In the editor’s update on Vascular Disease Management, we give you a sneak peek into the upcoming issue. In April, VDM will highlight covered stents in superficial femoral artery interventions. Clinical editor Craig Walker, MD, will also discuss “Covered Stents in the Treatment of SFA Disease” by Barry S. Weinstock, MD, in his monthly video message. See below for titles and abstracts for the April issue.
VASCULAR DISEASE MANAGEMENT
April 2014, Vol. 11, No. 4
Covered Stents in the Treatment of SFA Disease
Barry S. Weinstock, MD
From Orlando Regional Medical Center, Orlando, Florida.
Treatment of SFA disease remains challenging due to complex lesion morphologies, unique vessel characteristics, long lesion lengths and frequent chronic total occlusions. Numerous studies have been performed using various renditions of balloon angioplasty, atherectomy and stenting. The Viabahn endoprosthesis is an attractive option for long, complex segments of SFA disease including chronic total occlusions. Use of the Viabahn endograft to create an endoluminal bypass provides an angiographically optimal primary result while potential restenosis is limited to the proximal and distal edges of the endograft resulting in a length-independent restenosis rate, an advantage not offered by any other interventional procedure. Recent enhancements to the Viabahn stent as well as better understanding of optimal device sizing and procedural technique have resulted in highly acceptable patency rates in even the most complex SFA lesions. Strategies to optimize procedural success and to treat late complications such as restenosis and/or thrombosis are reviewed.
CASE FILES WITH DR. GEORGE
Isolated Tibiopedal Arterial Access for Minimally Invasive Retrograde Revascularization
Jon C. George, MD
From Division of Interventional Cardiology and Endovascular Medicine, Deborah Heart and Lung Center, Browns Mills, New Jersey.
A 71 year-old male with history of coronary artery disease, peripheral arterial disease (PAD), ulcerative colitis, and chronic thrombocytopenia presented with acute onset of severe right lower extremity claudication characterized by rest pain and a cold leg. The patient was treated using the tibiopedal arterial minimally invasive retrograde revascularization (TAMI) technique technique due to lack of alternative access with excellent outcomes.
Type I Endoleak Management after Endovascular Aneurysm Repair of Infrarenal Abdominal Aortic Aneurysm: Utilization of N-butyl Cyanoacrylate Embolization in a Case of Failed Secondary Intervention
Derya Tureli, MD, and Feyyaz Baltacioglu, MD
From the Department of Radiology, Marmara University, Istanbul, Turkey.
A 52-year-old male patient with infrarenal abdominal aortic aneurysm underwent an endovascular aneurysm repair procedure. At the end of the procedure, a type 1A endoleak was detected. Because there was no margin for placement of an aortic extender cuff, balloon dilatation was performed with an expectation for total resolution. A control angiogram performed 2 days later showed that the endoleak persisted and balloon dilatation was performed at the attachment site one more time. A control CT scan performed 2 days after the secondary procedure revealed that the type IA endoleak persisted and had grown larger. Open surgical repair was rejected by the patient. The patient underwent a single session of N-butyl cyanoacrylate embolization of the type IA endoleak using a transarterial approach. Coil utilization was not required. Technical success was achieved in the patient with complete resolution of the endoleak confirmed by follow-up CT studies. There were no procedure related complications.
LETTER TO THE EDITOR
Is ‘Substantially Equivalent’ Good Enough for Lower-Limb Therapy Patients: Contributions to the Meaningful Data Collection Discussion
Ragotham R. Patlola, MD
From Cardiovascular institute of the South, Lafayette, Louisiana.
Data on the Acuseal Graft for Hemodialysis: An Interview With Marc Glickman, MD
From Sentara Healthcare, Norfolk, Virginia.
* Articles are subject to change at the editor’s discretion.