Disclosures. Critical Limb Ischemia. Vascular Testing in the CLI Patient. Vascular Testing in Critical Limb Ischemia UCSF Vascular Symposium
|
|
- Katrina Bradford
- 5 years ago
- Views:
Transcription
1 Disclosures Vascular Testing in the CLI Patient None 2015 UCSF Vascular Symposium Warren Gasper, MD Assistant Professor of Surgery UCSF Division of Vascular Surgery Critical Limb Ischemia Chronic Limb Ischemia characterized by Ischemic Rest Pain Tissue Loss (non-healing ulceration or gangrene) Prognosis High risk of limb loss High risk of cardiovascular events Vascular Testing in Critical Limb Ischemia 1. Diagnostic Criteria Is this CLI? 2. Prognosis Will this heal? 3. Surveillance after revascularization 1
2 Which of the following tests is best suited to predict the healing potential of a patient with peripheral artery disease and an ulcer on the great toe? A. Contrast angiography with digital subtraction B. Computed Tomography Angiography (CTA) C. Transcutaneous pressure of oxygen (tcpo 2 ) D. 3-phase bone scan C o n t r a s t a n g i o g r a p h y w i.. 10% 10% C o m p u t e d T o m o g r a p h y... T r a n s c u t a n e o u s p r e s s u r e.. 81% 3 - p h a s e b o n e s c a n 0% Methods for Assessing Arterial Insufficiency Hemodynamic Measurements Ankle-brachial index (ABI) Toe-brachial index (TBI) Segmental Doppler Pressures Pulse Volume Recordings Tissue Perfusion Measurements Transcutaneous pressure of oxygen (tcpo 2 ) Skin Perfusion Pressure (SPP) Indocyanine green angiography (ICGA) Anatomic Imaging Duplex ultrasound, CTA, MRA, Angiography Ankle-brachial index Toe-brachial index ABI < 0.4 is consistent with severe PAD CLI is defined by absolute ankle pressure <50mmHg or <70mmHg with tissue loss Advantages: Cheap, quick, easy Disadvantage: Limited use in CLI due to tibial calcification TBI <0.2 Severity of PAD No significant PAD Moderate PAD Severe PAD / CLI Cuff on the toe, PPG or Doppler probe to monitor digital artery CLI is defined by absolute toe pressure <30mmHg or <50mmHg with tissue loss Advantages: Quick Digital artery calcification is uncommon Disadvantages: Special equipment Requires a toe 2
3 Transcutaneous pressure of oxygen (tcpo2) Transcutaneous oxygen tension measurement using a small electrode on the skin Transcutaneous pressure of oxygen (tcpo 2 ) tcpo 2 in practice Oxygen tension reflects the metabolic state of the tissue Limited use in mild to moderate PAD, because oxygen delivery far exceeds demand Severely limited inflow is necessary to create a condition where the balance of oxygen supplydemand can be assessed A reading of 0 represents consumption of all available oxygen, not a lack of flow Interpreting tcpo 2 values: >55mHg is normal >40mmHg wound healing is likely <10mmHg wound healing is unlikely Advantages Validated diagnostic and prognostic value in CLI Measurements are not affected by arterial calcification Can be performed at any level, regardless of wound, lack of toes, etc Disadvantages Time-intensive (30 minutes) Poor reproducibility Can be affected by many factors: Age Skin temperature Body temperature Sympathetic tone Cellulitis Edema Obesity Venous pressure Vertical level of the leg 3
4 Skin Perfusion Pressure (SPP) Laser Doppler probe detects RBC movement up to 1.5mm below the skin Coupled with a blood pressure cuff, the Skin Perfusion Pressure (SPP) can be measured Andersen CA J Vasc Surg 2010; 52:Suppl S Skin Perfusion Pressure (SPP) 403 limbs / 211 patients with PAD 50% diabetic, 21% dialysis-dependent 94 limbs with tissue loss Interpreting SPP values SPP >50mmHg is normal SPP <30mmHg wound healing is unlikely Advantages: Can be done at any level Results are independent of arterial calcification Disadvantages Reproducibility can be affected by the same factors as tcpo 2 J Vasc Surg 2008;47:
5 Indocyanine green angiography (ICGA) Method for assessing regional perfusion using an intravascular fluorophore Indocyanine green is administered intravenously and an 806nm wavelength laser is used for excitation. Resulting fluorescence is recorded with a digital camera ICG has a half-life of min Fluorescence is recorded for about 2 minutes after injection Promise: operator-independent, reproducible data on regional perfusion at the wound site 13 patients with CLI assessed before and after revascularization Phase I/II type report of the parameters that can be measured with the technique J Vasc Surg 2013;57: Testing Angiosomes Angiosome-targeted revascularizations may improve wound healing Angiosome anatomy is typically assessed with angiography The value of angiosome-specific perfusion measured with SPP, tcpo2, or ICGA remains to be seen J Vasc Surg 2013;57: Scand J Surg 101: ,
6 Imaging in CLI Multi-level arterial stenosis is common in critical limb ischemia Pulse exam Presence/absence of femoral and pedal pulses Duplex ultrasound Pro: Non-invasive, hemodynamic assessment Con: Limited evaluation of iliac and heavily calcified arteries Computed Tomography Angiography (CTA) Pro: Fast, non-invasive imaging Con: Radiation, iodinated contrast, calcium bloom Magnetic Resonance Angiography (MRA) Pro: no-radiation, no calcium artifacts Con: gadolinium contrast, long acquisition times Angiogram Pro: resolution, hemodynamic assessments, therapeutic Con: invasive, radiation, iodinated contrast Conclusions Toe pressure is the gold standard for noninvasive testing to predict wound healing There is no single perfect test for assessing foot perfusion in critical limb ischemia Perfusion based techniques may have a better predictive value for wound healing and for planning angiosome-directed revascularizations, although current technologies are limited by reproducibility 6
UC SF. Disclosures. Vascular Assessment of the Diabetic Foot. What are the best predictors of wound healing? None. Non-Invasive Vascular Studies
Disclosures Vascular Assessment of the Diabetic Foot What are the best predictors of wound healing? None Shant Vartanian MD Assistant Professor of Vascular Surgery UCSF Vascular Symposium April 20, 2013
More informationClinical Approach to CLI and Related Diagnostics: What You Need to Know
Clinical Approach to CLI and Related Diagnostics: What You Need to Know Ido Weinberg, MD Assistant Professor of Medicine Harvard Medical School Massachusetts General Hospital None Disclosures Critical
More informationPerfusion Assessment in Chronic Wounds
Perfusion Assessment in Chronic Wounds American Society of Podiatric Surgeons Surgical Conference September 22, 2018 Michael Maier, DPM, FACCWS Cardiovascular Medicine Cleveland Clinic Disclosures Speaker,
More informationLarry Diaz, MD, FSCAI Mehdi H. Shishehbor, DO, FSCAI
PAD Diagnosis Larry Diaz, MD, FSCAI Metro Health / University of Michigan Health, Wyoming, MI Mehdi H. Shishehbor, DO, FSCAI University Hospitals Harrington Heart & Vascular Institute, Cleveland, OH PAD:
More informationNon- invasive vascular testing. Pros and Cons of ABIs and Alternative Physiologic Assessments
Non- invasive vascular testing Pros and Cons of ABIs and Alternative Physiologic Assessments Non- Invasive Physiologic Arterial Studies Segmental Systolic Pressure Measurements ABIs, TBIs, and full segmentals
More informationCurrent Vascular and Endovascular Management in Diabetic Vasculopathy
Current Vascular and Endovascular Management in Diabetic Vasculopathy Yang-Jin Park Associate professor Vascular Surgery, Samsung Medical Center Sungkyunkwan University School of Medicine Peripheral artery
More informationV.A. is a 62-year-old male who presents in referral
, LLC an HMP Communications Holdings Company Clinical Case Update Latest Trends in Critical Limb Ischemia Imaging Amit Srivastava, MD, FACC, FABVM Interventional Cardiologist Bay Area Heart Center St.
More informationImaging for Peripheral Vascular Disease
Imaging for Peripheral Vascular Disease James G. Jollis, MD Director, Rex Hospital Cardiovascular Imaging Imaging for Peripheral Vascular Disease 54 year old male with exertional calf pain in his right
More informationArterial Studies And The Diabetic Foot Patient
Arterial Studies And The Patient George L. Berdejo, BA, RVT, FSVU gberdejo@wphospital.org Disclosures I have nothing to disclose! Diabetes mellitus continues to grow in global prevalence and to consume
More informationEVALUATION OF THE VASCULAR STATUS OF DIABETIC WOUNDS Travis Littman, MD NorthWest Surgical Specialists
EVALUATION OF THE VASCULAR STATUS OF DIABETIC WOUNDS Travis Littman, MD NorthWest Surgical Specialists Nothing To Disclosure DISCLOSURES I have no outside conflicts of interest, financial incentives, or
More informationPedal Bypass With Deep Venous Arterialization:
Pedal Bypass With Deep Venous Arterialization: Long Term Result For Critical Limb Ischemia With Unreconstructable Distal Arteries Pramook Mutirangura Professor of Vascular Surgery Faculty of Medicine Siriraj
More informationDue to Perimed s commitment to continuous improvement of our products, all specifications are subject to change without notice.
A summary Disclaimer The information contained in this document is intended to provide general information only. It is not intended to be, nor does it constitute, medical advice. Under no circumstances
More informationPractical Point in Holistic Diabetic Foot Care 3 March 2016
Diabetic Foot Ulcer : Vascular Management Practical Point in Holistic Diabetic Foot Care 3 March 2016 Supapong Arworn, MD Division of Vascular and Endovascular Surgery Department of Surgery, Chiang Mai
More informationNational Clinical Conference 2018 Baltimore, MD
National Clinical Conference 2018 Baltimore, MD No relevant financial relationships to disclose Wound Care Referral The patient has been maximized from a vascular standpoint. She has no other options.
More informationImaging Strategy For Claudication
Who are the Debators? Imaging Strategy For Claudication Duplex Ultrasound Alone is Adequate to Select Patients for Endovascular Intervention - Pro: Dennis Bandyk MD No Disclosures PRO - Vascular Surgeon
More informationPeripheral Arterial Disease. Westley Smith MD Vascular Fellow
Peripheral Arterial Disease Westley Smith MD Vascular Fellow Background (per 10,000) Goodney P, et al. Regional intensity of vascular care and lower extremity amputation rates. JVS. 2013; 6: 1471-1480.
More informationPeripheral Artery Disease Interventions Utilizing the Angiosomal Approach to the Complex Wound
Peripheral Artery Disease Interventions Utilizing the Angiosomal Approach to the Complex Wound Craig M. Walker, MD, FACC, FACP Chairman, New Cardiovascular Horizons Clinical Professor of Medicine Tulane
More informationRole of ABI in Detecting and Quantifying Peripheral Arterial Disease
Role of ABI in Detecting and Quantifying Peripheral Arterial Disease Difference in AAA size between US and Surgeon 2 1 0-1 -2-3 0 1 2 3 4 5 6 7 Mean AAA size between US and Surgeon Kathleen G. Raman MD,
More informationObjective assessment of CLI patients Hemodynamic parameters
Objective assessment of CLI patients Hemodynamic parameters Worth anything in end stage patients? Marianne Brodmann Angiology, Medical University Graz, Austria Disclosure Speaker name: Marianne Brodmann
More informationGarland Green, MD Interventional Cardiologist. Impact of PAD: Prevalence, Risk Factors, Testing, and Medical Management
Garland Green, MD Interventional Cardiologist Impact of PAD: Prevalence, Risk Factors, Testing, and Medical Management Peripheral Arterial Disease Affects over 8 million Americans Affects 12% of the general
More informationThe Many Views of PAD: Imaging Modalities for the Interventionist
The Many Views of PAD: Imaging Modalities for the Interventionist Timothy E. Yates, MD Interventional Vascular & Oncological Radiology Mount Sinai Medical Center 5 December 2015 None Disclosures Objectives
More informationI have no financial disclosures
Manpreet Singh MD I have no financial disclosures Exercise Treadmill Bicycle Functional capacity assessment Well validated prognostic value Ischemic assessment ECG changes ST segments Arrhythmias Hemodynamic
More informationFluorescent Angiography: Practical uses in the Clinical Setting
Fluorescent Angiography: Practical uses in the Clinical Setting Charles Andersen MD, FACS, MAPWCA Chief Vascular/Endovascular/ Limb Preservation Surgery Service (Emeritus) Chief of Wound Care Service Madigan
More informationFluorescence Angiography in Limb Salvage
Fluorescence Angiography in Limb Salvage Ryan H. Fitzgerald, DPM, FACFAS Associate Professor of Surgery-University Of South Carolina School of Medicine, Greenville Etiology of Lower extremity wounds Neuropathy
More informationLower Extremity Artery: Physiologic Testing
Master Title Ultrasound for Initial Evaluation of Lower Extremity Arterial Occlusive Disease: WHY? Gregory L. Moneta MD Professor and Chief Knight Cardiovascular Institute Division of Vascular Surgery
More informationMy Diabetic Patient Has No Pulses; What Should I Do?
Emily Malgor, MD Assistant Professor of Surgery University of Oklahoma, Oklahoma City My Diabetic Patient Has No Pulses; What Should I Do? There are no disclosures. Background Diabetes affects 387 million
More informationNon-Invasive Assessment of Neuroischemic Limb, What s New. Minimally-Invasive Assessment of Neuroischemic Limb, What s New
Non-Invasive Assessment of Neuroischemic Limb, What s New Minimally-Invasive Assessment of Neuroischemic Limb, What s New Venita Chandra, MD Clinical Assistant Professor of Surgery Division of Stanford
More informationWill it heal? How to assess the probability of wound healing
Will it heal? How to assess the probability of wound healing Richard F. Neville, M.D. Professor of Surgery Chief, Division of Vascular Surgery George Washington University Limb center case 69 yr old male
More informationGlobal Vascular Guideline on the Management of Chronic Limb Threatening Ischemia -a new foundation for evidence-based care
Global Vascular Guideline on the Management of Chronic Limb Threatening Ischemia -a new foundation for evidence-based care Michael S. Conte MD Professor and Chief, Division of Vascular and Endovascular
More informationLIMB SALVAGE IN THE DIABETIC PATIENT
LIMB SALVAGE IN THE DIABETIC PATIENT WHO? HOW? BEST? DISCLOSURES Educational grant from Cook Inc OBJECTIVES Review risk stratification and staging schemes for the threatened limb Discuss current concepts
More informationStratifying Management Options for Patients with Critical Limb Ischemia: When Should Open Surgery Be the Initial Option for CLI?
Stratifying Management Options for Patients with Critical Limb Ischemia: When Should Open Surgery Be the Initial Option for CLI? Peter F. Lawrence, M.D. Gonda Vascular Center Division of Vascular Surgery
More informationAcknowledgements. No tengo conflictos de interés que revelar. I have no conflicts of interest to disclose. Michael S. Conte. David G.
No tengo conflictos de interés que revelar I have no conflicts of interest to disclose. Critical Limb Ischemia : The Need for a New System to Define Disease Burden and Stratify Amputation Risk and Need
More informationLower Extremity Arterial Disease
Lower Extremity Arterial Disease Circulating the Facts About Peripheral Disease Brought to you by the Education Committee of the Society for 1 www.svnnet.org Peripheral Artery Disease (PAD) Many people
More informationGLOBAL VASCULAR GUIDELINES: A NEW PATHWAY FOR LIMB SALVAGE
GLOBAL VASCULAR GUIDELINES: A NEW PATHWAY FOR LIMB SALVAGE Michael S. Conte MD Professor and Chief, Vascular and Endovascular Surgery Co-Director, Center for Limb Preservation Co-Director, Heart and Vascular
More informationForget about the angiosome theories. Yann Gouëffic, MD, PhD Department of vascular surgery, institut du thorax, Nantes, France
Forget about the angiosome theories Yann Gouëffic, MD, PhD Department of vascular surgery, institut du thorax, Nantes, France Disclosure of Interest Research grants /Consulting/Honoraria for - Abbott -
More informationGuidelines for Management of Peripheral Arterial Disease
Guidelines for Management of Peripheral Arterial Disease Subhash Banerjee, MD, FACC, FSCAI Professor of Medicine, Univ. of Texas Southwestern Medical Center Chief, Division of Cardiology, VA North Texas
More informationSurgery is and Remains the Gold Standard for Limb-Threatening Ischemia
Surgery is and Remains the Gold Standard for Limb-Threatening Ischemia Albeir Mousa, MD., FACS.,MPH., MBA Professor of Vascular and Endovascular Surgery West Virginia University Disclosure None What you
More informationDiagnosis and Endovascular Treatment of Critical Limb Ischemia: What You Need to Know S. Jay Mathews, MD, MS, FACC
Diagnosis and Endovascular Treatment of Critical Limb Ischemia: What You Need to Know S. Jay Mathews, MD, MS, FACC Interventional Cardiologist/Endovascular Specialist Bradenton Cardiology Center Bradenton,
More informationIndex. cardiology.theclinics.com. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A ABI. See Ankle-brachial index (ABI). Afterload, deconstructing of, in ventricular vascular interaction in heart failure, 449 Air plethysmography
More informationEvaluating The Utility Of Spect/ct Imaging Of Angiosome Perfusion In Diabetic Patients With Critical Limb Ischemia
Yale University EliScholar A Digital Platform for Scholarly Publishing at Yale Yale Medicine Thesis Digital Library School of Medicine 1-1-2017 Evaluating The Utility Of Spect/ct Imaging Of Angiosome Perfusion
More informationDisclosures. Carotid artery stenting. Surveillance after Endovascular Intervention: When to Re-Intervene and What s the Evidence
Disclosures Surveillance after Endovascular Intervention: When to Re-Intervene and What s the Evidence None 2015 UCSF Vascular Symposium Warren Gasper, MD Assistant Professor of Surgery UCSF Division of
More informationPractical Point in Diabetic Foot Care 3-4 July 2017
Diabetic Foot Ulcer : Role of Vascular Surgeon Practical Point in Diabetic Foot Care 3-4 July 2017 Supapong Arworn, MD Division of Vascular and Endovascular Surgery Department of Surgery, Chiang Mai University
More informationSTPH Clinic for Wound Care and Hyperbaric Medicine
STPH Clinic for Wound Care and Hyperbaric Medicine Ochsner/St. Tammany Partnership John Kessels, MD Medical Director St. Tammany Wound Center Chantal Lorio, DPM Associate Medical Director Ochsner Wound
More informationUSWR 23: Outcome Measure: Non Invasive Arterial Assessment of patients with lower extremity wounds or ulcers for determination of healing potential
USWR 23: Outcome Measure: Non Invasive Arterial Assessment of patients with lower extremity wounds or ulcers for determination of healing potential MEASURE STEWARD: The US Wound Registry [Note: This measure
More informationPhysician s Vascular Interpretation Examination Content Outline
Physician s Vascular Interpretation Examination Content Outline (Outline Summary) # Domain Subdomain Percentage 1 2 3 4 5 6 Cerebrovascular Abdominal Peripheral Arterial - Duplex Imaging Peripheral Arterial
More informationClasificación WIFI: Finalmente hablaremos el mismo idioma! WIfI: Wound, Ischemia, foot Infection The SVS Threatened Limb Classification
Clasificación WIFI: Finalmente hablaremos el mismo idioma! WIfI: Wound, Ischemia, foot Infection The SVS Threatened Limb Classification Joseph L. Mills, Sr., M.D. Professor of Surgery, Chief, Vascular
More informationVeinOPlus Vascular Peripheral Vascular & Wound Therapy Device
VeinOPlus Vascular Peripheral Vascular & Wound Therapy Device Calf Muscle Pump Dysfunction Therapy Increases blood flow, accelerates wound healing, and improves CVD and PAD symptoms Tomorrow s Technology
More informationSAVE LIMBS SAVE LIVES!
SAVE LIMBS SAVE LIVES! PAD Awareness: The Key to Limb Preservation By Frank J Tursi, D.P.M., F.A.C.F.A.S. Epidemiology Over 12 million people are afflicted with PAD 11 Million of these-dm 4 Million DFU
More informationPATIENT SPECIFIC STRATEGIES IN CRITICAL LIMB ISCHEMIA. Dr. Manar Trab Consultant Vascular Surgeon European Vascular Clinic DMCC Dubai, UAE
PATIENT SPECIFIC STRATEGIES IN CRITICAL LIMB ISCHEMIA Dr. Manar Trab Consultant Vascular Surgeon European Vascular Clinic DMCC Dubai, UAE Disclosure Speaker name: DR. Manar Trab I have the following potential
More informationDisclosures. Talking Points. An initial strategy of open bypass is better for some CLI patients, and we can define who they are
An initial strategy of open bypass is better for some CLI patients, and we can define who they are Fadi Saab, MD, FASE, FACC, FSCAI Metro Heart & Vascular Metro Health Hospital, Wyoming, MI Assistant Clinical
More informationSkin Perfusion Pressure (SPP) Assessments with the moorvms-vasc Application note #105
innovation in microvascular assessment Skin Perfusion Pressure (SPP) Assessments with the moorvms-vasc Application note #105 Application Skin Perfusion Pressure (SPP) is the pressure required for restoring
More informationManaging Conditions Resulting from Untreated Cardiometabolic Syndrome
Managing Conditions Resulting from Untreated Cardiometabolic Syndrome Matthew P. Namanny DO, FACOS Vascular/Endovascular Surgery Saguaro Surgical/AZ Vascular Specialist Tucson Medical Center Critical Limb
More informationBoca Raton Regional Hospital Grand Rounds September 13, 2016
Boca Raton Regional Hospital Grand Rounds September 13, 2016 W. Anthony Lee, MD, FACS Chief, BocaCare Vascular Surgery Christine E. Lynn Heart and Vascular Institute Boca Raton, Florida Disclosures No
More informationIntroduction to Peripheral Arterial Disease. Stacey Clegg, MD Interventional Cardiology August
Introduction to Peripheral Arterial Disease Stacey Clegg, MD Interventional Cardiology August 20 2014 Outline (and for the ABIM board exam * ** ***) Prevalence* Definitions Lower Extremity: Aorta*** Claudication***
More informationVASCULAR DISEASE: THREE THINGS YOU SHOULD KNOW JAMES A.M. SMITH, D.O. KANSAS VASCULAR MEDICINE, P.A. WICHITA, KANSAS
VASCULAR DISEASE: THREE THINGS YOU SHOULD KNOW JAMES A.M. SMITH, D.O. KANSAS VASCULAR MEDICINE, P.A. WICHITA, KANSAS KANSAS ASSOCIATION OF OSTEOPATHIC MEDICINE ANNUAL CME CONVENTION APRIL 13, 2018 THREE
More informationJun 15, CPT codes and are assigned for bilateral upper or lower extremity arterial assessments to check blood flow in relation to a
Jun 15, 2009. CPT codes 93922 and 93923 are assigned for bilateral upper or lower extremity arterial assessments to check blood flow in relation to a blockage.. 93922 Noninvasive physiologic studies of
More informationI am no good at debates!
Disclosure Statement of Financial Interest Imaging Strategy for Claudication: Ultrasound Alone is Not Adequate to Select Patients for Endovascular Intervention Within the past 12 months, I or my spouse/partner
More informationApproach to the Patient with (suspected) Arterial Insufficiency Related Ulceration
Approach to the Patient with (suspected) Arterial Insufficiency Related Ulceration Elisa C. Taffe, MD, CWSP Vascular Medicine Medical Director Allegheny General Advanced Wound Healing and Lymphedema Center
More informationThe relation of 2D perfusion angiography after BTK intervention and wound healing in patient with CLI - Single center prospective study -
The relation of 2D perfusion angiography after BTK intervention and wound healing in patient with CLI - Single center prospective study - Shinya Sasaki, MD. Saka General Hospital Miyagi, JAPAN Disclosure
More informationMR Angiography in the evaluation of Lower Extremity Arterial Disease
March 2001 MR Angiography in the evaluation of Lower Extremity Arterial Disease Ted Mau, Harvard Medical School Year III Objectives We will cover: Indications for Magnetic Resonance Angiography (MRA) Basic
More informationDisclosure. Objectives. Pre Test Question One. Pre Test Question Three. Pre Test Question Two. Assessing Bloodflow and Perfusion in Chronic Wounds
Disclosure Assessing Bloodflow and Perfusion in Chronic Wounds Enoch T. Huang, MD, MPH&TM, FUHM Adventist Medical Center Portland, OR Novadaq Technologies, Inc. Speaker s Bureau Consultant Clinician Advisory
More informationRecommendations for Follow-up After Vascular Surgery Arterial Procedures SVS Practice Guidelines
Recommendations for Follow-up After Vascular Surgery Arterial Procedures 2018 SVS Practice Guidelines vsweb.org/svsguidelines About the guidelines Published in the July 2018 issue of Journal of Vascular
More informationJohn E. Campbell, MD Assistant Professor of Surgery and Medicine Department of Vascular Surgery West Virginia University, Charleston Division
John E. Campbell, MD Assistant Professor of Surgery and Medicine Department of Vascular Surgery West Virginia University, Charleston Division John Campbell, MD For the 12 months preceding this CME activity,
More informationDETECT-PAD Computerized and patient specific model to determine pressure gradients in borderline iliac artery stenosis with MRA/ CTA
DETECT-PAD Computerized and patient specific model to determine pressure gradients in borderline iliac artery stenosis with MRA/ CTA Jean-Paul P.M. de Vries Head Department of Surgery University Medical
More informationVascular screening in diabetic patients: how aggressive should we be and when to intervene?
Vascular screening in diabetic patients: how aggressive should we be and when to intervene? Roberto Ferraresi Peripheral Interventional Unit Bergamo Italy Disclosure Speaker name: ROBERTO FERRARESI X X
More information1 of :19
1 of 8 3-12-2012 12:19 Diabetic foot ulcer classification system for research purposes Introduction Aims of the ulcer research classification system Definitions and categorisation for the ulcer research
More informationSurgical Options for revascularisation P E T E R S U B R A M A N I A M
Surgical Options for revascularisation P E T E R S U B R A M A N I A M The goal Treat pain Heal ulcer Preserve limb Preserve life The options Conservative Endovascular Surgical bypass Primary amputation
More informationCLINICAL PRESENTATION AND RADIOLOGY QUIZ QUESTION
Donald L. Renfrew, MD Radiology Associates of the Fox Valley, 333 N. Commercial Street, Suite 100, Neenah, WI 54956 6/30/2012 Radiology Quiz of the Week # 79 Page 1 CLINICAL PRESENTATION AND RADIOLOGY
More informationNow That You Have the Tools
blockosu@gmail.com Now That You Have the Tools Alan Jay Block, DPM, MS, FASPS, FACFAS Assistant Professor Dept Of Orthopeadics The Ohio State University Medical Board Kent State University Editor-in -Chief
More informationCritical Limb Ischemia A Collaborative Approach to Patient Care. Christopher LeSar, MD Vascular Institute of Chattanooga July 28, 2017
Critical Limb Ischemia A Collaborative Approach to Patient Care Christopher LeSar, MD Vascular Institute of Chattanooga July 28, 2017 Surgeons idea Surgeons idea represents the final stage of peripheral
More informationSalvaging the Unsalvageable: Intermittent Pneumatic Compression and Foot Ulcer Healing. Revascularize (when possible)
Salvaging the Unsalvageable: Intermittent Pneumatic Compression and Foot Ulcer Healing Thom Rooke, MD Thom Krehbiel Professor of Vascular Medicine Mayo Clinic Approach to the Severely Ischemic Limb Identify
More informationIntercepting PAD. Playbook for Cardiovascular Care 2018 February 24, Jonathan D Woody, MD, FACS. University Surgical Vascular
Intercepting PAD Playbook for Cardiovascular Care 2018 February 24, 2018 Jonathan D Woody, MD, FACS University Surgical Vascular Attending Vascular Surgeon - Piedmont Athens Regional Adjunct Clinical Associate
More informationNorth American Society of Cardiovascular Imaging Annual Meeting, Baltimore MD, October 15-18, Tips and Tricks in Vascular Imaging
North American Society of Cardiovascular Imaging Annual Meeting, Baltimore MD, October 15-18, 2016 Tips and Tricks in Vascular Imaging Lower Extremity CTA Dominik Fleischmann, Richard Hallett Division
More informationOMNIA case results: Lumee Oxygen measurements representative for CLI wound healing prognosis. M Werner 1 Feb 2018
OMNIA case results: Lumee Oxygen measurements representative for CLI wound healing prognosis M Werner 1 Feb 2018 Disclosure Speaker name:... I have the following potential conflicts of interest to report:
More informationPeripheral arterial disease for primary care Ed Aboian, MD
Peripheral arterial disease for primary care Ed Aboian, MD Division of Vascular and Endovascular Surgery Palo Alto Medical Foundation, Burlingame Ca Disclosures Nothing to disclose Clinical presentation
More informationMaximally Invasive Vascular Surgery for the Treatment of Critical Limb Ischemia
Maximally Invasive Vascular Surgery for the Treatment of Critical Limb Ischemia Traci A. Kimball, MD Department of Surgery Grand Rounds Septemember 13, 2010 Overview Defining Critical Limb Ischemia Epidemiology
More informationSteal Syndrome: The Role of the Vascular Lab
Steal Syndrome: The Role of the Vascular Lab Eighth Overlook Noninvasive Vascular Lab Symposium Larry A. Scher, M.D. Professor of Surgery Division of Vascular Surgery Montefiore Medical Center Albert Einstein
More informationPUT YOUR BEST FOOT FORWARD
PUT YOUR BEST FOOT FORWARD Bala Ramanan, MBBS 1 st year vascular surgery fellow Introduction The epidemic of diabetes and ageing of our population ensures critical limb ischemia will continue to grow.
More informationCase Discussion. Disclosures. Critical Limb Ischemia: A Selective Approach to Revascularization Works Best 4/28/2012. None. 58 yo M, DM, CAD, HTN
Critical Limb Ischemia: A Selective Approach to Revascularization Works Best None Disclosures Michael S. Conte MD, FACS Division of Vascular and Endovascular Surgery Co-Director, Heart and Vascular Center
More informationUtility of Exercise-Induced Zero TBI Sign in Patients on Maintenance Hemodialysis
2016 Annals of Vascular Diseases doi:10.3400/avd.oa.16-00074 Original Article Utility of Exercise-Induced Zero TBI Sign in Patients on Maintenance Hemodialysis Kazuo Tsuyuki, CVT, PhD, 1 Kenji Kohno, PhD,
More informationArterial & Venous Ulcers. A Comprehensive Review Assessment & Management
Arterial & Venous Ulcers A Comprehensive Review Assessment & Management 1 Objectives Understand Arterial & Venous disease Understand the etiology of lower extremities ulcers Understand assessment of lower
More informationNurse and Technician Forum Part II Critical Limb Ischemia: Optimal care, an interdisciplinary challenge
L E I P Z I G I N T E R V E N T I O N A L C O U R S E 2017 Nurse and Technician Forum Part II Critical Limb Ischemia: Optimal care, an interdisciplinary challenge Markus Haumer Landesklinikum Baden-Mödling
More informationPeripheral Arterial Disease: Who has it and what to do about it?
Peripheral Arterial Disease: Who has it and what to do about it? Seth Krauss, M.D. Alaska Annual Nurse Practitioner Conference September 16, 2011 Scope of the Problem Incidence: 20%
More informationSynchronous TBI and ABI measurement Scheme for Diabetes Patients Synchronous Sphygmomanometer of Four Limbs
Synchronous Sphygmomanometer of Four Limbs Sung-Tsun Shih 1, Kuan-Yu Chang 2 Department of Electronic Engineering, Cheng Shiu University, Kaohsiung, Taiwan. 2 Mackay Memorial Hospital Taitung Branch, Taitung,
More informationThe present status of selfexpanding. for CLI: Why and when to use. Sean P Lyden MD Cleveland Clinic Cleveland, Ohio
The present status of selfexpanding and balloonexpandable tibial BMS and DES for CLI: Why and when to use Sean P Lyden MD Cleveland Clinic Cleveland, Ohio Disclosure Speaker name: Sean Lyden, MD I have
More informationAngiosome concept myth or truth? Does it make a real difference in real world cases?
Angiosome concept myth or truth? Does it make a real difference in real world cases? Osamu Iida, MD, FACC Kansai Rosai Hospital Amagasaki, Hyogo, Japan Disclosure Speaker name:... I have the following
More informationNon-invasive examination
Non-invasive examination Segmental pressure and Ankle-Brachial Index (ABI) The segmental blood pressure (SBP) examination is a simple, noninvasive method for diagnosing and localizing arterial disease.
More informationInterventional Treatment First for CLI
Interventional Treatment First for CLI Patrick Alexander, MD, FACC, FSCAI Interventional Cardiology Medical Director, Critical Limb Clinic Providence Heart Institute, Southfield MI 48075 Disclosures Consultant
More informationRadiologic Evaluation of Peripheral Arterial Disease
January 2003 Radiologic Evaluation of Peripheral Arterial Disease Grace Tye, Harvard Medical School Year III Patient D.M. CC: 44 y/o male with pain in his buttocks Occurs after walking 2 blocks. Pain is
More informationPeripheral Arterial Disease Extremity
Peripheral Arterial Disease Lower Extremity 05 Contributor Dr Steven Chong Advisors Dr Ashish Anil Dr Tay Jam Chin Introduction Risk Factors Clinical Presentation Classification History PHYSICAL examination
More informationRichard C. Staab Memorial Symposium. Vascular Primer for the Internist Sharolyn Cook DO OSU Dept of IM, Cardiology Division
Richard C. Staab Memorial Symposium Vascular Primer for the Internist Sharolyn Cook DO OSU Dept of IM, Cardiology Division Goals of our 50 min Together Review the incidence and prevalence of vascular disease
More informationAngiosome revascularization strategies in real world practice: how much difference does it make?
Angiosome revascularization strategies in real world practice: how much difference does it make? Peter A. Schneider, MD Kaiser Foundation Hospital Honolulu, Hawaii Disclosure Peter A. Schneider... I have
More informationDisclosures. Tips and Tricks for Tibial Intervention. Tibial intervention overview
Tips and Tricks for Tibial Intervention Donald L. Jacobs, MD C Rollins Hanlon Endowed Professor and Chair Chair of Surgery Saint Louis University SSM-STL Saint Louis University Hospital Disclosures Abbott
More informationPeripheral Arterial Disease: Diagnosis and Management
National Institute for Health and Care Excellence Consultation Peripheral Arterial Disease: Diagnosis and Management [A] Evidence review for determining diagnosis and severity of PAD in people with diabetes
More informationPeripheral Arterial Disease: Objectives. Disclosure. Definition: Peripheral Arterial Disease (PAD)
Geriatric Grand Rounds Tuesday, April 21, 2009 12:00 noon Dr. Bill Black Auditorium Glenrose Rehabilitation Hospital In keeping with Glenrose Rehabilitation Hospital policy, speakers participating in this
More informationAmputation as a Last Resort A Multidisciplinary Approach to Limb Salvage
Amputation as a Last Resort A Multidisciplinary Approach to Limb Salvage George L. Adams, MD, MHS, MBA, FACC, FSCAI Clinical Associate Professor of Medicine University of North Carolina Health System Director
More informationWhat s New in the Management of Peripheral Arterial Disease
What s New in the Management of Peripheral Arterial Disease Sibu P. Saha, MD, MBA Professor of Surgery Chairman, Directors Council Gill Heart Institute University of Kentucky Lexington, KY Disclosure My
More informationPOPLITEAL ARTERY ENTRAPMENT SYNDROME
POPLITEAL ARTERY ENTRAPMENT SYNDROME Background 1. Definition: Rare cause of exertional leg pain o Due to an abnormal relationship between popliteal artery and surrounding myofascial structures in popliteal
More informationObjectives. Abdominal Aortic Aneuryms 11/16/2017. The Vascular Patient: Diagnosis and Conservative Treatment
The Vascular Patient: Diagnosis and Conservative Treatment Ferrell-Duncan Clinic Zachary C. Schmittling, M.D., F.A.C.S. Vascular and General Surgery Ferrell-Duncan Clinic Cox Health Systems Objectives
More informationAccess strategy for chronic total occlusions (CTOs) is crucial
Learn How Access Strategy Impacts Complex CTO Crossing Arthur C. Lee, MD The Cardiac & Vascular Institute, Gainesville, Florida VASCULAR DISEASE MANAGEMENT 2018;15(3):E19-E23. Key words: chronic total
More information