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Target Audience: Physicians, nurses, and technologists.
This activity is supported by an educational grant from Terumo Medical Corporation.
Commentary
The Use of the Aorto-Uni-Iliac Device in the Treatment of Abdominal Aortic Aneurysms
1Jeffrey H. Freihage, MD, 2Aravinda Nanjundappa, MD, RVT, 3Pranab Das, MD, 1Robert S. Dieter, MD, RVT
Author Affiliations:
From 1Loyola University, Maywood, Illinois, 2East Carolina University, Greenville, North Carolina, and 3Memphis Medical Center, Memphis, Tennessee.
Correspondence: Robert S. Dieter, MD, RVT, Assistant Professor of Medicine, Vascular and Endovascular Medicine, Interventional Cardiology, Loyola University, 2160 S. First Ave., Maywood, IL 60153.
E-mail: rdieter@lumc.edu.
Rupture of a Sinus of Valsalva Aneurysm: Put it in your Differential Diagnosis for CHF
In this issue of Vascular Disease Management, Zavala-Alarcon et al1 present an interesting look at an uncommon cardiovascular problem and the unique opportunity to “witness” a potentially highly morbid event if not diagnosed and treated properly. Aneurysms of the aortic root involving the sinuses of Valsalva (SVA) are a distinct entity from atherosclerotic ascending aortic aneurysms or aneurysmal dilatation associated with a bicuspid aortic valve. The authors have done a nice job describing the pathogenesis and clinical signs and symptoms of SVA. I will reserve my comments on wh
Distal Embolization in Lower Extremity Interventions: It’s Time We “Get Our Heads Out of the Sand”
These authors very admirably present their recommendations, strategies, and tips in utilizing filter embolic protection devices (EPD) during lower extremity percutaneous peripheral interventions (PPI).1 As a cardiovascular surgeon by training, and having witnessed the large amount of both atherosclerotic and thrombotic plaque burden inside infrainguinal vessels many times, I’ve often wondered where this debris goes during our PPIs and how we get by without at least some degree of embolization on every case. With the recent advent of atherectomy devices and EPDs that allow us to ac
Below-the-Knee Intervention: Promises and Reality
Occlusive disease affecting the below-the-knee (BTK) arteries is a common and often serious manifestation of atherosclerosis. It tends to carry a number of significant implications (Table 1), but causing claudication (in the absence of more proximal disease) is not one of them! So here’s the first important message: claudication is not an appropriate indication for treatment of BTK disease alone. Critical limb ischemia (CLI, Table 2) is the only acceptable indication for intervention in this setting.
Surgical bypass grafting has long been considered the “gold standard” (or “standard
The Rodney Dangerfield of Abdominal Aortic Branch Disease
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
Intravascular MRI: A Novel Tool in the Assessment of High-Risk Plaques
Atherothrombosis is a systemic disease of large- and medium-sized arteries, including the coronary, aorta, and peripheral arteries. The clinical manifestations depend on the size of the vessel and the regional circulation involved and include coronary artery disease, stroke, and peripheral vascular disease. A paradigm shift is occurring, with a change in focus from the assessment and treatment of luminal narrowing towards greater understanding of the vascular biology in the arterial wall that leads to plaque vulnerability. High-risk or vulnerable plaques are characterized by the presence of a
Percutaneous Revascularization of Peripheral Chronic Total Occlusion — Which Patients, Why, and How?
Recanalization of peripheral arterial total occlusion in lower extremities plays a pivotal role to improve claudication symptoms and limb salvage. Coronary chronic total occlusion (CTO) recanalization has recently gathered controversy with the publication of the occluded artery trial (OAT). However, in peripheral vasculature, specifically in the superficial femoral artery (SFA), occlusion predominates stenosis. The predominance of occlusion is due to limited collaterals, namely the profunda femoris artery and the diffuse nature of the disease.2 The constant endothelial injury, d
SAPPHIRE: The Gem Still Shines
“And I said of medicine, that this is an art which considers the constitution of the patient, and has principles of actions and reasons in each case.” – Plato: Georgias.
In his classic textbook of medicine, The Principles and Practice of Medicine, William Osler states the treatment of gastric ulcer includes:
A. Absolute bed rest;
B. A carefully and systematically regulated diet;
C. Medicinal measures are of very little value in gastric ulcer, and the remedies employed do not probably benefit the ulcer, but the gastric catarr
The Power-Pulse Spray Technique in Complex Venous Thrombotic Disease: A Multidisciplinary “Call to Action”
In this issue of Vascular Disease Management, Sharifi et al, obviously cardiologists, did a nice job treating their patient and identifying a great clinical need, an aggressive endovascular interventional mindset and treatment for venous thrombotic disease (VTD). They are to be congratulated for their “call to action” for more cardiologists becoming involved with treating VTD. This “call to action” has gone out before and must also be repeated to all surgical and radiology specialists and to all multidisciplinary healthcare providers who treat or manage vascular disease, includi
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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. 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. |
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