June 2023

The need for cost-effective, quality care will drive patient treatment decisions and trends. Traditionally, the transfemoral approach has offered a dependable primary access site particularly to approach lower extremity disease. Why should there be a shift toward TR peripheral interventions?

A paradigm shift appears to be occurring with overwhelming evidence of transradial access (TRA) being a safe and feasible approach for peripheral interventions compared to transfemoral access (TFA). Our study explores the additional, multifactorial benefits of TRA regarding perioperative times, radiation, contrast administration, and cost-savings for patients and hospitals.

The development of BRS would have the benefit of mechanical support to prevent early vessel recoil and treat dissection similar to BMS and DES, without the permanent metallic struts that would lead to medi- um- and long-term complications such as hampered vasomotion, neo-intimal hyperplasia, and in-stent restenosis/thrombosis.

In this review, we examine the current state of bioresorbable technologies for peripheral arterial disease, particularly disease found below the knee.

Chronic limb threatening ischemia (CLTI) remains a challenging problem, associated with both significant morbidity and mor- tality. Effective interventions, especially among those patients with complex infrapopliteal disease, have been limited. Reasons for failure are multifactorial including the nature of disease, calcification, vessel recoil, and arterial dissection.

The role of real-time, invasive hemodynamic assessment during endovascular therapy for lower extremity peripheral arterial disease (PAD) has not been well established. The purpose of this study was to examine the feasibility of the Navvus microcatheter coupled to the RXi system (ACIST Medical Systems) to measure lower extremity pre- and post-intervention resting and hyperemic translesional systolic pressure gradients (sTPG) and mean distal to proximal pressure gradients (Pd/Pa).

Focal treatment of post-angioplasty dissections in below-the-knee lesions with the novel Tack Endovascular System might provide an attractive treatment approach that contributes clinical benefit at concurrent cost savings at 2-year follow-up. Further studies are warranted to confirm these exploratory findings.

Although the standard of care has evolved, the majority of patients with CLI undergoing primary amputation have never received a diagnostic angiogram, prohibiting the opportunity for revascularization and limb salvage.

The authors completed an observational Michigan Medicare analysis to investigate the rates of peripheral vascular intervention (PVI) via endovascular approach or surgical bypass, as well as the amputation rates for potentially informative trends.

Endovascular treatment of critical limb ischemia has been shown to be effective in preventing amputation and is oftentimes the treatment modality of first choice.