Initial experience with the use of fractional flow reserve in the hemodynamic evaluation of transplant renal artery stenosis

Abstract ObjectiveTo describe and standardize an original protocol for fractional flow reserve (FFR) pre and postangioplasty in an initial series of patients with clinically manifested transplant renal artery stenosis (TRAS). BackgroundThere is no data in the literature about the use of FFR in TRAS. MethodsPatients with TRAS detected in a noninvasive study were referred to diagnostic angiography and stenosis considered visually severe (≥ 60%) were included. After selective cannulation, a PressureWire 0.014” (Certus™—St. Jude Medical) was advanced to the distal portion of the vessel. Resting Pd/Pa ratio (ratio of mean distal to lesion and mean proximal pressures) and translesional systolic pressure gradient were obtained and FFR and hyperemic translesional systolic and mean pressure gradients (HSG and HMG) were registered after papaverine induced maximum hyperemia—pre and poststent implantation. Creatinine levels and office blood pressure measurements were registered at the baseline, 6 and 12 months after intervention. ResultsTen consecutive patients had successful stent implantation and were included. After treatment, significant increase in FFR (0.76 ± 0.09 vs. 0.96 ± 0.04, P 
Source: Catheterization and Cardiovascular Interventions - Category: Cardiovascular & Thoracic Surgery Authors: Tags: PERIPHERAL VASCULAR DISEASE Source Type: research

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AbstractNowadays nurse practitioners are working in several acute hospital settings in different specialized departments. For decades, studies have shown the implications of nurse practice in peripheral vascular disease (PVD) and peripheral vascular intervention (PVI) to have several major benefits. However, there are very limited studies and data on this particular aspect. In this literature review, we briefly discuss the implication of nursing practice in PVD/PVI. This review briefly shows that nursing practice has a major contribution and implication in the treatment of patients with PVD or PVI, especially in patients w...
Source: Advances in Therapy - Category: Drugs & Pharmacology Source Type: research
Authors: Traven SA, Synovec JD, Walton ZJ, Leddy LR, Suleiman LI, Gross CE Abstract INTRODUCTION: The purpose of this study is to investigate the current disparities for major lower extremity amputation in patients with critical limb ischemia (CLI) and infection. METHODS: A retrospective analysis of the National Surgical Quality Improvement Program's database for the years 2011 to 2017 was conducted. Multivariate models were used to isolate the effect of race and ethnicity on the likelihood of a below-knee or above-knee amputation (BKA and AKA, respectively) for CLI secondary to type 2 diabetes mellitus, athero...
Source: The Journal of the American Academy of Orthopaedic Surgeons - Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research
Condition:   Infrainguinal Peripheral Artery Disease Intervention:   Device: AURYON™ System Sponsor:   Angiodynamics, Inc. Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Publication date: Available online 14 January 2020Source: Journal of Cardiology CasesAuthor(s): Shota Okuno, Osamu Iida, Katsumi Inoue, Mitsutoshi Asai, Masaharu Masuda, Shin Okamoto, Takayuki Ishihara, Kiyonori Nanto, Takashi Kanda, Takuya Tsujimura, Yasuhiro Matsuda, Yosuke Hata, Toshiaki ManoAbstractA 58-year-old male with gangrene in his left 1st digit due to critical limb ischemia had undergone endovascular therapy for chronic total occlusion of the left superficial femoral artery using bare-metal stents (BMSs). Angiography revealed in-stent occlusion of the BMS site when he was referred to our hospital with a recurre...
Source: Journal of Cardiology Cases - Category: Cardiology Source Type: research
Conclusions: Due to the high prevalence of CAD and/or PAD and the associated high unit costs, this population generates a significant economic burden, which is higher among patients with PAD and in those presenting simultaneously with both conditions. PMID: 31928390 [PubMed - as supplied by publisher]
Source: Journal of Medical Economics - Category: Health Management Tags: J Med Econ Source Type: research
CONCLUSIONS: EVAR in the elderly can be performed with a high rate of success; however, it is associated with a substantial rate of morbidity and mortality, particularly when patients present with multiple co-morbidities. When performing EVAR in this population group, the risk of rupture must be considered opposed to the life expectancy of these patients and the risk of perioperative morbidity and mortality. PMID: 31927800 [PubMed - in process]
Source: The Israel Medical Association Journal - Category: General Medicine Tags: Isr Med Assoc J Source Type: research
Conditions:   Peripheral Artery Disease;   Overweight or Obesity Interventions:   Behavioral: Weight loss;   Behavioral: Exercise Sponsors:   Northwestern University;   National Heart, Lung, and Blood Institute (NHLBI);   Wake Forest University Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
The recommended imaging tests for nonatherosclerotic peripheral artery disease include ultrasound duplex Doppler (ultrasound), intravascular ultrasound (inside arteries), MR angiography (MRA; MRI of arteries with or without intravenous [IV] contrast dye), CT angiography (CTA; CT scan of arteries using IV contrast), arteriography (x-rays of arteries with IV contrast).
Source: Journal of the American College of Radiology : JACR - Category: Radiology Authors: Tags: Appropriate use criteria Source Type: research
AbstractPurpose of ReviewDespite major advances in terms of prevention, diagnosis, risk-stratification, management and rehabilitation, atherosclerosis and atherothrombosis continue to have major morbidity and mortality implications worldwide. Since the unraveling of the pivotal role of inflammation in atherothrombosis pathophysiology, several focused treatments have been proposed with the ultimate goal of preventing or treating myocardial infarction, stroke, and peripheral artery disease. In particular, given the centrality of interleukin-1 (IL-1), targeted anti-IL-1 agents have attracted substantial attention and efforts....
Source: Current Atherosclerosis Reports - Category: Cardiology Source Type: research
Publication date: Available online 9 January 2020Source: Journal of the American College of RadiologyAuthor(s): Susan Anemone, MacArinze Ojiaku
Source: Journal of the American College of Radiology - Category: Radiology Source Type: research
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