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Your search keyword '"*ANKLE brachial index"' showing total 3 results
Start Over Descriptor "*ANKLE brachial index" Topic intermittent claudication Topic peripheral arterial disease Journal circulation
3 results on '"*ANKLE brachial index"'

1. Paclitaxel-Coated Balloons and Eluting Stents: Is There a Mortality Risk in Patients With Peripheral Artery Disease?

Author

Beckman, Joshua A. and White, Christopher J.

Subjects
*PERIPHERAL vascular diseases, *ANKLE brachial index, *INTERMITTENT claudication, *CLINICAL trials, *VASCULAR surgery, *PHYSICIANS
Abstract

Paclitaxel drug-coated balloons and drug-eluting stents became commercially available for the treatment of intermittent claudication in 2015 and 2012, respectively. Both devices demonstrated superiority in limb revascularization compared with non-paclitaxel-coated devices and were rapidly accepted into clinical practice. In a recent systematic review and study-level meta-analysis, Katsanos et al reported a late all-cause mortality signal for patients in the drug-coated balloon and drug-eluting stent arms of randomized clinical trials for both devices. As a result of this safety signal, Vascular InterVentional Advances Physicians (VIVA), a not-for-profit 501c(3) organization, convened the Vascular Leaders Forum on March 1 and 2, 2019, in Washington, DC, to initiate an open and collaborative process of investigation into this finding. The Vascular Leaders Forum brought together 100 stakeholders, including an international group of representatives of cardiovascular medicine, interventional radiology, vascular medicine, and vascular surgery; oncologists; basic scientists; the Food and Drug Administration; the Centers for Medicare and Medicaid Services; and commercial manufacturers of these products. The Vascular Leaders Forum reviewed the natural history of peripheral arterial disease, the use of paclitaxel in peripheral arterial disease and other conditions, the harm signal noted by Katsanos et al, the impact of the methods chosen by Katsanos et al, possible mechanisms of harm, the role of the Food and Drug Administration in a setting like this one, and guidance for clinicians taking care of patients with symptomatic peripheral arterial disease. This document integrates the most current data to help establish an appropriate path forward to understand the risks and benefits associated with these technologies while ensuring the best treatment paradigm for patients. [ABSTRACT FROM AUTHOR]

Published
2019
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2. Paclitaxel-Based Therapies for Patients With Peripheral Artery Disease.

Author

Misra, Sanjay and Dake, Michael D.

Subjects
*PERIPHERAL vascular diseases, *DRUG-eluting stents, *ANKLE brachial index, *INTERMITTENT claudication, *POPLITEAL artery
Abstract

First, a detailed analysis of the specific causes of death in all patients enrolled in all PTX-based trials for PAD treatment needs to be performed. Third, all ongoing PTX-based clinical trials need to determine and monitor the cause of mortality and possible link to PTX therapy. [Extracted from the article]

Published
2019
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3. Management of Patients After Endovascular Interventions for Peripheral Artery Disease

Author

Andrew C. Eisenhauer and Piotr Sobieszczyk

Subjects
medicine.medical_specialty, medicine.medical_treatment, Aftercare, Tetrazoles, Constriction, Pathologic, Disease, Peripheral Arterial Disease, Pharmacotherapy, Fibrinolytic Agents, Physiology (medical), Angioplasty, Secondary Prevention, medicine, Humans, Ankle Brachial Index, Popliteal Artery, Myocardial infarction, Disease management (health), Intensive care medicine, Physical Examination, Stroke, Vascular Patency, Postoperative Care, Clinical Trials as Topic, Ultrasonography, Doppler, Duplex, Aspirin, business.industry, Endovascular Procedures, Disease Management, Critical limb ischemia, medicine.disease, Combined Modality Therapy, Intermittent claudication, Cilostazol, Femoral Artery, Physical therapy, Stents, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Angioplasty, Balloon, Platelet Aggregation Inhibitors
Abstract

Endovascular therapy to relieve intermittent claudication or critical limb ischemia in patients with lower-extremity peripheral artery disease is now firmly established as an alternative to surgical revascularization.1 The advent of novel technologies allows percutaneous interventions of increasingly complex arterial disease previously reserved for surgical interventions.2 Although the durability of aortoiliac interventions rivals that of surgical bypass, restenosis after femoropopliteal interventions remains the Achilles’ heel of endovascular therapies. Despite the growth of endovascular procedures, the optimal postprocedural care is not well established. Moreover, it is not clear how surveillance strategies influence health resource use and whether they can prolong the durability of vascular interventions and affect the patient’s cardiovascular health. The following recommendations are therefore extrapolated from clinical experience gained in medical and surgical management of patients with peripheral artery disease and patients undergoing percutaneous coronary interventions. In the absence of data derived from randomized, controlled trials, these recommendations necessarily reflect an interpretation of “best clinical practice” of an understudied clinical area. In this article, we attempt to outline a clinically sound strategy for long-term postprocedural care. Aggressive cardiovascular risk factor reduction is a key component of postprocedural care to prevent cardiovascular events in patients with peripheral artery disease such as myocardial infarction or stroke. Regular exercise should be an integral part of postprocedural care both because of its well-established clinical benefit and because it provides a gauge for detecting the progression of obstructive arterial disease. Formal exercise therapy is a potent treatment for claudication3 and may offer additional benefits after femoral artery revascularization.4 The details and justification for risk factor modification and regular exercise are discussed in published national guidelines.5–7 Postprocedural care and surveillance also aim to optimize the durability of endovascular procedures by combining appropriate pharmacotherapy, periodic assessment of vessel patency, and …

Published
2013

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