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Vascular & Endovascular

 - Big Risk

Before you cross that bridge, consider: A fresh look at the data from ORBIT-AF suggests that bridging oral anticoagulation instead of temporary cessation for a procedure may put patients at greater risk for bleeding or adverse events.

 - Surgery

Consider it one more reason to make that surgery a quick one. Researchers found that the longer a surgery goes, the more risk of venous thromboembolism (VTE) for the patient. 

 - Smoking Skeleton

According to findings presented Nov. 16 at the American Heart Association scientific session in Chicago, endothelial function was just as impaired in rats exposed to second-hand smoke from marijuana as cigarettes.

 - walk

Patients with peripheral artery disease (PAD) and diabetes who underwent treatment with a drug-coated balloon fared better than counterparts who received standard care, according to a subanalysis of the IN.PACT SFA trial.

 - clinical trial

At five years, the Zilver PTX stent proved to be a durable treatment for peripheral artery disease with sustained benefit, results presented Nov. 4 at the 2014 Vascular Interventional Advances (VIVA) meeting showed.


More Stories

Trial seeks best outcomes in midgrade SFA PAD

When a patient’s peripheral artery disease (PAD) is in the middle of two extremes, which is the best method of treatment: open bypass or angioplasty and stenting? A randomized trial is under way to compare treatment outcomes for patients with the middle two tiers of PAD in the superficial femoral artery (SFA). 

Complex patients less likely to die at high-volume stroke centers

Brain hemorrhage survival was highest among patients taken to high-volume stroke care units, according to findings published in the November issue of Neurosurgery. Comprehensive stroke centers and other high-volume stroke care units had the fewest subarachnoid hemorrhage in-hospital deaths, researchers found. 

FDA OKs stent system for peripheral disease

The FDA approved the Ever-Flex Self-Expanding Peripheral Stent System for use in the common and external iliac arteries.

Lowering blood pressure has no effect on stroke outcomes

Blood pressure may not be the key to improving stroke outcomes after all. In an international study published online Oct. 22 in The Lancet, stroke patients randomized to have blood pressure control within 48 hours of infarct did no better than patients whose high blood pressure remained untreated. They did no worse, either. 

EVAR trial results don't sync with real-world outcomes

Endovascular aneurysm repair (EVAR) has a lower 30-day mortality rate than open abdominal aortic aneurysm (AAA) surgery in trials, but rates may not be as low in a real-world setting. Researchers who compared findings from a national clinical database against a recent trial believe the difference may be in the patient cohort’s pre-existing health status.

DEB diverts recurrent in-stent carotid artery restenosis long term

Drug-eluting balloons (DEBs) gave patients with early, recurrent and significant in-stent carotid artery restenosis longer freedom from restenosis in a trial published in the October issue of the Journal of Endovascular Therapy. More than half of patients in this small cohort were symptom-free at a mean follow-up of 36.6 months.

The carotid conundrum

It may look like a fielder’s choice between carotid artery stenting and endarterectomy for patients with carotid artery stenosis, with conclusions from one recent analysis and another randomized trial leaning in opposite directions. 

Surgery vs. stents: Both effective for treating carotid artery stenosis

In the battle between endarterectomy and carotid artery stenting, the patient emerged as the ultimate victor in a study published online Oct. 14 in The Lancet. Both approaches proved to be equally effective at preventing severe stroke at 10 years, giving physicians a green light to choose the treatment that best fits the individual patient.

No equipoise, just better outcomes found in CEA over CAS

Atherosclerotic patients in a real-world setting did better when carotid endarterectomy (CEA) was used as opposed to carotid angioplasty and stenting (CAS). Contradictory to some earlier prospective studies, at no point did researchers find equipoise between the two procedures. 

1 in 5 at-risk stroke patients meet low LDL targets

Efforts to bring low-density lipoprotein (LDL) cholesterol levels within guideline parameters fall short with stroke. Only one in five patients at high risk for recurrent stroke met recommendations for LDL cholesterol levels below 70 mg/dL, according to results published online Oct. 9 in Stroke.

FDA gives drug-coated balloon a green light

The FDA approved a drug-coated balloon (DCB) as a treatment for peripheral artery disease, making it the first DCB to be approved in the U.S. for use in the superficial femoral and popliteal arteries.

Drug-eluting balloon sputters out as infrapopliteal intervention

Patients with critical limb ischemia experienced two-and-a-half-fold higher amputation rates when physicians used paclitaxel-eluting IN.PACT Amphirion drug-eluting balloons as opposed to percutaneous transluminal angiography. Although the trial met its noninferiority threshold, findings resulted in the manufacturer pulling the device from the market.

Watchman gets tepid support from FDA panel

Watchman’s future became even murkier with the latest vote from an FDA advisory panel. Panelists voted unanimously in favor of the device for safety but split on efficacy.

More than a pain: NSAIDs may raise VTE risk

Non-steroidal anti-inflammatory drugs (NSAIDs) may be good for what hurts, but they also could be setting patients up for pulmonary embolism. Venous thromboembolism (VTE) risk was increased in patients on NSAIDs, according to a study published Sept. 29 in Rheumatology.

Pharmacies to offer rivaroxaban starter packs

Janssen Pharmaceuticals plans to make a starter pack of the anticoagulant rivaroxaban available in pharmacies in October. The starter pack is designed to simplify dosing for patients at risk of deep vein thrombosis or pulmonary embolism during the first 30 days of treatment.

Review of thromboembolism treatments finds one laggard, two contenders

Unfractionated heparin-vitamin K antagonist combination was found to be the least effective of venous thromboembolism treatments in a meta-analysis published online Sept. 17 in JAMA while some novel oral anticoagulants carried lower bleeding risks.

SCAI releases recommendations for renal artery stenting

Experts from the Society for Cardiovascular Angiography and Interventions (SCAI) recommended the use of renal artery stenting to benefit patients who historically were excluded from clinical trials in a document published Aug. 19 in Catheterization and Cardiovascular Intervention.

An aspirin a day can keep VTE at bay

Venous thromboembolism (VTE) risks in patients taking aspirin were significantly reduced over nontreatment in a study published online Aug. 25  in Circulation.

Do-it-yourself BP control: Hypertension treatment puts patients in charge

The best way to reduce a patient’s blood pressure may be by getting the patient more involved. Hypertension patients not only effectively self-managed, but saw a greater reduction in mean blood pressure compared to those who did not, according to a study published in the Aug. 27 issue of JAMA.

PAD’s promise: Same-day discharge after angioplasty

Hospitals that want to add efficiencies to their peripheral artery disease (PAD) programs might take a page from PCI’s playbook. Just as same-day PCI can be feasible and safe for selected patients, same-day discharge after angioplasty may be possible for PAD patients.