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Yasuhiro Honda, MD. Clinical Professor, Medicine - Cardiovascular Medicine. David Lee, MD. Jennifer Tremmel. Susan P. Simon H. Celina Yong. This profile is not available. Abstract Critical limb ischemia CLI is a terminal stage of peripheral arterial disease that, in the absence of intervention, may lead to lower extremity amputation or death. Endovascular interventions have become a first-line approach to the management of CLI and have advanced considerably within [ Critical limb ischemia CLI is a terminal stage of peripheral arterial disease that, in the absence of intervention, may lead to lower extremity amputation or death.

Endovascular interventions have become a first-line approach to the management of CLI and have advanced considerably within the past decade. This review summarizes the types of percutaneous devices and the techniques that are available for the management of CLI and the data supporting their use. These include devices that establish and maintain vessel patency, including percutaneous transluminal angioplasty, drug-coated balloons, bare metal stents, drug-eluting stents, bioresorbable vascular scaffolds, and atherectomy; devices that provide protection from embolization; and, cell-based therapies.

The beginning

Additionally, ongoing trials with important implications for the field are discussed. Open Access Feature Paper Review. Abstract Venous disease is more common than peripheral arterial disease. Pathophysiologically, venous disease can be associated with obstruction, reflux, or both. A common feature in chronic venous disease is ambulatory venous hypertension. Inflammatory and pro-thrombotic mechanisms can be activated. The current therapies, including compression, [ Venous disease is more common than peripheral arterial disease.

The current therapies, including compression, ablation, and recanalization are discussed. Abstract Percutaneous coronary intervention PCI with stenting for the treatment of acute coronary syndrome ACS is the contemporary standard of care. The efficacy of this therapy has been [ Percutaneous coronary intervention PCI with stenting for the treatment of acute coronary syndrome ACS is the contemporary standard of care. The efficacy of this therapy has been well established but the optimal duration of DAPT remains elusive, and has thus far attracted a prodigious deal of scientific attention.

The decision regarding DAPT duration can be clinically challenging in the modern era with the evolution of newer stents, more potent antiplatelet agents, and novel anticoagulant drugs in addition to an older patient population with multiple comorbidities. The following review is aimed at critically evaluating the available evidence to help make these crucial clinical decisions regarding duration of DAPT and triple therapy.

Figure 1. Abstract The trans-venous implantable cardioverter defibrillator TV-ICD is effective in treating life-threatening ventricular arrhythmia and reduces mortality in high-risk patients. However, there are significant short- and long-term complications that are associated with intravascular leads.

Multimodality Imaging in the Cardiac Catheterization Laboratory

These shortcomings are mostly relevant in young patients with long [ The trans-venous implantable cardioverter defibrillator TV-ICD is effective in treating life-threatening ventricular arrhythmia and reduces mortality in high-risk patients. These shortcomings are mostly relevant in young patients with long life expectancy and low risk of death from non-arrhythmic causes.

Drawbacks of trans-venous leads recently led to the development of the entirely subcutaneous implantable cardioverter defibrillator S-ICD. The S-ICD does not require vascular access or permanent intravascular defibrillation leads. Therefore, it is expected to overcome many complications associated with conventional ICDs. This review highlights data on safety and efficacy of the S-ICD and is envisioned to help in identifying the role of this device in clinical practice.

The very latest advances about to be unveiled 31 August to 4 September in Paris, France

The primary sensing vector was selected by the system and approved by the physician. One year after implantation, the patient experienced an episode of ventricular fibrillation. Time to therapy was Abstract Non-surgical left atrial appendage occlusion has emerged as an alternative to anticoagulant therapy in the management of stroke risk in patients with atrial fibrillation.

This review reports on some of the more common devices that are currently being used to manage patients in [ Non-surgical left atrial appendage occlusion has emerged as an alternative to anticoagulant therapy in the management of stroke risk in patients with atrial fibrillation. This review reports on some of the more common devices that are currently being used to manage patients in this challenging group. Image reproduced with permission from Boston Scientific.

Abstract Interventional cardiologists have witnessed an explosive growth in the field. A wide array of percutaneous procedures allow us to treat numerous cardiac conditions less invasively. However, the way we work has changed very little over the past decades. We continue to stand at [ Interventional cardiologists have witnessed an explosive growth in the field. We continue to stand at the tableside for prolonged periods of time, exposing ourselves to the very real risks of radiation exposure as well as to the associated orthopedic injuries from radiation protection.

The precision of our procedures is limited by the distance from the fluoroscopic images and, furthermore, patients are potentially at risk from operator fatigue caused by a physician standing at the table for prolonged periods while wearing cumbersome radiation protection gear.

Robotic-assisted coronary intervention removes the operator from the radiation field and has been shown to markedly reduce operator exposure as well as allow for more precise positioning of balloons and stents.

Cardiovascular medicine will never be the same

This technology holds great promise for making interventional procedures safer and more comfortable for the operators as well as reducing fatigue, potentially improving patient outcomes. These images are from a 72 year-old with unstable angina referred to our hospital for intervention. Terms and Conditions Privacy Policy. We use cookies on our website to ensure you get the best experience. Safety and efficacy of dalcetrapib on atherosclerotic disease using novel non-invasive multimodality imaging dal-PLAQUE : a randomised clinical trial. Lancet ;— From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: Part II.

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