaviness, burning, itching, superficial thrombophlebitis, skin changes, and



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CME Showcase

"Diabetic Peripheral Neuropathy"

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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).

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