The Role of EVUS and IVUS in Endovascular Procedures and Managing CLI with Pedal Access


In this special 2-part episode, The PVD Channel is pleased to welcome Drs. Fadi Saab and Marco Manzi for an exploration into the role of EVUS and IVUS in endovascular procedures, including an in-depth look at managing CLI with pedal access.

Part I – The Role of EVUS and IVUS in Endovascular Procedures

In Part I, Fadi Saab, MD explores the role of Extravascular Ultrasound and Intravascular Ultrasound in the treatment of patients with advanced peripheral arterial disease and critical limb ischemia. Join us as Dr. Saab reviews case-related images and clinical trial data, delineating areas within vascular disease in which EVUS or IVUS are the optimal choice for your patients.

Part II – Managing CLI with Pedal Access

In Part II, Marco Manzi, MD sharpens our focus with a deep dive into the management of critical limb ischemia with pedal access. Dr. Manzi shares his experience and expertise as he discusses appropriate sites for puncture, radiological projections, as well as a stepwise review of proven techniques.

Learning Objectives

After completing this activity, the participant should be better able to:

  • Identify conditions for which EVUS or IVUS is the ideal choice for vascular patient imaging
  • Describe the advantages of utilizing Ultrasound over fluoroscopy or digital subtraction angiography (DSA)
  • Discuss appropriate tools and techniques for pedal access in patients with CLI

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.

Marco Manzi, MD

Marco Manzi, MD

Director, Interventional Radiology
Foot & Ankle Clinic
Abano Terme, Italy

Dr. Marco Manzi is an Interventional Radiologist practicing in Abano Terme, Italy. Dr. Manzi earned his medical degree at the University of Milan, and after serving as an Army Medical Officer, he completed Radiology training at Boldrini Hospital, Vicenza and at the Radiology Institute at the University of Ferrara.

Dr. Manzi then joined the Radiology Institute at San Bartolo Hospital, Vicenza, where he served as Director of the International Radiology Unit from 1999 until he assumed his current position in 2007.

An active industry proctor, Dr. Manzi has been involved in teaching distal revascularization technical courses for many years.

Dr. Manzi has authored more than 50 publications in peer-reviewed medical journals and has been an invited faculty member at leading medical congresses and courses in Europe and the United States. These include: Cardiovascular and Interventional Society of Europe (CIRSE), LINC, Charing Cross, VEITH, VIVA, Cleveland Clinic, NCVH, PAIRS, EuroPCR, ASVS, Encore Seoul , JET, CCT Japan, APSCVIR and more.

Dr. Manzi is member of CIRSE, the Interventional Radiology Section of the SIRM (Italian Society of Medical Radiology), the Italian-European Society of Interventional Radiology (IESIR), the European Society of Radiology (ESIR), and is an honorary member of the Interventional Radiology Society of Australasia (IRSA).

Dr. Manzi’s clinical interests include vascular imaging, atherosclerotic vascular diseases, atherectomy, endovascular procedures, PAD, CLI, arterial occlusive diseases, and limb salvage.



Chief Operating Officer
Director of Cardiology & Vascular Medicine
Advanced Cardiac & Vascular Centers for Amputation Prevention
Grand Rapids, MI, USA

Dr. Fadi A. Saab is an Interventional Cardiologist specializing in endovascular revascularization of peripheral vascular disease. A leader in critical limb ischemia (CLI), he also specializes in treating varicose veins and cardiac issues, including high blood pressure and carotid artery disease.

Board-certified in Internal Medicine, with subspecialty certification in Cardiology and Interventional Cardiology, Dr. Saab holds additional certification in Cardiovascular Medicine, Nuclear Cardiology, and Echocardiography. Dr. Saab also serves as a Clinical Associate Professor of Medicine at the Michigan State University College of Human Medicine.

Dr. Saab earned his medical degree from the Damascus University School of Medicine in Syria and completed his Internal Medicine residency at Detroit Medical Center-Sinai Grace Hospital in Detroit, Michigan. He then completed a Cardiology Outcome research fellowship at the University of Michigan in Ann Arbor; a Noninvasive Cardiology fellowship at St. John Hospital & Medical Center in Detroit; and fellowships in Cardiovascular Medicine and Interventional Cardiology at Baystate Medical Center (Tufts School of Medicine), in Springfield, MA.

In 2017, Dr. Saab co-founded the Advanced Cardiac and Vascular Amputation Prevention Centers, envisioning a nationwide network for patients seeking specialized cardiac care and alternatives to limb amputation.

Dr. Saab has participated in more than 15 clinical research studies, has authored more than 25 peer-reviewed publications, and has been an invited speaker at regional, national, and international conferences. In addition, he is Co-Director of the AMPutation Prevention Symposium, an international conference focusing on CLI therapy.

A fellow of the American College of Cardiology, the Society for Cardiac Angiography & Interventions, and the American Society of Echocardiography, Dr. Saab is also a member of the Critical Limb Ischemia Global Society.

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 1.25 AMA PRA Category 1 Credits™. Physicians should claim only the credits 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 1.25 medical knowledge MOC points 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 1.25 contact hour(s) (which includes 0.0 hour(s) of pharmacology).

American Society of Radiologic Technologists

This activity has been reviewed and approved for 1.25 Category A CE credits 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(s) of external CE credit(s). Each participant should claim only those hours of credit that have actually been spent in the educational activity.

Term of Offering

This activity was released on September 30, 2021 and is valid for one year. Requests for credit must be made no later than October 1, 2022.

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, and complete the post-activity questions, evaluation form, and credit request.

Fee Information and Refund/Cancellation Policy

There is no fee for this educational activity.

Disclosure of Conflicts of Interest

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:

Name of Faculty or Presenter

Reported Financial Relationship

Marco Manzi, MD

Consulting Fees: BD Bard, Cook
Speaker’s Bureau: Biotronik, Abbott, Terumo, Angiodroid


Consultant Fee: Bard Peripheral Vascular, Boston Scientific, Cardiovascular Systems, Inc., Medtronic, Philips, Terumo
Grant/Research Support: CardioFlow, Boston Scientific, PQ Bypass

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
Lindsay Borvansky
Nothing to disclose
Andrea Funk
Nothing to disclose
Liddy Knight
Nothing to disclose
Ashley Cann
Nothing to disclose
Kim Rodriguez 
Nothing to disclose
Maria DelCegno
Nothing to disclose
James Miller
Nothing to disclose
Daniel Romanowitz
Nothing to disclose
Paul J. Gagne, MD, FACS, RVT
Consulting Fees: Philips, Cook Medical, Boston Scientific
Contracted Research: Vesper, Humacyte, Boston Scientific, PQ Bypass, Merit Medical, Medtronic, Intervene
Speaker’s Bureau: Philips, Cook Medical, Medtronic, Boston Scientific

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.


Educational Awareness Solutions
7 Hollyhock Road, Wilton, CT 06897
+1 (203) 604-1850

The PVD Channel is intended for healthcare professionals, and the material provided therein is not a substitute for professional medical advice.

All material on this website may not be published, broadcast, rewritten, or redistributed in any form without prior authorization.

Need technical assistance? Email