Complexities in CLTI Management & Novel Technologies in BTK Scaffolding


In Part I of this special episode, The PVD Channel is pleased to welcome back Dr. Michael Lichtenberg for an in-depth look at complexities in the management of chronic, limb-threatening ischemia (CLTI). Join Dr. Lichtenberg as he outlines the burden and intricacies of this often underdiagnosed and undertreated disease, discusses the challenges of below-the-knee arterial disease and the appropriate role of precision diagnostic imaging, and the novel technologies that can help us address calcium challenges for our patients.

In Part II, join Dr. Andrey Espinoza for an in-depth evaluation of contemporary approaches to diagnostics in arterial interventions. Focusing on enhancing your understanding of best practices for multi-modal imaging interpretation, Dr. Espinoza reviews the benefits of imaging technologies, highlighting the advantages that have rendered intravascular ultrasound the dominant modality in our field. Through analysis of a challenging, real-world case, you’ll learn how to utilize non-invasive and invasive imaging to optimally assess, prepare, and treat your patients with peripheral vascular disease, while also reducing risks, setting the stage for improved outcomes.

Learning Objectives

Upon viewing this educational episode, vascular professionals will be better able to:

  • Explain the burden of chronic, limb-threatening ischemia
  • Identify the challenges of managing below-the-knee arterial disease and the appropriate role of precision imaging
  • Describe types of arterial dissections and current treatment options for below-the-knee dissection repair

Target Audience

The educational design of this activity addresses the needs of Interventional Radiologists, Vascular Surgeons, Vascular Specialists, Nurse Practitioners, Radiologic Technologists, and Vascular Allied Health Professionals involved in the treatment of patients with peripheral vascular disease.

Michael Klaus William Lichtenberg, MD, FESC

Michael Klaus William Lichtenberg, MD, FESC

Chief Medical Officer
Angiology Clinic, Vascular Center
Arnsberg Clinic
Arnsberg, Germany

Dr. Michael Lichtenberg is the Chief Medical Officer and Director of the Angiology Department and Vascular Center at the Arnsberg Clinic in Arnsberg, Germany.

Dr. Lichtenberg earned his medical degree from the Heinrich-Heine Medical University of Dusseldorf, and also studied at the Tulane University School of Medicine in New Orleans, Louisiana and the Texas Heart Institute in Houston, Texas.

An esteemed Interventional Cardiologist and Angiologist with 20 years of experience in endovascular interventions, Dr. Lichtenberg was elected to serve as Managing Director of the German Society for Angiology in 2017. In 2019, he was elected to serve as the society’s President.

Dr. Lichtenberg’s areas of clinical interest include deep venous intervention, peripheral artery disease, coronary thrombosis, and atherosclerosis.

In addition to his day-to-day work in interventional care, his main interest is the evaluation of new devices, techniques and procedures for intervention of peripheral artery disease. Dr. Lichtenberg has performed a series of studies in this area and conducted many clinical trials.

Andrey Espinoza, MD, FACC, FSCAI

Andrey Espinoza, MD, FACC, FSCAI

Advanced Heart & Vascular Institute of Hunterdon
Hunterdon Medical Center
Morristown Medical Center
Robert Wood Johnson University Hospital
Flemington, NJ

With more than two decades of experience, triple board-certified Interventional Cardiologist Dr. Andrey Espinoza has amassed many accolades. A repeat New Jersey Monthly Top Doctor, he is also a manuscript reviewer for the Journal of Cardiac Catheterization and Intervention and served on an investigational team that led to approval of a breakthrough stent technology to replace permanent metallic implants.

When it comes to assessing his accomplishments, however, Dr. Espinoza insists there’s only one metric that matters. “I gauge my success,” he says, “by the embraces I receive from my patients.”

It’s no wonder then that when he founded the Advanced Heart and Vascular Institute of Hunterdon, Dr. Espinoza sought to create a compassionate, patient-oriented practice that leverages his expertise in cardiovascular medicine, endovascular medicine and interventional cardiology, as well as his keen interest in cardiovascular genetics, cardio-oncology and sports cardiology.

Always striving to bring his patients the most innovative cardiac techniques, Dr. Espinoza—a member of the American College of Cardiology’s Peripheral Vascular Disease Section and the Society of Cardiovascular Angiography and Intervention’s Carotid Committee and Vascular Disease Council—was also involved in an international clinical trial leading to the approval of a PCSK9 inhibitor for lowering cholesterol in heart disease patients.

Physician Accreditation Statement

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Global Education Group (Global) and Educational Awareness Solutions. Global is accredited by the ACCME to provide continuing medical education for physicians.

Physician Credit Designation

Global Education Group designates this enduring activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABIM MOC Recognition Statement

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 medical knowledge MOC point in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Nurse Practitioner Continuing Education

This activity has been planned and implemented in accordance with the Accreditation Standards of the American Association of Nurse Practitioners (AANP) through the joint providership of Global Education Group and Educational Awareness Solutions. Global Education Group is accredited by the American Association of Nurse Practitioners as an approved provider of nurse practitioner continuing education. Provider number: 110121. This activity is approved for 1.0 contact hour (which includes 0.0 hour(s) of pharmacology).

American Society of Radiologic Technologists

This activity has been reviewed and approved for 1.0 Category A CE credit by the ASRT.

European Board for Accreditation in Cardiology

This programme is accredited by the European Board for Accreditation of Continuing Education for Health Professionals (EBAC) for 1.0 hour of external CE credit. Each participant should claim only those hours of credit that have actually been spent in the educational activity.

Global Contact Information

For information about the accreditation of this program, please contact Global at 303-395-1782 or

Instructions to Receive Credit

In order to receive credit for this activity, the participant must complete the pre-activity questions, view the program in its entirety, pass the post-activity questions with 75% or better and complete the evaluation form and credit request.

Fee Information and Refund/Cancellation Policy

There is no fee for this educational activity.

Disclosure of Relevant Financial Relationships

Global Education Group (Global) adheres to the policies and guidelines, including the Standards for Integrity and Independence in Accredited CE, set forth to providers by the Accreditation Council for Continuing Medical Education (ACCME) and all other professional organizations, as applicable, stating those activities where continuing education credits are awarded must be balanced, independent, objective, and scientifically rigorous. All persons in a position to control the content of an accredited continuing education program provided by Global are required to disclose all financial relationships with any ineligible company within the past 24 months to Global. All financial relationships reported are identified as relevant and mitigated by Global in accordance with the Standards for Integrity and Independence in Accredited CE in advance of delivery of the activity to learners. The content of this activity was vetted by Global to assure objectivity and that the activity is free of commercial bias. 

In compliance with EBAC guidelines, all speakers/ chairpersons participating in this programme have disclosed or indicated potential conflicts of interest which might cause a bias in the presentations. The Organizing Committee/Course Director is responsible for ensuring that all potential conflicts of interest relevant to the event are declared to the audience prior to the CE activities.

All relevant financial relationships have been mitigated.

The faculty have the following relevant financial relationships with ineligible companies:

Michael K. W. Lichtenberg, MD, FESC
Consulting Fees:   Philips, BD, Medtronic, Veryan, Biotronik, Inari, Cordis, Bentley
Contracted Research: Philips, BD, Medtronic, Veryan, Biotronik, Inari, Cordis, Bentley
Honoraria: Philips, BD, Medtronic, Veryan, Biotronik, Inari, Cordis, Bentley
Speaker’s Bureau: Philips, BD, Medtronic, Veryan, Biotronik, Inari, Cordis, Bentley
Andrey Espinoza, MD Consulting Fees: Philips
Contracted Research: Phillips TOBA registry
Honoraria: Philips

The planners and managers have the following relevant financial relationships with ineligible companies:

Name of Planner or Manager
Reported Financial Relationship
Kristin Delisi, NP
Nothing to disclose
Andrea Funk
Nothing to disclose
Liddy Knight
Nothing to disclose
Ashley Cann
Nothing to disclose
Maria DelCegno
Nothing to disclose
James Miller
Nothing to disclose
Daniel Romanowitz
Nothing to disclose
Lauren Sinclair
Nothing to disclose
Deborah Sharkey
Nothing to disclose
Paul J. Gagne, MD, FACS, RVT
Consulting Fees: Philips, Cook Medical, Boston Scientific, Medtronic, Endologix
Contracted Research: Medtronic, Mercator, Reva Medical, MedAlliance, Boston Scientific, Philips, Intervene, Vesper Medical

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. Global Education Group (Global) and Educational Awareness Solutions do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of any organization associated with this activity. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed in this activity should not be used by clinicians without evaluation of patient conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.

System Requirements

An Internet-connected web browser is required.


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