Lower extremity ischemia due to unusual causes Non-atherosclerotic disease and dissection
|
|
|
- Theodora May
- 5 years ago
- Views:
Transcription
1 Lower extremity ischemia due to unusual causes Non-atherosclerotic disease and dissection Kenneth Rosenfield, MD, MHCDS, MSCAI Section of Vascular Medicine and Intervention Cardiology Division MGH, Boston, MA
2 Kenneth Rosenfield, MD Conflicts of Interest Consultant/Scientific Advisory Board Abbott Vascular Cardinal Health Inari Medical InspireMD Surmodics Volcano/Philips Proteon Personal Equity Access Vascular CardioMEMs Contego CRUZAR Systems Embolitech Icon Janacare MD Insider Primacea PQ Bypass Vortex Consultant/Scientific Advisory Board with Equity or Stock Options Capture Vascular Contego CRUZAR Systems Endospan Eximo MD Insider Micell Shockwave Silk Road Medical Valcare Research or Fellowship Support Abbott Vascular Atrium NIH Lutonix-Bard Board Member VIVA Physicians
3 Lower Extremity Ischemia Due to Inflow Compromise Causes that are non-standard (i.e. Not related directly to PAOD) Symptoms and presentation How to diagnose and treat
4 CASE 20 year old male college student on cycling scholarship Competitive cyclist, miles/ride Lt leg aching during exercise x years 2 mos of Lt leg weakness w/maximal exertion Starts in groin, extends to thigh Resolve 2-10 minutes w/rest Vascular Exam - Normal
5 Physical Exam (cont.) Vascular: 2+ C, R, B, A, F, P, PT, DP bilaterally No carotid bruits No radio-radial or radio-femoral delays +Lt femoral systolic bruit No right femoral or pelvic bruit No change in pedal pulses with knee or hip flexion No elevation pallor or dependent rubor
6 Bicyclist - Resting ABI
7 Post Cycle Ergometry 284 cm/sec
8 CT Angiogram Abd/Pel/Run-off Mild stenosis Post - stenotic dilation
9 46 yo F, amateur runner with left thigh claudication Focal Stenosis Saw in past 4 yrs: chiropractor Acupuncturist sports medicine physician Neurologist Clinical evaluation electromyography muscle biopsy Neg hx for athero Exam normal Resting PVR/ABI normal Exercise absent Lt pedal signal
10 Endofibrosis of Iliac Artery Pathophysiology repeated stretching/compression of ext iliac extrinsic compression by hypertrophic psoas enhanced shear force from supraphysiological flow Epidemiology Rare Mostly cyclists; occas runners
11 Treatment Conservative Activity modification Surgical options Endofibrosectomy with patch angioplasty Reconstruction with interposition graft Percutaneous options IVUS/translesion pressure gradient Angioplasty +/- stent
12 46 yo F, amateur runner with left thigh claudication Focal Stenosis Post PTA and stent
13 Iliac endofibrosis in a runner: 9 year follow up post-stent
14 Other Aorto-iliac Causes of Lower Extremity Ischemia Atypical causes of PAOD Pseudoxanthoma elasticum Coral reef pathology Non-atherosclerotic PAD External Iliac Artery Endofibrosis Iliac Artery FMD Medium and Large Vessel Vasculitis Takayasu s arteritis (TA) Giant cell arteritis (GCA) Behcet disease Mid-Aortic Syndrome Aortic Dissection
15 Iliac Artery Fibromuscular Dysplasia string of beads 5% of all FMD cases Renal/carotid FMD often present Often accompanied by PAOD Rx PTA (+/-stent)
16 Non-Atherosclerotic Causes of Lower Extremity Ischemia (Aorto-iliac level) What features makes should make one think of non-atherosclerotic causes? Younger age Absence of atherosclerotic risk factors, or athero in other vascular beds Inconsistencies between symptoms and imaging findings Sx to suggest inflammation fever, sweats,etc. (mucosal lesions for Behcet s)
17 Aortic Dissection- Initial presentation Acute limb ischemia or sudden onset of claudication sx s Pain: Chest, Back, Abdomen Limb pain, weakness, parasthesia, paralysis Pulse deficit or pulseless Compartment syndrome Bladder dysfunction
18 IRAD Registry 17 year trends (12/95 2/13) 28 International Centers 4428 patients w/acute Aortic Dissection 67% type A 33% type B Demographics 2/3 men 77% HTN 4% Marfans Pape et al. Presentation, Diagnosis, and Outcomes of Acute Aortic Dissection: 17-Year Trends From the International Registry of Acute Aortic Dissection. J Am Coll Cardiol. 2015;66(4):
19 IRAD Registry 17 year trends Symptoms on presentation Severe pain (worst ever) Chest pain Back pain HTN Pulse deficit Type A (%) Type B(%) Pape et al. Presentation, Diagnosis, and Outcomes of Acute Aortic Dissection: 17-Year Trends From the International Registry of Acute Aortic Dissection. J Am Coll Cardiol. 2015;66(4):
20 IRAD Registry 17 year trends Management/Outcome Surgery (open) Medical Rx EndoRx (for distal malperf) Mortality in-hosp Type A (%) Type B (%) <5 (mortal-71) Pape et al. Presentation, Diagnosis, and Outcomes of Acute Aortic Dissection: 17-Year Trends From the International Registry of Acute Aortic Dissection. J Am Coll Cardiol. 2015;66(4):
21 Mechanisms of Malperfusion Syndromes (LE and Visceral) Static Obstruction Dissection extends into the branch vessel lumen
22 Mechanisms of Malperfusion Syndromes Dynamic Obstruction Distal re-entry No distal re-entry Distension of the false lumen compresses the true lumen and impairs its flow
23 Thoracic Aortic Endovascular Stent-grafts for Non-surgical Management of Type B Dissection Purpose: Close entry site (intimal tear) Decompress false lumen/ promote its thrombosis Relieve obstruction of branch arteries
24 Malperfusion Syndromes: Surgical Fenestration of Affected Segment Overall mortality 18%
25 Endovascular Techniques for Non-surgical Management of Acute Vascular Complications Static obstruction: Stent affected arterial branch Dynamic obstruction Balloon fenestrate intimal flap to decompress the false lumen and restore flow in true lumen In IRAD centers from : 5% were treated with percutaneous stenting or fenestration procedures
26 Fenestration Procedure FL FEN FL 26
27 Sequential 10 16mm dilation across fenestration FL TL FEN FEN 27
28 Palmaz 3010 deployed to 16mm immed below fenestration. Kissing balloons FEN 28
29 Lt Iliac Stent Final 29 Post-procedure 2+ femoral & ankle pulses bilat Resolution of sx s
30 Iatrogenic Causes Dissection or plaque disruption Stent malpositioning Atheroembolism Graft or stent thrombosis Closure device failure
31
32 Arteriotomy management LE Ischemia Vascular Closure Devices Manual compression Fem-o-stop Post closure device Byrne RA, et al. Nat. Rev. Cardiol. 2013; 10:
33 Vascular Closure Devices (meta-analysis data) Limb ischemia 3 out of 1000 patients with closure device Biancari F, et al. Am Heart J 2010; 159:
34 Conclusion Non-Atherosclerotic Etiology for LE extremity ischemia is infrequent Clinician must be aware of these various entities, or will miss important diagnoses
35 The Global Education Course for Vascular Medicine and Intervention September 18-22, 2016 Wynn Las Vegas Attend live, online Visit our booth!
36 Lower extremity ischemia due to unusual causes Non-atherosclerotic disease and dissection Kenneth Rosenfield, MD, MHCDS, MSCAI Section of Vascular Medicine and Intervention Cardiology Division MGH, Boston, MA
BEST-CLI Trial Study Concept and Current Status
BEST-CLI Trial Study Concept and Current Status Kenneth Rosenfield, MD, MHCDS National Co-PI BEST-CLI Trial Section Head, Vascular Medicine and Intervention Institute for Heart, Vascular, and Stroke Care
Thrombus Removal in Acute Pulmonary Embolism: When and How?
Thrombus Removal in Acute Pulmonary Embolism: When and How? Kenneth Rosenfield, MD, MHCDS, MSCAI Cardiology Division Section of Vascular Medicine and Intvn MGH Kenneth Rosenfield, MD, MHCDS Conflicts of
CT angiography in type I acute aortic dissection complicated with malperfusion - a visual review of obstruciton patterns
CT angiography in type I acute aortic dissection complicated with malperfusion - a visual review of obstruciton patterns Eneva M. St. Ekaterna University Hospital Report objectives 1. Review malperfusion
Subclavian artery Stenting
Subclavian artery Stenting Etiology Atherosclerosis Takayasu s arteritis Fibromuscular dysplasia Giant Cell Arteritis Radiation-induced Vascular Injury Thoracic Outlet Syndrome Neurofibromatosis Incidence
Endovascular Treatment of Malperfusion Syndrome
Endovascular Treatment of Malperfusion Syndrome in Type B Aortic Dissection Department of Cardiology, Pusan National luniveristy i Hospital, Han Cheol Lee Endovascular Treatment Indication of Type B Aortic
Acute Type B dissection. Closure of the infra diaphragmatic tear: how and when?
Acute Type B dissection. Closure of the infra diaphragmatic tear: how and when? Prof. Olgierd Rowiński II Department of Clinical Radiology Medical University of Warsaw Disclosure Speaker name: Olgierd
NON-ATHEROSCLEROTIC PATHOLOGY OF THE CAROTID ARTERIES
NON-ATHEROSCLEROTIC PATHOLOGY OF THE CAROTID ARTERIES Leslie M. Scoutt, MD, FACR Professor of Diagnostic Radiology & Surgery Vice Chair, Dept of Radiology & Biomedical Imaging Chief, Ultrasound Section
Malperfusion Syndromes Type B Aortic Dissection with Malperfusion
Malperfusion Syndromes Type B Aortic Dissection with Malperfusion Jade S. Hiramoto, MD, MAS April 27, 2012 Associated with early mortality Occurs when there is end organ ischemia secondary to aortic branch
Peripheral Vascular Disease
Peripheral artery disease (PAD) results from the buildup of plaque (atherosclerosis) in the arteries of the legs. For people with PAD, symptoms may be mild, requiring no treatment except modification of
Coral Reef Aorta- Treatment Options?
Chronic mesenteric ischemia (CMI) Coral Reef Aorta- Treatment Options? Bala Ramanan Vascular Fellow, UCSF CMI is a life-threatening problem that can result in death from inanition or bowel infarction Incidence
Practical 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
CORAL Trial Aftermath: What Do We Do Now? Renal Revascularization in Perspective
CORAL Trial Aftermath: What Do We Do Now? Renal Revascularization in Perspective Michael R. Jaff, DO Massachusetts General Hospital Boston, Massachusetts, USA Michael R. Jaff, DO Conflicts of Interest
FMD 101. Esther S.H. Kim, MD, MPH, FACC, FSVM FMDSA Annual Meeting 18 May 2013
FMD 101 Esther S.H. Kim, MD, MPH, FACC, FSVM FMDSA Annual Meeting 18 May 2013 Back to basics Blood Bodily fluid that transports necessary substances (oxygen, nutrients, antibodies, hormones, etc) and waste
Patterns of Vessel Calcification and Clinical Relevance
Patterns of Vessel Calcification and Clinical Relevance Michael R. Jaff, DO Paul and Phyllis Fireman Endowed Chair in Vascular Medicine Massachusetts General Hospital Professor of Medicine Harvard Medical
Combat Extremity Vascular Trauma
Combat Extremity Vascular Trauma Training teams to be a TEAM Chatt A. Johnson LTC, MC, USA 08 March 2010 US Army Trauma Training Center Core Discussion Series Outline: Combat Vascular Injury Physiologic
RadRx Your Prescription for Accurate Coding & Reimbursement Copyright All Rights Reserved.
Interventional Radiology Coding Case Studies Prepared by Stacie L. Buck, RHIA, CCS-P, RCC, CIRCC, AAPC Fellow President & Senior Consultant Week of November 19, 2018 Abdominal Aortogram, Bilateral Runoff
The role of false lumen intervention to promote remodelling via induced thrombosis the FLIRT concept
The role of false lumen intervention to promote remodelling via induced thrombosis the FLIRT concept Professor Christoph A. Nienaber The Royal Brompton and Harefield NHS Trust Cardiology and Aortic Centre
Subclavian Revascularization. Douglas E. Drachman, MD, FSCAI Division of Cardiology Vascular Medicine Section December 9, 2014
Subclavian Revascularization Douglas E. Drachman, MD, FSCAI Division of Cardiology Vascular Medicine Section December 9, 2014 Disclosure Information Douglas E. Drachman, MD, FACC Abbott Vascular, Inc.:
Minimally Invasive Treatment Options for Renal Artery FMD
Minimally Invasive Treatment Options for Renal Artery FMD FMDSA Meeting 2016 Alan H. Matsumoto, M.D., FSIR, FACR, FAHA Professor and Chair Department of Radiology & Medical Imaging University of Virginia
Aortic Triumph or Tragedy. Sean Lyden, MD Cleveland Clinic Cleveland, Ohio
Aortic Triumph or Tragedy Sean Lyden, MD Cleveland Clinic Cleveland, Ohio Disclosures Consultant: Phillips, Endologix, Shockwave, Abbott, BSC, Medtronic, PQ Bypass VIVA Physicians 501c3 Board Member Stock
Algorithm for Managing Acute Lower Extremity Ischemia. Peter A. Schneider, MD Honolulu, Hawaii
Algorithm for Managing Acute Lower Extremity Ischemia Peter A. Schneider, MD Honolulu, Hawaii Disclosure Peter A. Schneider, MD... I have the following potential conflicts of interest to report: Consulting:
Introduction 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***
Garland 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
Peripheral Arterial Disease: A Practical Approach
Peripheral Arterial Disease: A Practical Approach Sanjoy Kundu BSc, MD, FRCPC, DABR, FASA, FCIRSE, FSIR The Scarborough Hospital Toronto Endovascular Centre The Vein Institute of Toronto Scarborough Vascular
Open fenestration for complicated acute aortic B dissection
Art of Operative Techniques Open fenestration for complicated acute aortic B dissection Santi Trimarchi 1, Sara Segreti 1, Viviana Grassi 1, Chiara Lomazzi 1, Marta Cova 1, Gabriele Piffaretti 2, Vincenzo
The Petticoat Technique Managing Type B Dissection with both Early and Long Term Considerations
The Petticoat Technique Managing Type B Dissection with both Early and Long Term Considerations Joseph V. Lombardi, MD Professor & Chief, Division of Vascular & Endovascular Surgery Department of Surgery,
Acute dissections of the descending thoracic aorta (Debakey
Endovascular Treatment of Acute Descending Thoracic Aortic Dissections Nimesh D. Desai, MD, PhD, and Joseph E. Bavaria, MD Acute dissections of the descending thoracic aorta (Debakey type III or Stanford
Endovascular Management of Thoracic Aortic Pathology Stéphan Haulon, J Sobocinski, B Maurel, T Martin-Gonzalez, R Spear, A Hertault, R Azzaoui
Endovascular Management of Thoracic Aortic Pathology Stéphan Haulon, J Sobocinski, B Maurel, T Martin-Gonzalez, R Spear, A Hertault, R Azzaoui Aortic Center, Lille University Hospital, France Disclosures
Hybrid Procedures for Peripheral Obstructive Disease - Step by Step -
Hybrid Procedures for Peripheral Obstructive Disease - Step by Step - Holger Staab, MD University Hospital Leipzig, Germany Clinic for Vascular Surgery Disclosure Speaker name:..holger Staab... I have
Christian Wissgott MD, PhD Assistant Director, Radiology Westküstenkliniken Heide
2-Year Results Of The Tack Optimized Balloon Angioplasty (TOBA) Trial For Fem- Pop Lesions Demonstrates Safety and Efficacy Of The Tack Endovascular System In Repairing Focal Post-PTA Dissections Christian
AORTIC DISSECTIONS Current Management. TOMAS D. MARTIN, MD, LAT Professor, TCV Surgery Director UF Health Aortic Disease Center University of Florida
AORTIC DISSECTIONS Current Management TOMAS D. MARTIN, MD, LAT Professor, TCV Surgery Director UF Health Aortic Disease Center University of Florida DISCLOSURES Terumo Medtronic Cook Edwards Cryolife AORTIC
Diagnosis and Management of Femoral Access Site Complications IV: Novel Techniques for Endovascular Rescue
Diagnosis and Management of Femoral Access Site Complications IV: Novel Techniques for Endovascular Rescue Robert M. Bersin, M.D. Director, Endovascular Services Seattle Cardiology and the Cardiovascular
Disclosures: Acute Aortic Syndrome. A. Michael Borkon, M.D. Director of CV Surgery Mid America Heart Institute Saint Luke s Hospital Kansas City, MO
Acute Aortic Syndrome Disclosures: A. Michael Borkon, M.D. Director of CV Surgery Mid America Heart Institute Saint Luke s Hospital Kansas City, MO No financial relationships to disclose 1 Acute Aortic
Asymptomatic Radiology / Clinical data Report / Cohort bias Referral bias. UCSF Vascular Symposium April 7-9, Acute Aortic Dissection
Aortic Dissection: Natural History What is the Natural History of Aortic Dissection? UCSF Vascular Symposium April 7-9, 2011 Asymptomatic Radiology / Clinical data Report / Cohort bias Referral bias Stephen
Peripheral 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
Step by step Hybrid procedures in peripheral obstructive disease. Holger Staab, MD University Hospital Leipzig, Germany Clinic for Vascular Surgery
Step by step Hybrid procedures in peripheral obstructive disease Holger Staab, MD University Hospital Leipzig, Germany Clinic for Vascular Surgery Disclosure Speaker name: H.H. Staab I have the following
Introduction. Risk factors of PVD 5/8/2017
PATHOPHYSIOLOGY AND CLINICAL FEATURES OF PERIPHERAL VASCULAR DISEASE Dr. Muhamad Zabidi Ahmad Radiologist and Section Chief, Radiology, Oncology and Nuclear Medicine Section, Advanced Medical and Dental
Non-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.
Intervention for Deep Venous Thrombosis and Pulmonary Embolus
Intervention for Deep Venous Thrombosis and Pulmonary Embolus Michael R. Jaff, DO Paul and Phyllis Fireman Endowed Chair in Vascular Medicine Massachusetts General Hospital Professor of Medicine Harvard
Long Lesions: Primary stenting or DCB first? John Laird MD Adventist Heart and Vascular Institute, St. Helena, CA
Long Lesions: Primary stenting or DCB first? John Laird MD Adventist Heart and Vascular Institute, St. Helena, CA Disclosures John R. Laird Within the past 12 months, I or my spouse/partner have had a
UC SF. Disclosures. Thoracic Endovascular Aortic Repair 4/24/2009. Management of Acute Dissections: Is There Still a Role for Open Surgery?
UC SF Management of Acute Dissections: Is There Still a Role for Open Surgery? Darren B. Schneider, M.D. Assistant Professor of Surgery and Radiology Division of Vascular Surgery University of California
Radiologic 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
Role 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,
Resident Teaching Conference 3/12/2010
Resident Teaching Conference 3/12/2010 Goals Definition and Classification of Acute Limb Ischemia Clinical Assessment of the Vascular Patient History and Physical Diagnostic Modalities Management of Acute
PERPHERAL ARTERY ANEURYSM. By Pooja Sharma and Susanna Sebastianpillai
PERPHERAL ARTERY ANEURYSM By Pooja Sharma and Susanna Sebastianpillai Defintions True Aneurysm Involves all three layers of the vessel. Have two basic shapes; Fusiform = symmetric widening of the vessels
SCAI Fall Fellows Course Subclavian/Innominate Case Presentation
SCAI Fall Fellows Course 2012 Subclavian/Innominate Case Presentation Daniel J. McCormick DO, FACC, FSCAI Director, Cardiovascular Interventional Therapy Pennsylvania Hospital University of Pennsylvania
Current Role of Renal Artery Stenting in Patients with Renal Artery Stenosis
Current Role of Renal Artery Stenting in Patients with Renal Artery Stenosis Young-Guk Ko, M.D. Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea Etiology Fibromuscular
Device Evolution. Atherectomy: Where Do We Stand After 12 Years Since FDA Clearance. Where Do We Stand? 4/18/2015
Disclosure Statement of Financial Interest Atherectomy: Where Do We Stand After 12 Years Since FDA Clearance Within the past 12 months, I or my spouse/partner have had a financial interest/arrangement
Imaging 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
Patient Brochure. Clearstream Technologies, Ltd. Moyne Upper Enniscorthy Co. Wexford, Ireland. PK Rev. 0 05/17
Patient Brochure Clearstream Technologies, Ltd. Moyne Upper Enniscorthy Co. Wexford, Ireland PK1411100 Rev. 0 05/17 LIFESTREAM Patient Brochure If you or a member of your family has been diagnosed with
Diagnosis 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,
Cath Lab Essentials : Peripheral Vascular Disease in Patients with CAD
Cath Lab Essentials : Peripheral Vascular Disease in Patients with CAD Pranav M. Patel, MD, FACC, FSCAI Interim Chief & Associate Professor of Medicine Director, Cardiac Catheterization Lab University
11 TH ANNUAL VASCULAR NONINVASIVE TESTING SYMPOSIUM NOVEMBER 10, 2018
11 TH ANNUAL VASCULAR NONINVASIVE TESTING SYMPOSIUM NOVEMBER 10, 2018 RENAL ARTERY DISEASE AND RENOVASCULAR HYPERTENSION 1 WHAT IS RENOVASCULAR HYPERTENSION? https://my.clevelandclinic.org/health/diseases/16459-renovascular-hypertension
Abdominal Exam: The examination of the abdomen used by physicians to detect an abdominal aortic aneurysm.
Glossary of Terms Abdominal Exam: The examination of the abdomen used by physicians to detect an abdominal aortic aneurysm. Angiogram: A diagnostic test requiring the insertion of a catheter into an artery
La sindrome aortica acuta oggi
University of Milan Thoracic Aortic Research Center La sindrome aortica acuta oggi Santi Trimarchi, MD, PhD Professore Associato di Chirurgia Vascolare, Università degli Studi di Milano Direttore, Divisione
TOBA II 12-Month Results Tack Optimized Balloon Angioplasty
TOBA II 12-Month Results Tack Optimized Balloon Angioplasty William Gray, MD System Chief, Cardiovascular Division Main Line Health, Philadelphia, PA Dissection: The Primary Mechanism of Angioplasty Lesions
9/7/2018. Disclosures. CV and Limb Events in PAD. Challenges to Revascularization. Challenges. Answering the Challenge
Disclosures State-of-the-Art Endovascular Lower Extremity Revascularization Promotional Speaker Jansen Pharmaceutical Promotional Speaker Amgen Pharmaceutical C. Michael Brown, MD, FACC al Cardiology Associate
Non Atheromatous Lesions Fibromuscular Dysplasia. Rod Samuelson, MD Babak Jahromi,, MD Elad Levy, MD Adnan Siddiqui,, PhD, MD Nick Hopkins, MD
Non Atheromatous Lesions Fibromuscular Dysplasia Rod Samuelson, MD Babak Jahromi,, MD Elad Levy, MD Adnan Siddiqui,, PhD, MD Nick Hopkins, MD Presenter Disclosure Information L. Nelson Hopkins MD FINANCIAL
Boca 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
WHICH PLACE FOR EMERGENT INTERVENTION IN COMPLICATED ACUTE TYPE B DISSECTION (ctbaod)
WHICH PLACE FOR EMERGENT INTERVENTION IN COMPLICATED ACUTE TYPE B DISSECTION (ctbaod) Epidemiology of type B Aortic Dissection TYPE B dissection: 0,5-2,1/100.000/year (40% of all dissection) Hospital mortality
CHALLENGING ILIAC ACCESSES AND THROMBOSIS PREVENTION
CHALLENGING ILIAC ACCESSES AND THROMBOSIS PREVENTION ARMANDO MANSILHA MD, PhD, FEBVS UNIVERSITY HOSPITAL - PORTO Disclosure of Interest Speaker name: ARMANDO MANSILHA I have the following potential conflicts
Practical 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
Introduction History Preceded by Arterial Doppler and ABI Indications
Elise Brady, RVT, RDMS Introduction History Preceded by Arterial Doppler and ABI Indications 1) Abnormal ABI (within 2weeks of duplex) 2) Abnormal Doppler waveforms 3) Claudication 4) History of PVD 5)
Chimney technique combined with aortoiliac stenting for the treatment. disease. of juxtarenal aortoiliac occlusive
Chimney technique combined with aortoiliac stenting for the treatment of juxtarenal aortoiliac occlusive disease Suwanruangsri Veera,MD Kaviros Pruesttipong,MD Department of Surgery, Maharat Nakhon Ratchasima
BC Vascular Day. Contents. November 3, Abdominal Aortic Aneurysm 2 3. Peripheral Arterial Disease 4 6. Deep Venous Thrombosis 7 8
BC Vascular Day Contents Abdominal Aortic Aneurysm 2 3 November 3, 2018 Peripheral Arterial Disease 4 6 Deep Venous Thrombosis 7 8 Abdominal Aortic Aneurysm Conservative Management Risk factor modification
Intervention for Lower Extremity PAD: When, why and what?! Robert F Cuff, MD FACS RVT RPVI
Intervention for Lower Extremity PAD: When, why and what?! Robert F Cuff, MD FACS RVT RPVI 1 Disclosures I have no financial disclosures related to this talk Objectives 1. Discuss indications for intervention
La dissection aortique de type B : Dépistage et Suivi
La dissection aortique de type B : Dépistage et Suivi Philippe Cluzel Département d Imagerie Cardiovasculaire et de Radiologie Interventionnelle et Thoracique (DICVRIT) Sorbonne Université Médecine, UMR
Fibromuscular Dysplasia. Miranda Forrest Baker College
Fibromuscular Dysplasia Miranda Forrest Baker College Overview Case Study Patient Information Exam Images Findings FMD Types Signs and Symptoms Treatment Case Study Patient Information Female 57 years
Vascular Surgery Cases: Detours. Brian F. Stull, RDMS, RVT UNC REX Healthcare Vascular Specialists
Vascular Surgery Cases: Detours Brian F. Stull, RDMS, RVT UNC REX Healthcare Vascular Specialists Brian.Stull@Unchealth.unc.edu Objectives Anatomy of a bypass graft Where does it connect, where does it
Carotid Revascularization 20 Years From Now
Carotid Revascularization 20 Years From Now Kenneth Rosenfield, MD, MHCDS, MSCAI Section of Vascular Medicine and Intervention Cardiology Division MGH, Boston, MA In 2036, if we are all still alive This
Renal Artery Disease. None > 65,000,000. Learning objectives: Renal Artery Disease
Renal Artery Disease Robert D. McBane, M.D. Division of Cardiology Mayo Clinic Rochester Financial Disclosure Information Renal Artery Disease Robert McBane, MD None To appreciate: Learning objectives:
Patient Information. Peripheral Arterial Disease and the Lutonix 035 Balloon. Advancing Lives and the Delivery of Health Care
Patient Information Peripheral Arterial Disease and the Lutonix 035 Balloon Advancing Lives and the Delivery of Health Care Contents Peripheral Arterial Disease (PAD) Peripheral Arterial Disease (PAD)
Challenges. 1. Sizing. 2. Proximal landing zone 3. Distal landing zone 4. Access vessels 5. Spinal cord ischemia 6. Endoleak
Disclosure I have the following potential conflicts of interest to report: Consulting: Medtronic, Gore Employment in industry Stockholder of a healthcare company Owner of a healthcare company Other(s)
Coral Trials: A personal experience that challenges its results in patients with uncontrolled blood pressure.
Coral Trials: A personal experience that challenges its results in patients with uncontrolled blood pressure.. Dr. Javier Ruiz Aburto, FACS, FICS Assistant Professor Ponce School of Medicine Puerto Rico
2017 Cardiology Survival Guide
2017 Cardiology Survival Guide Chapter 2: Angioplasty/Atherectomy/Stent The term angioplasty literally means "blood vessel repair." During an angioplasty procedure, the physician inserts a catheter, with
Diseases of the aorta
Diseases of the aorta Aneurysm, dissection and aortitis are the main pathologies (Fig. 18.79 ). data:text/html;charset=utf-8,%3ch2%20id%3d%22cc5a0836d6aa490ca26dd7c15632b559%22%20style%3d%22margin%3a%201.3em%200px%200.5em%3b%20padding%3a%200px%3b%20border%3a%200px%3b%20font-fa
Approach 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
North 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
Acute Aortic Dissection: Decision and Outcome
Acute Aortic Dissection: Decision and Outcome Marc R. Moon, M.D. John M. Shoenberg Chair in CV Disease Chief, Cardiac Surgery Director, Center for Diseases of the Thoracic Aorta Washington University School
Endovascular therapy for Ischemic versus Nonischemic complicated acute type B aortic dissection (catbad).
Endovascular therapy for Ischemic versus Nonischemic complicated acute type B aortic dissection (catbad). AS. Eleshra, MD 1, T. Kölbel, MD, PhD 1, F. Rohlffs, MD 1, N. Tsilimparis, MD, PhD 1,2 Ahmed Eleshra
Optimal repair of acute aortic dissection
Optimal repair of acute aortic dissection Dept. of Vascular Surgery, The 2nd Xiang-Yale Hospital, Central-South University, China Hunan Major Vessels Diseases Clinical Center Chang Shu Email:changshu01@yahoo.com
Peripheral 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%
Vascular injury from an arterial closure device
Washington University School of Medicine Digital Commons@Becker Open Access Publications 1-1-2007 Vascular injury from an arterial closure device Jeffrey P. C. Lin Brian G. Rubin William D. Middleton Follow
Critical 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
SANWICH TECHNIQUE TO REDUCE COMPLICATIONS WHEN TREATING BILATERAL INTERNAL ILIAC ARTERY
SANWICH TECHNIQUE TO REDUCE COMPLICATIONS WHEN TREATING BILATERAL INTERNAL ILIAC ARTERY TRAN TRA GIANG.MD Interventional cardiovascular department Hanoi Heart Hospital, Hanoi, Viet Nam Nothing to Disclose
Peripheal artery occlusive disease(from aorta to popliteal) 연세대학교의과대학 심장혈관병원최동훈
Peripheal artery occlusive disease(from aorta to popliteal) 연세대학교의과대학 심장혈관병원최동훈 Case 1 Aorta disease -antegrade via brachial artery, subintimal approach, wire retraction, kissing stent- M / 59 # 4268376
2018 ACOI Internal Medicine Board Review. Peripheral Vascular Disease. Robert Bender, DO, FACOI, FACC
2018 ACOI Internal Medicine Board Review Peripheral Vascular Disease Robert Bender, DO, FACOI, FACC Peripheral Vascular Disease (PVD) Arteriosclerosis Obliterans (ASO) Aneurysmal Disease Acute Arterial
Calcified lesions optimal treatment
Calcified lesions optimal treatment I give you the latest innovation in balloon angioplasty. Dr. Mathias TISCHLER Hanusch Krankenhaus, Vienna, Austria 1 Nothing to disclose 2 Dienstag, 2. Februar 16 Calcification
Objectives. 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
FLEXIBLE, BALOON EXPANDABLE
EARLY RESULTS OF A CLINICAL TRIAL OF FLEXIBLE, BALOON EXPANDABLE COVERED STENT GRAFT IN ILIAC OCCLUSIVE DISEASE Chris LeCroy Coastal Vascular and Interventional Pensacola, Florida Clinical Trial WL GORE
Copyright HMP Communications
Treatment of Angioseal-Related Femoral Artery Occlusion Using TurboHawk Directional Atherectomy Anvar Babaev, MD, PhD; David W. Lee, MD; Anna Kurayev, MD; Heather Yang, PA From the Division of Cardiology,
Aortoiliac occlusive disease
Role of endovascular therapy in TASC II C & D inflow disease Per the TASC II Document: Surgery is the treatment of choice for type D lesions Aortoiliac occlusive disease Bala Ramanan, MBBS 1 st year vascular
9 : , cutting balloon 9 : , PTA cutting balloon. bruit. 4 cutting balloon. WBC 5300 µl CRP 0.1 ESR. Hb 11.8 A G. X CT Fig.
9 : 659-663, 2000 4 cutting balloon 29 bruit angiography 4 cutting balloon cutting balloon 9 : 659-663, 2000 PTA cutting balloon 4 cutting balloon 765-0001 2-1-1 2000 7 12 2000 9 26 29 18 1999 3 bruit
Animesh Rathore, MD 4/22/17. The Great Debate 45yo Man With Uncomplicated Acute TBAD: The Case For Medical Management
Animesh Rathore, MD 4/22/17 The Great Debate 45yo Man With Uncomplicated Acute TBAD: The Case For Medical Management Disclosures Just a young vascular surgeon who would like to keep his job My opponent
WHO YOU GONNA CALL? CLOT-BUSTERS!
WHO YOU GONNA CALL? CLOT-BUSTERS! Jayer Chung MD, MSc Assistant Professor Division of Vascular Surgery and Endovascular Therapy Michael E DeBakey Department of Surgery Baylor College of Medicine Annual
Performance of the conformable GORE TAG device in Type B aortic dissection from the GORE GREAT real world registry
University of Milan Thoracic Aortic Research Center Performance of the conformable GORE TAG device in Type B aortic dissection from the GORE GREAT real world registry Santi Trimarchi, MD, PhD Associate
Multimodality Imaging in Spontaneous Coronary Artery Dissection in the Peripartum Period
Multimodality Imaging in Spontaneous Coronary Artery Dissection in the Peripartum Period Marysia Tweet, MD NASCI Annual Meeting October 18 th, 2016 2016 MFMER slide-1 DISCLOSURE No relevant financial relationship(s)
John 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,
Imaging 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
Current Status of Endovascular Therapies for Critical Limb Ischemia
Current Status of Endovascular Therapies for Critical Limb Ischemia Bulent Arslan, MD Associate Professor of Radiology Director, Vascular & Interventional Radiology Rush University Medical Center bulent_arslan@rush.edu