Prospective, Multicenter Registry to Assess Safety and Efficacy of Radial Access for Peripheral Artery Interventions.

Background: Radial access (RA) may offer advantages in peripheral interventions, but previous studies on this approach have been limited to retrospective or single-center studies. Our aim was to prospectively evaluate the safety and feasibility of RA for complex endovascular lower extremity interventions.

Methods: In this prospective, multicenter, and observational study, eligible patients with peripheral artery disease scheduled for intervention through RA were enrolled.

Clinical Outcomes of Additional Below-The-Ankle Intervention Compared to Below-The-Knee Intervention Alone: A Post-Hoc Analysis of a Prospective Multicenter Study.

Purpose: To investigate the clinical implication of additional below-the-ankle (BTA) intervention in patients with chronic limb-threatening ischemia (CLTI) undergoing below-the-knee (BTK) intervention.

Materials And Methods: A sub-analysis was performed using data from the LIBERTY trial (.gov identifier NCT01855412), a prospective, observational, core-laboratory adjudicated, multicenter study of endovascular intervention in 1204 patients.

Endovascular Treatment of a Popliteal Artery Aneurysm Via Transpedal Approach: A Case Report.

Popliteal artery aneurysm (PAA) has been increasingly treated with endovascular intervention in recent years. However, whether transpedal access can be utilized to treat PAA has not been widely reported. We report a case of successful treatment of a PAA with a covered stent via retrograde transpedal approach in an 80-year male with prohibitive surgical risk who initially failed antegrade approach.

Transradial Endovascular Intervention: Results From the Radial accEss for nAvigation to Your CHosen Lesion for Peripheral Vascular Intervention (REACH PVI) Study.

Background/purpose: The transradial approach has been proposed as an alternative to traditional transfemoral access for diagnostic and therapeutic purposes in several catheterization procedures. Historically, extended length devices for lower limb endovascular interventions have been limited. The aim of this study was to investigate the acute clinical outcomes of orbital atherectomy (OA) via transradial access (TRA) for the treatment of lower extremity peripheral artery disease (PAD).

Transpedal approach for femoral-popliteal chronic total occlusions using the outback® elite re-entry device.

Background: Transpedal access is increasingly utilized for the treatment of peripheral artery disease (PAD). Femoral-popliteal artery chronic total occlusions (CTOs) are some of the most difficult lesion subsets that sometimes require the use of re-entry support devices during percutaneous intervention. Limited data is available on the use of re-entry devices when treating femoral-popliteal CTOs via transpedal access.

Dual alternate access sites for the treatment of an ostial left common iliac artery chronic total occlusion.

Growing endovascular strategies with TASC D lesions in aortoiliac disease reflect increasing technical success with evidenced safety and efficacy. In cases of failed transfemoral access, revascularization of iliac chronic total occlusions has prompted the utilization of other alternate access sites (e.g.

Delayed Presentation of a Large Pseudoaneurysm in the Common Femoral Artery After an Electrophysiology Study.

We describe a rare case of an exceptionally large pseudoaneurysm that developed in the right common femoral artery 6 months after an electrophysiological study. Surgical and other conventional methods to treat his pseudoaneurysm were not feasible. Therefore, the pseudoaneurysm was successfully treated via an endovascular approach with a covered stent.

Treatment of an external iliac artery chronic total occlusion using alternate access sites.

Background: With the advent of endovascular techniques, alternate sites such as the pedal and radial arteries can now be accessed when treating peripheral arterial disease to reduce procedural complications, shorten recovery time, and improve patient comfort. However, a paucity of literature exists on the availability of support devices that can be utilized during challenging cases.

Case Presentation: A 70 year-old female patient presented for evaluation of severe lifestyle-limiting left-sided claudication refractory to maximal medical therapy.

Development and treatment of two distinct pseudoaneurysms following transradial coronary catheterization in a patient with high bleeding risk: a case report.

Background: A pseudoaneurysm is a rare but serious complication after transradial coronary catheterization. Although different treatment modalities have been proposed to treat post-catheterization pseudoaneurysm, only limited data are available to guide the treatment approach.

Case Presentation: We report a rare case of two distinct pseudoaneurysms complicating transradial percutaneous coronary intervention in a 75-year-old Hispanic woman being treated with dual antiplatelet agents for myocardial infarction and warfarin for atrial fibrillation.

Transpedal approach for iliac artery stenting: A pilot study.

Objective: To demonstrate the safety and feasibility of the transpedal approach as an alternate arterial access site for iliac artery intervention.

Background: The common femoral artery is the traditional access site for the endovascular treatment of iliac artery stenoses. However, this approach is associated with complication rates as high as 2%, including retroperitoneal bleeding which carries high patient morbidity and mortality.

Comparison of TR Band™ and VasoStat™ Hemostasis Devices following Transpedal Catheterization for Lower Extremity Revascularization for Peripheral Arterial Disease.

Background: Transpedal access is increasingly utilized for peripheral vascular catheterization. There is a paucity of data on the use of radial hemostasis devices as an alternative to manual compression for achievement of hemostasis after this approach.

Objective: To compare safety and efficacy of two hemostasis devices following transpedal catheterization for lower extremity revascularization for peripheral arterial disease.

Safety and Feasibility of the Coronary Orbital Atherectomy System via the Transradial Approach.

Technological innovations have enabled higher success rates with percutaneous coronary intervention (PCI) of complex coronary lesions via the transradial approach. The orbital atherectomy system (OAS; Cardiovascular Systems, Inc) is the most recent innovation that abrades plaque using a rotation device for the facilitation of stent placement in heavily calcified lesions. Fifty patients with classic anginal symptoms and an abnormal stress test demonstrating ischemia underwent PCI using the coronary OAS.

Superficial Femoral Artery Intervention by Single Transpedal Arterial Access.

Background: Atherosclerotic disease of the superficial femoral artery (SFA) is frequently seen and can be treated with percutaneous interventions, traditionally via femoral artery access. There are limited reports of transpedal artery access for peripheral artery interventions, but none to date describing routine primary transpedal artery approach for SFA stenting.

Methods: In this preliminary study, we report 4 patients who underwent successful endovascular SFA stenting using a single transpedal artery access via a new ultra-low profile 6 Fr sheath (Glidesheath Slender; Terumo Corporation).

Feasibility and Safety of Routine Transpedal Arterial Access for Treatment of Peripheral Artery Disease.

Objective: To demonstrate the feasibility and safety of transpedal arterial access for lower-extremity angiography and intervention.

Background: Traditionally, the femoral artery is chosen for the initial access site in symptomatic peripheral artery disease (PAD), but this approach carries a substantial portion of the entire procedural complication risk.

Methods: 80 patients were prospectively evaluated for the treatment of PAD between May and July 2014.

Tips and tricks for antegrade recanalization of chronic total occlusions using the CrossBoss catheter.

Objectives: To provide new strategies and techniques for the successful recanalization of chronic total occlusions (CTOs) with the sole use of the CrossBoss catheter. In addition, some common CTO scenarios are illustrated in detail.

Background: CTOs are one of the most challenging complex coronary lesion subsets to intervene upon.

The utility of extension catheters in transradial percutaneous coronary intervention.

Objectives: To evaluate the use of extension catheters in transradial intervention of complex coronary lesions.

Background: Complex percutaneous coronary intervention (PCI) via transradial approach remains a challenge for many interventionalists, primarily due to the difficulty in obtaining adequate guide catheter support.

Methods: A retrospective case series identified 54 patients who presented for PCI of complex coronary lesions.

Mortality in the coronary care unit.

Objectives: Currently, there are limited data on mortality or predictors of survival for patients admitted to the coronary care unit (CCU). The purpose of this study was to provide data on mortality in the modern-day CCU and to better define factors influencing patient survival.

Methods: A survey was conducted of all patients admitted to CCUs in New York City metropolitan academic hospitals in 2011, followed by a retrospective analysis comparing clinical data from 59 nonsurvivors with those from 897 survivors at two representative institutions.

A novel technique in the use of fractional flow reserve in coronary artery bifurcation lesions.

The side branch (SB) in bifurcation lesions is a frequently encountered challenge that interventional cardiologists must face. There is great interest in determining fractional flow reserve (FFR) in the SB to help guide treatment decisions; however, difficulty with the pressure guidewire limits its widespread use. We propose a novel technique that will ease the incorporation of FFR in routine evaluation of bifurcation lesions, and allow better assessment of provisional stenting and need for SB intervention.

Transulnar catheterization in patients with ipsilateral radial artery occlusion.

Background: The transradial approach to percutaneous coronary intervention (PCI) has recently gained popularity among interventionalists. However, radial artery occlusion (RAO) limits the ability for repeat catheterization. In current practice, transulnar catheterization is thought to be a contraindication in patients with ipsilateral RAO.

Balloon-assisted sheathless transradial intervention (BASTI) using 5 Fr guiding catheters.

Background: The sheathless approach to transradial percutaneous coronary intervention (PCI) has recently gained popularity among interventionalists. However, technical problems and lack of approved equipment in the United States has limited its applicability. We describe a new approach, balloon-assisted sheathless transradial intervention (BASTI) that can ease the use of 5 Fr sheathless guiding catheters and decrease complication rates.

The impact of iso-osmolar contrast use in emergent percutaneous coronary intervention for ST-segment elevation myocardial infarction.

The incidence of contrast-induced nephropathy (CIN) in primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) was previously reported to be as high as 19%. Iso-osmolar contrast has frequently been used for populations at high risk for CIN, but a recent meta-analysis did not show a significant benefit of using iso-osmolar contrast in preventing CIN. The aim of our study is to evaluate the impact of iso-osmolar contrast use in patients undergoing emergent PCI.

Prevention of contrast-induced nephropathy: A randomized controlled trial of sodium bicarbonate and N-acetylcysteine.

Background: Contrast-induced nephropathy (CIN) continues to be a common cause of acute renal failure in high-risk patients undergoing radiocontrast studies. However, there is still a lack of consensus regarding the most effective measures to prevent CIN.

Methods: ONE HUNDRED EIGHTEEN PATIENTS WITH DIABETES MELLITUS AND/OR RENAL INSUFFICIENCY, SCHEDULED FOR CORONARY ANGIOGRAPHY OR INTERVENTION, WERE RANDOMLY ASSIGNED TO ONE OF FOUR TREATMENT GROUPS: intravenous (IV) 0.