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John A Phillips, Anna Falls, Raghu Kolluri, Aaron Whipp, Christy Collins, Samer Mohir-Sadaai, Blake Reid, Nirav Patil, Maurice Alston, Melissa Troyan, Gary M Ansel
PURPOSE: To evaluate the 1- and 2-year patency and reintervention rates with the Zilver PTX drug-eluting stent (DES) in long complex femoropopliteal disease. METHODS: A retrospective review was conducted of 89 consecutive patients (mean age 68.7±9.8 years; 86 men) with femoropopliteal occlusive disease (Rutherford category 2-6) treated with the Zilver PTX between December 2012 and December 2013. Mean lesion length for the entire cohort was 24.2±11.3 cm (median 24...
March 1, 2018: Journal of Endovascular Therapy
Antonio Micari, Roberto Nerla, Alberto Cremonesi
No abstract text is available yet for this article.
February 2018: Journal of Cardiovascular Medicine
Matthew C Bunte, David J Cohen, Michael R Jaff, William A Gray, Elizabeth A Magnuson, Haiyan Li, Andrew Feiring, Marco Cioppi, Robert Hibbard, Bruce Gray, Yazan Khatib, David Jessup, Roberto Patarca, Jing Du, Hans-Peter Stoll, Joe Massaro, David M Safley
OBJECTIVES: To evaluate the clinical and health status outcomes of patients undergoing superficial femoral artery (SFA) revascularization using the Shape Memory Alloy Recoverable Technology (S.M.A.R.T.®) nitinol self-expanding stent through 3 years of follow-up. BACKGROUND: Limited long-term data are available describing the durability of benefits after femoropopliteal revascularization. METHODS: In a multicenter, prospective, core-lab adjudicated study, 250 subjects with de novo or restenotic femoropopliteal arterial lesions were treated with the S...
March 9, 2018: Catheterization and Cardiovascular Interventions
Yong Ding, Min Zhou, Yonggang Wang, Liang Cai, Zhenyu Shi
OBJECTIVE: This study aimed to perform a systematic review and meta-analysis of current evidence comparing the drug-eluting stent (DES) with the bare-metal stent (BMS) in the treatment of femoropopliteal artery disease (FPAD). METHOD: All relevant articles reporting the results of DES versus BMS implantation in FPAD were systematically searched in MEDLINE, EMBASE, and Cochrane database. Randomized controlled trial, cohort, and retrospective study were all included...
March 4, 2018: Annals of Vascular Surgery
Jihad A Mustapha, Alexandra Lansky, Mehdi Shishehbor, John Miles McClure, Sarah Johnson, Thomas Davis, Prakash Makam, William Crowder, Eitan Konstantino, Robert R Attaran
The Chocolate BAR study is a prospective multicenter post-market registry designed to evaluate the safety and performance of the Chocolate percutaneous transluminal angioplasty balloon catheter in a broad population with symptomatic peripheral arterial disease. The primary endpoint is acute procedural success (defined as ≤30% residual stenosis without flow-limiting dissection); secondary long-term outcomes include freedom from target lesion revascularization (TLR), major unplanned amputation, survival, and patency...
March 7, 2018: Catheterization and Cardiovascular Interventions
Sevan Komshian, Thomas W Cheng, Alik Farber, Marc L Schermerhorn, Jeffrey A Kalish, Denis Rybin, Douglas W Jones, Jeffrey J Siracuse
OBJECTIVE: Retrograde popliteal artery (RPA) access to treat superficial femoral artery and popliteal artery disease is an option when treatment through common femoral artery (CFA) access is not possible. Our goal was to compare the safety and efficacy of RPA access with CFA access for treatment of femoral and popliteal artery lesions. METHODS: The Vascular Quality Initiative was queried for all patients undergoing RPA access from 2010 to 2016 for symptomatic peripheral arterial disease...
March 1, 2018: Journal of Vascular Surgery
Thiago Silva Guimaraes, Laura Andrade da Rocha, Christiane Becari, Carlos Eli Piccinato, Renata Dellalibera Joviliano, Mauricio Serra Ribeiro, Edwaldo Edner Joviliano
OBJECTIVE: The objective of this study was to evaluate the relationship between inflammatory markers interleukin (IL)-1β, IL-6, IL-8, IL-10, tumor necrosis factor α (TNF-α), transforming growth factor β (TGF-β), highly sensitive C-reactive protein (CRP), and the development of arterial restenosis six months after femoropopliteal (FP) percutaneous transluminal angioplasty (PTA) with covered stent implantation. METHODS: We recruited 27 patients of a tertiary hospital in Brazil treated with covered stents for atherosclerotic peripheral arterial disease...
February 23, 2018: Annals of Vascular Surgery
Hsuan-Li Huang, Hsin-Hua Chou, I-Chih Chen, Chien-An Hsieh, Shih-Jung Jang, I-Shiang Tzeng, Yu-Lin Ko
BACKGROUND: Pattern of DCB restenosis and associated outcomes in facing complex femoropopliteal lesions remain uncertain. METHODS: Data were retrospectively collected from dual centers in Taiwan on patients who underwent treatment with DCBs for femoropopliteal lesions between 2013 and 2016. The restenosis pattern was categorized by the index-treated length. Clinical outcomes and time to DCB restenosis were retrospectively analyzed. Cox proportional hazards model identified restenosis predictors...
February 17, 2018: International Journal of Cardiology
Kaspars Maleckis, Eric Anttila, Paul Aylward, William Poulson, Anastasia Desyatova, Jason MacTaggart, Alexey Kamenskiy
Endovascular stenting has matured into a commonly used treatment for peripheral arterial disease (PAD) due to its minimally invasive nature and associated reductions in short-term morbidity and mortality. The mechanical properties of the superelastic Nitinol alloy have played a major role in the explosion of peripheral artery stenting, with modern stents demonstrating reasonable resilience and durability. Yet in the superficial femoral and popliteal arteries, even the newest generation Nitinol stents continue to demonstrate clinical outcomes that leave significant room for improvement...
February 22, 2018: Annals of Biomedical Engineering
Pierleone Lucatelli, Marco Cini, Giulio Tommasino, Antonio Benvenuti, Giulia Guaccio, Stefano Bascetta, Eugenio Neri, Carmelo Ricci
PURPOSE: To prospectively evaluate the safety and efficacy of using the Tigris vascular stent (Gore, Flagstaff, Arizona) alone or in combination with the Viabahn stent (Gore) for revascularizing femoropopliteal Trans-Atlantic Intersociety Consensus (TASC) type B-D lesions with varying degrees of calcification. MATERIALS AND METHODS: Patients with Rutherford stage ≥ 3 and TASC type ≥ B were included in the study. From January 2015 to April 2017, 31 segments in 31 patients (21 men, ovarall mean age 73...
February 13, 2018: Journal of Vascular and Interventional Radiology: JVIR
Shoichi D Takekawa
Background and aims: We devised a technique to treat peripheral arterial disease (PAD) with laser, i.e. percutaneous transluminal laser angioplasty (PTLA). Considerable good results were obtained with PTLA, but it is apparently considered obsolete as a technique to treat occlusive arterial disease of peripheral arteries, perhaps because of the development and improvement of stents and the ease of their use compared to the somewhat intricate technique required for PTLA. Although the author admits the usefulness of stents, they are foreign to a human body...
December 31, 2017: Laser Therapy
Michinao Tan, Kazushi Urasawa, Ryoji Koshida, Takuya Haraguchi, Shunsuke Kitani, Yasumi Igarashi, Katsuhiko Sato
PURPOSE: To describe the feasibility of balloon angioplasty using a long balloon for chronic femoropopliteal occlusions by evaluating angiographic dissection patterns for optimization of outcomes in balloon angioplasty. METHODS: A retrospective, single-center analysis examined 101 symptomatic patients (mean age 75.6±9.9 years; 65 men) with single de novo femoropopliteal occlusive lesions treated with balloon angioplasty between August 2012 and October 2016. The patients were classified into 2 groups for comparison of angiographic dissection patterns: 51 patients were treated with balloon angioplasty using long balloons (L-BA; defined as ≥220 mm in length) and 50 patients were treated with short balloon angioplasty (S-BA; defined as <150-mm-long balloons)...
February 1, 2018: Journal of Endovascular Therapy
Sayaka Funabashi, Osami Kawarada, Takeshi Yagyu, Teruo Noguchi, Satoshi Yasuda
No abstract text is available yet for this article.
February 9, 2018: Cardiovascular Intervention and Therapeutics
Katie E Shean, Sara L Zettervall, Sarah E Deery, Thomas F X O'Donnell, Peter A Soden, Joel M Johnson, Raul J Guzman, Marc L Schermerhorn
BACKGROUND: The prevalence of obesity is increasing in the United States; however its impact on adverse outcomes in patients with peripheral vascular disease is not well studied. Obesity is associated with higher rates of complications following open bypass surgery, but limited data are available on its effect on endovascular intervention. This study aimed to identify whether obese patients suffer the same complications when undergoing lower extremity endovascular interventions. METHODS: All patients who underwent femoropopliteal or tibial endovascular interventions between 2011 and 2013 were identified in the Targeted Vascular Module of the NSQIP...
February 5, 2018: Annals of Vascular Surgery
Ayşe Keven, Mehmet Sedat Durmaz
Background: Peripheral arterial disease is an atherosclerotic disease characterized by an increase in morbidity and mortality. For these reasons early diagnosis of peripheral arterial disease is important. Ankle-brachial systolic pressure index measurement is frequently used in screening studies. Evaluating waveforms of distal lower extremities with Doppler ultrasound can be used as a screening program and provides more accurate information on peripheral arterial disease. Aim: We investigate the prevalence of peripheral arterial disease, compare the efficacy of Doppler ultrasound evaluation of distal lower extremity waveforms and ankle-brachial systolic pressure index measurement in screening programs, and discuss the importance of early diagnosis of asymptomatic cases...
December 2017: Journal of Ultrasonography
Alexey Kamenskiy, William Poulson, Sylvie Sim, Austin Reilly, Jiangtao Luo, Jason MacTaggart
OBJECTIVE: Arterial calcification and stiffening increase the risk of reconstruction failure, amputation, and mortality in patients with peripheral arterial disease, but underlying mechanisms and prevalence are unclear. APPROACH AND RESULTS: Fresh human femoropopliteal arteries were obtained from n=431 tissue donors who are aged 13 to 82 years (mean age, 53±16 years) recording the in situ longitudinal prestretch. Arterial diameter, wall thickness, and opening angles were measured optically, and stiffness was assessed using planar biaxial extension and constitutive modeling...
January 25, 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
Marcus Thieme, Michael Lichtenberg, Marianne Brodmann, Angelo Cioppa, Dierk Scheinert
BACKGROUND: Most common clinical presentation of peripheral artery disease (PAD) comprises intermittent claudication (IC), but about one third of patients will progress to critical limb ischemia (CLI), characterized by rest pain and/or tissue loss, which is the most severe limb manifestation of PAD. Paclitaxel-coated balloons are well established for the endovascular treatment of femoropopliteal lesions in patients with IC and CLI. This ongoing multicenter registry study is exploring the role of the Lutonix® 014 drug- coated balloon (DCB) in the treatment of below-the-knee (BTK) arteries and CLI...
January 23, 2018: Journal of Cardiovascular Surgery
Luis M Palena, Larry J Diaz-Sandoval, Laiq M Raja, Luis Morelli, Marco Manzi
PURPOSE: To describe a novel technique designed to safely and precisely deploy the Supera stent accurately at the ostium of the proximal superficial femoral artery (SFA) without compromising the profunda and common femoral arteries. TECHNIQUE: After antegrade crossing of the chronic total occlusion (CTO) at the SFA ostium and accurate predilation of the entire SFA lesion, a retrograde arterial access is obtained. The Supera stent is navigated in retrograde fashion to position the first crown to be released just at the SFA ostium...
January 1, 2018: Journal of Endovascular Therapy
S Michael Gharacholou, Marshall Dworak, Ala S Dababneh, Raj Varatharaj Palraj, Michael C Roskos, Scott C Chapman
Peripheral stents are increasingly used for treatment of peripheral arterial disease, yet all implanted devices are potentially at risk for infection. We describe a 51-year-old man who underwent stenting in the femoropopliteal artery and presented 3 days later with leg pain, fever, and evidence of peripheral stigmata of embolization. Blood cultures grew methicillin-resistant Staphylococcus aureus and remained persistently positive despite antibiotic therapy. At surgical exploration, the popliteal artery had essentially been disintegrated by the infection, with only visible stent graft maintaining arterial continuity...
June 2017: Journal of Vascular Surgery Cases and Innovative Techniques
William A Gray, Lawrence A Garcia, Ali Amin, Nicolas W Shammas
OBJECTIVES: To report on procedural, safety, and effectiveness outcomes of real-world practice with the Jetstream rotational atherectomy system for treatment of femoropopliteal artery lesions. BACKGROUND: Safety and effectiveness of treatment with the Jetstream device has been demonstrated in clinical trials, but outcomes during real-world clinical practice have yet to be examined. METHODS: 241 patients (66% male, mean age 67years, 41% diabetes; Rutherford 1-3) with de novo or restenotic (non-stent) femoropopliteal lesions ≥4cm in length were recruited...
December 27, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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