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).

Dr Pliagas discusses his retrospective study, recently published in JCLI, in which he and his co-investigators sought to demonstrate safety and performance of the Terumo Glidesheath Slender for tibiopedal access. Initially, tibiopedal access was considered a very experimental technique, but over the past few years, Dr Pliagas and his colleagues have learned to routinely gain access to vessels from below, using this technique.

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 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.

Drs Driver and Neville discuss the crucial component of podiatry in the multidisciplinary treatment of CLTI.

Dr John H Rundback discusses his recent JCLI article, "Patterns of Failure in Deep Venous Arterialization and Implications for Management."