Library

Welcome to the Library of Vascupedia. Use our filters on the left side of the page to quickly find the content of your interest. You may select an area of interest and the respective indication or the media type.

Poll 04/10/2019 – 31/10/2019

Choice of antiplatelet therapy around complex revascularisation

A 79-year-old diabetic male patient with no history of coronary disease is referred to you to undergo angioplasty for tissue loss on the tips of the hallux and second toe. He is taking Aspirin 75mg. From preoperative imaging he needs a 20cm SFA occlusion stopping before the adductor hiatus recanalizing as well as multilevel tibial disease which appears to be a combination of short occlusions and stenoses. The dorsal pedal is seen in the foot and is in continuity with the arch. The PT artery appears occluded through it’s whole length.

Recorded video case

Retrograde femoropopliteal recanalization through the dorsal pedal artery

This case demonstrates the recanalization of the femoropopliteal artery in a patient with CLTI. The reason for the solely retrograde approach was a Y-graft for AAA having the anastomoses at both common femoral arteries, the above-knee amputation of the contralateral limb and the extent of the disease. Primary stent implantation was performed by using the Pulsar-18 (Biotronik) bare-metal stent, which has a 4Fr profile and a proven efficacy according to the 4EVER trial.

July 14, 2019 No Comments
Clinical investigation

24-month outcomes in the EVOLUTION study: Investigating the iVolution stent in femoropopliteal lesions

Investigating the iVolution 3rd generation nitinol stent in TASC A&B femoropopliteal lesions : 24-month outcomes in the EVOLUTION study, first presented at LINC 2019.

January 28, 2019 No Comments
Clinical investigation

Final 12-month results of the ZILVERPASS-RCT of ZILVER PTX vs. bypass

ZILVER PTX treatment versus bypass surgery for the treatment of TASC C&D fempop lesions.
Final 12-month results of the ZILVERPASS study, first presented at LINC 2019.

January 28, 2019 No Comments
Awareness

VRTD 2: Association between PTX-coated devices and overall mortality

This is an exclusive interview with the first three authors (Dr. Katsanos, Dr. Spiliopoulos, Dr. Kitrou) of the paper entitled ‘Risk of Death Following Application of Paclitaxel-Coated Balloons and Stents in the Femoropopliteal Artery of the Leg: A Systematic Review and Meta-Analysis of Randomized Controlled Trials’ (J Am Heart Assoc. 2018 Dec 18;7(24):e011245). The authors answered relevant questions about the impact of their findings and the future of PTX-eluting devices.

January 11, 2019 6 Comments
Review of the literature

When to use a self-expandable covered stent in the SFA in PAD patients?

In this presentation, we demonstrate three interesting and debatable PAD cases, where a self-expandable covered stent was used to treat different types of SFA disease. The decision making about the use of a self-expandable stent is supported by a current overview of the literature.

December 18, 2018 1 Comment
Case report

Decision making by a complex case of iatrogenically created A-V fistula with concomitant AAA and fem-pop bypass occlusion

This is a complex case of a 74-year-old female with an acute onset of rest pain of the right limb. Previous Rx: primary stenting of both renal arteries, endovascular repair of both CIA in CERAB technique and fem-pop 1 bypass right limb.
During her current readmission, the CT-scan revealed a high-flow AV fistula of the right CFA, an abdominal aortic aneurysm (4.7 cm), an occluded stent in the right renal artery as well as an occluded fem-pop bypass. What would you do in this case?

November 29, 2018 No Comments
Live case

Two different techniques for retrograde infrainguinal CTO recanalization

This live case demonstrates two different techniques of retrograde recanalization: through collaterals of the CTO and through a retrograde tibial puncture. Moreover, you will see tips and tricks about the snaring of the wire and the further steps of such a procedure. Finally, the intervention was performed with CO2 angiography due to the chronic kidney disease of this patient suffering from chronic limb-threatening ischemia (CLTI).

November 26, 2018 No Comments
Review of the literature

Decision-making in intermediate femoropopliteal lesions

Professor Katsanos (Interventional Radiology, Patras, Greece) provides an evidence-based overview of different techniques and devices for the treatment of intermediate (<15cm) femoropopliteal lesions. Which should be your first treatment strategy? Which is the role of drug-eluting stents? Do we have enough evidence about atherectomy? What is vessel prep and how important is for the durability of the treatment strategy? Is there still space for the use of stent-grafts in the SFA?

October 8, 2018 No Comments
Poll 01/10/2018 – 31/10/2018

Critical limb-threatening ischemia – CLI Global Society

Patient’s characteristics

 

Gender: Male

Age: 79 years old

Comorbidity: Arterial hypertension, hypercholesterinemia, chronic kidney disease (GFR: 53 ml/min/1,73m²), NYHA II, Coronary artery disease, previous CABG

Symptoms:  Toe ulceration of the left limb

Previous operations: None

ABI: incompressible, Toe pressure: 32 mmHg

Vascular Imaging – Duplex ultrasound: Isolated tibial vessel disease