PVD News

AMERICAN HEART ASSOCIATION NEWS

Early diagnosis and treatment of peripheral artery disease (PAD) are essential to prevent amputations and cardiovascular issues. New guidelines emphasize the need to address disparities in amputation and revascularization procedures to help improve outcomes for all PAD patients. Early diagnosis, a multispecialty approach, and targeted treatments are crucial. Special focus on at-risk groups is essential for better management and outcomes.

CIRCULATION

In the BEST-CLI trial (Best Endovascular Versus Best Surgical Therapy for Patients With Chronic Limb-Threatening Ischemia), a prespecified secondary objective was to assess the effects of revascularization strategy on health-related quality of life (HRQoL).

AMERICAN COLLEGE OF CARDIOLOGY

3D imaging approach improves outcomes with procedure to open clogged arteries in the leg.

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

Patients with chronic limb-threatening ischemia, the terminal stage of peripheral artery disease, are frequently afflicted by below-the-knee disease. Although all patients should receive guideline-directed medical therapy, restoration of inline flow is oftentimes necessary to avoid limb loss. Proper patient selection and proficiency in endovascular techniques for below-the-knee revascularization are intended to prevent major amputation and promote wound healing. This review, a consensus among an international panel of experienced operators, provide...

JOURNAL OF THE SOCIETY FOR CARDIOVASCULAR ANGIOGRAPHY & INTERVENTIONS

Percutaneous revascularization is the primary strategy for treating lower extremity venous and arterial disease. Angiography is limited by its ability to accurately size vessels, precisely determine the degree of stenosis and length of lesions, characterize lesion morphology, or correctly diagnose postintervention complications. These limitations are overcome with use of intravascular ultrasound (IVUS). IVUS has demonstrated the ability to improve outcomes following percutaneous coronary intervention, and there is increasing...

CUREUS

Phlegmasia cerulea dolens is a rare and severe form of deep venous thrombosis (DVT), characterized by an extensive thrombus burden and compromised venous outflow. We present the case of a 28-year-old male with a history of bilateral lower extremity DVTs and multiple venous stents who presented with acute-onset pain and swelling in the left lower extremity. Diagnostic imaging confirmed an acute DVT extending throughout the left lower extremity, including the external iliac vein. Given the diagnosis of phlegmasia cerulea dolens, a multidisciplinary approach involving interventional cardio...

THE LANCET

Chronic limb-threatening ischaemia is the severest manifestation of peripheral arterial disease and presents with ischaemic pain at rest or tissue loss (ulceration, gangrene, or both), or both. We compared the effectiveness of a vein bypass first with a best endovascular treatment first revascularisation strategy in terms of preventing major amputation and death in patients with chronic limb threatening ischaemia who required an infra-popliteal, with or without an additional more proximal infra-inguinal, revascularisation procedure to restore limb perfusion.

THE NEW ENGLAND JOURNAL OF MEDICINE

BACKGROUND Approximately 20% of patients with chronic limb-threatening ischemia have no revascularization options, leading to above-ankle amputation. Transcatheter arterialization of the deep veins is a percutaneous approach that creates an artery-to-vein connection for delivery of oxygenated blood by means of the venous system to the ischemic foot to prevent amputation.

EUROPEAN HEART JOOURNAL OPEN

Sleep duration has been associated with cardiovascular disease, however the effect of sleep on peripheral artery disease (PAD) specifically remains unestablished. We conducted observational and Mendelian randomization (MR) analyses to assess the associations of sleep duration and daytime napping with PAD risk.

CARDIOVASCULAR BUSINESS

We spoke with BEST-CLI trial principal investigators Alik Farber, MD, from Boston Medical Center; Matthew Menard, MD, from Brigham and Women's Hospital; and Ken Rosenfield, MD, from Mass General Hospital during the American Heart Association’s Scientific Sessions 2022 conference in Chicago The trial looked at endovascular versus bypass surgery in patients with critical limb ischemia (CLI) to see which treatment option is better.