Orbital atherectomy - Another tool in the art of peripheral arterial intervention

2009 ◽  
pp. NA-NA
Author(s):  
Ivan P Casserly
Keyword(s):  
Arterial Intervention ◽  
Orbital Atherectomy ◽  
Peripheral Arterial

scholarly journals P6: ANTIPLATELET AND ANTICOAGULANT USE IN RANDOMISED TRIALS OF PATIENTS UNDERGOING ENDOVASCULAR INTERVENTION FOR PERIPHERAL ARTERIAL DISEASE: SYSTEMATIC REVIEW

2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
MI Qureshi ◽  
HL Li ◽  
GK Ambler ◽  
KHF Wong ◽  
S Dawson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Peripheral Arterial Disease ◽  
Antiplatelet Therapy ◽  
Dual Antiplatelet Therapy ◽  
Arterial Intervention ◽  
Arterial Disease ◽  
Endovascular Intervention ◽  
Randomised Trials ◽  
Peripheral Arterial ◽  
High Level

Abstract Introduction Guideline recommendations for antithrombotic (antiplatelet and anticoagulant) therapy during and after endovascular intervention are patchy and conflicted, in part due to a lack of evidence. The aim of this systematic review was to examine the antithrombotic specifications in randomised trials for peripheral arterial endovascular intervention. Method This review was conducted according to PRISMA guidelines. Randomised trials including participants with peripheral arterial disease undergoing endovascular arterial intervention were included. Trial methods were assessed to determine whether an antithrombotic protocol had been specified, its completeness, and the agent(s) prescribed. Antithrombotic protocols were classed as periprocedural (preceding/during intervention), immediate postprocedural (up to 14 days following intervention) and maintenance postprocedural (therapy continuing beyond 14 days). Trials were stratified according to type of intervention. Result Ninety-four trials were included. Only 29% of trials had complete periprocedural antithrombotic protocols, and 34% had complete post-procedural protocols. In total, 64 different periprocedural protocols, and 51 separate postprocedural protocols were specified. Antiplatelet monotherapy and unfractionated heparin were the most common choices of regimen in the periprocedural setting, and dual antiplatelet therapy (55%) was most commonly utilised postprocedure. There is an increasing tendency to use dual antiplatelet therapy with time or for drug-coated technologies. Conclusion Randomised trials comparing different types of peripheral endovascular arterial intervention have a high level of heterogeneity in their antithrombotic regimens, and there has been an increasing tendency to use dual antiplatelet therapy over time. Antiplatelet regimes need to be standardised in trials comparing endovascular technologies. Take-home message To determine the benefits of any endovascular intervention within a randomised trial, antithrombotic regimens should be standardised to prevent confounding. This systematic review demonstrates a high level of heterogeneity of antithrombotic prescribing in randomised trials of endovascular intervention, and an increasing tendency to utilise dual antiplatelet therapy, despite a lack of evidence of benefit, but an increased risk of harm.

Clinical and economic burden of heparin-induced thrombocytopenia in hospitalized patients undergoing percutaneous peripheral arterial interventions

Vascular ◽  
2019 ◽  
Vol 28 (1) ◽  
pp. 81-86 ◽  
Author(s):  
Ahmed Subahi ◽  
Mohammed Osman ◽  
Oluwole Adegbala ◽  
Hossam Abubakar ◽  
Babikir Kheiri ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Pulmonary Embolism ◽  
Ischemic Stroke ◽  
Venous Thrombosis ◽  
Arterial Intervention ◽  
Kidney Injury ◽  
Heparin Induced Thrombocytopenia ◽  
Baseline Characteristics ◽  
Peripheral Arterial ◽  
Prolonged Hospital

Background Percutaneous peripheral arterial intervention (PPAI) patients are at a high risk of developing heparin-induced thrombocytopenia due to the need for repeated and prolonged heparin exposure. We sought to investigate the incidence, outcomes, and economic impact of heparin-induced thrombocytopenia post-PPAI utilizing the National Inpatient Sample. Methods All patients who underwent PPAI (age ≥18 years) from 2007 to 2014 were identified by using ICD-9-CM codes. Patients were then classified into two groups based on the presence or absence of heparin-induced thrombocytopenia during hospitalization. In-hospital outcomes were compared between the two groups after propensity-score matching to account for differences in baseline characteristics. Results Heparin-induced thrombocytopenia was reported in 527 patients (0.23%). After adjusting for patient-level and hospital-level characteristics, in-hospital mortality differences were not significantly different between patients with heparin-induced thrombocytopenia vs. those without heparin-induced thrombocytopenia (odds ratio (OR) 1.02, 95% confidence interval (CI) 0.67 to 1.57, p = 0.951). However, PPAI patients with heparin-induced thrombocytopenia were more likely to develop ischemic stroke (OR 3.84, 95%CI 1.26 to 11.75, p = 0.018), deep venous thrombosis/pulmonary embolism (OR 1.32, 95%CI 0.79 to 1.79, p = 0.078), and acute kidney injury requiring dialysis (OR 4.04, 95%CI 1.72 to 9.50, p = 0.001). Furthermore, post-PPAI patients who developed heparin-induced thrombocytopenia had longer hospitalizations (13.8 vs. 9.8 days, p < 0.0001), higher cost of stay ($62,022 vs. $44,904, p < 0.0001), and higher rates of non-routine home discharges (50.15% vs. 42.19%, p = 0.013). Conclusion Among patients who underwent PPAI, heparin-induced thrombocytopenia was associated with a higher risk of venous thrombosis/pulmonary embolism, ischemic stroke, acute kidney injury requiring dialysis, prolonged hospital stay, and increased cost.

scholarly journals Successful Use of the MYNXGRIP Closure Device during Repeated Transbrachial Percutaneous Peripheral Intervention

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Klaus Hertting ◽  
Werner Raut
Keyword(s):  
Arterial Intervention ◽  
Arterial Puncture ◽  
Closure Device ◽  
Peripheral Arterial

The use of closure devices after transbrachial arterial puncture is still controversial. Here we report on a case where the MYNXGRIP (AccessClosure Inc., Santa Clara, CA, USA) could be used successfully in a patient, who underwent percutaneous peripheral arterial intervention twice via transbrachial access.

Infrainguinal Arterial Intervention: Is There a Role for an Atherectomy Device?

Vascular ◽  
2006 ◽  
Vol 14 (5) ◽  
pp. 313-318 ◽  
Author(s):  
Leila Mureebe ◽  
James F. McKinsey
Keyword(s):  
Peripheral Arterial Disease ◽  
Arterial Intervention ◽  
Arterial Disease ◽  
Atheromatous Plaque ◽  
Peripheral Arteries ◽  
Invasive Treatment ◽  
Attractive Option ◽  
Percutaneous Removal ◽  
Peripheral Arterial ◽  
Redwood City

Excision of atheromatous plaque is an attractive option for the minimally invasive treatment of peripheral arterial disease. Approved for use in 2003, the SilverHawk Plaque Exicison System (FoxHollow Technologies, Redwood City, CA) is a catheter-based plaque excision device allowing percutaneous removal of atheromatous material. This device represents the most recent generation of atherectomy tools. Overall experience with plaque debulking in the peripheral arteries spans almost two decades, and understanding of the technique continues to evolve. This article reviews the technology, current practices, and data on plaque excision.

scholarly journals Impact of severe chronic kidney disease on outcomes of infrainguinal peripheral arterial intervention

2014 ◽  
Vol 59 (2) ◽  
pp. 368-375 ◽  
Author(s):  
Virendra I. Patel ◽  
Shankha Mukhopadhyay ◽  
Julie M. Guest ◽  
Mark F. Conrad ◽  
Michael T. Watkins ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Arterial Intervention ◽  
Severe Chronic Kidney Disease ◽  
Peripheral Arterial

scholarly journals Initial Experience With the Terumo Radial to Peripheral Catheter System for Peripheral Arterial Intervention

2019 ◽  
Vol 70 (2) ◽  
pp. e24 ◽  
Author(s):  
David J. O'Connor ◽  
Stanton Nielsen ◽  
Priya Patel ◽  
Kristin Cook ◽  
Anjali Ratnathicam ◽  
...  
Keyword(s):  
Arterial Intervention ◽  
Initial Experience ◽  
Catheter System ◽  
Peripheral Catheter ◽  
Peripheral Arterial

Two Cases of Compartment Syndrome Complicating Percutaneous Transluminal Peripheral Arterial Intervention

2002 ◽  
Vol 32 (5) ◽  
pp. 442
Author(s):  
Jae Hun Jung ◽  
Pil Ki Min ◽  
Bon Kwon Koo ◽  
Ki Hwan Kwon ◽  
Young Guk Ko ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Arterial Intervention ◽  
Peripheral Arterial ◽  
Percutaneous Transluminal
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