An Update on Drug-eluting Technology in Peripheral Arteries to Treat Peripheral Arterial Disease.

For the treatment of peripheral arterial disease, drug-eluting technology is a widely accepted therapeutic option, with significant reduction in intimal hyperplasia and, consequently, use of target lesion revascularization. Nevertheless, the reputation of such devices was damaged after a meta-analysis, published in December 2018, showed increased mortality in patients receiving paclitaxel-eluting devices. Although subsequent studies have failed to establish such correlation, the use of paclitaxel-eluting devices remains heavily restricted.

Pulmonary echinococcosis: A rare pseudotumour of the lung.

Cystic echinococcosis is a widely endemic helminthic disease worldwide but occurs only rarely in Central Europe. Humans are infected as 'aberrant' hosts by and develop cysts in numerous different organs. 20%-30% of the affected individuals develop hydatid disease in the lungs with associated complications including pleuritis, lung abscess and pneumothorax.

Sustained benefit at 2 years for covered stents versus bare-metal stents in long SFA lesions: the VIASTAR trial.

Purpose: The hypothesis that covered stents are superior to bare-metal stents (BMS) in long femoropopliteal artery disease was tested. The one-year results of the VIASTAR trial revealed a patency benefit of covered stents in the treatment-per-protocol (TPP) analysis only.

Methods: A prospective, randomized, single-blind, multicenter study evaluated 141 patients with symptomatic peripheral arterial disease (PAD) after treatment with heparin-bonded covered stents (VIABAHN(®) Endoprosthesis) or BMS.

Treating with an implant: BMS or DES?

As the minimal invasive procedures for the treatment of peripheral arterial disease grow at exponential rates, interventional radiologists and vascular surgeons are more often faced with the difficult decision of which devices are the most appropriate to bring the desired results. Under the light of the newest studies and always having in mind the concept of "leaving no metal behind", when focusing on the lesions within the superficial femoral artery and popliteal arteries, we try to answer the question: treating with an implant, bare metal stents or drug eluting stents?

Heparin-bonded covered stents versus bare-metal stents for complex femoropopliteal artery lesions: the randomized VIASTAR trial (Viabahn endoprosthesis with PROPATEN bioactive surface [VIA] versus bare nitinol stent in the treatment of long lesions in superficial femoral artery occlusive disease).

Objectives: The hypothesis that endovascular treatment with covered stents has equal risks but higher efficacy than bare-metal stents (BMS) in long femoropopliteal artery disease was tested.

Background: Although endovascular treatment of short superficial femoral artery lesions revealed excellent results, efficacy in long lesions remains unsatisfactory.

Methods: In a prospective, randomized, single-blind, multicenter study, 141 patients with symptomatic peripheral arterial disease were assigned to treatment with heparin-bonded, covered stents (Viabahn 72 patients) or BMS (69 patients).

Prospective, randomized single-center trial to compare cryoplasty versus conventional angioplasty in the popliteal artery: midterm results of the COLD study.

Purpose: To evaluate safety and efficacy of cryoplasty versus conventional angioplasty for focal popliteal arterial occlusive disease.

Materials And Methods: Patients with focal atherosclerotic stenoses and occlusions of the popliteal artery were randomized to cryoplasty or conventional angioplasty as the initial treatment strategy. The primary objective was target lesion patency.

Low-profile primary stent placement for the treatment of focal calcified ulcerated stenosis in the infrarenal aorta.

Purpose: To analyze the immediate and midterm success of low-profile stent placement in calcified ulcerated lesions of the infrarenal aorta in patients with arterial occlusive disease.

Materials And Methods: In this prospective case series, 13 symptomatic patients (eight men, five women; mean age, 64.8 years +/- 12.

Interventional management of massive hemothorax due to inadvertent puncture of an aberrant right subclavian artery.

We report a case of massive hemothorax due to inadvertent puncture of an aberrant right subclavian artery during central venous access. Iatrogenic laceration at the origin of the right internal thoracic artery was successfully treated with coil embolization of the internal thoracic artery followed by stent-graft placement into the subclavian artery. Due to its elongated and abnormal course, an aberrant right subclavian artery may predispose to inadvertent puncture during vein catheterization and should be recognized as a potential threat for such procedures.

Value of single-dose contrast-enhanced magnetic resonance angiography versus intraarterial digital subtraction angiography in therapy indications in abdominal and iliac arteries.

The objective of the study was to prove the value of single-dose contrast-enhanced magnetic resonance angiography [three-dimensional (3D) ceMRA] in abdominal and iliac arteries versus the reference standard intra-arterial digital subtraction angiography (i.a.DSA) when indicating a therapy.

Chronic mesenteric ischemia: stenting of mesenteric arteries.

This article focuses on stent placement in mesenteric arteries in patients with the rare diagnosis of chronic mesenteric ischemia. We present a survey from the initial stage of recognition of this gastrointestinal disorder and its manifestations to treatment by stenting to avoid further ischemic episodes and bowel infarction and necrosis. The advantages of stent placement in splanchnic arteries are discussed in comparison to open surgical revascularization.

Stent placement with the monorail technique for treatment of mesenteric artery stenosis.

Purpose: To analyze the immediate and midterm success of stenting of mesenteric arteries by a monorail technique in patients with chronic mesenteric ischemia.

Materials And Methods: In this prospective case series, 19 patients (11 male, 8 female; mean age, 62.9 +/- 10.

Micro-CT of carotid arteries: a tool for experimental studies.

Micro-computed tomography (micro-CT) is a high-resolution, non-destructive tool for two- and three-dimensional imaging and quantification. The ability of this technique to assess atherosclerosis of the carotid artery was evaluated in three human cadaver samples based on the original axial acquisitions, multiplanar reconstructions and volume rendering techniques. Quantitative analysis included the calculation of: (1) the original lumen perimeter, original lumen area, plaque area, residual lumen area, calcified area and gross sectional area reduction of the vascular lumen from two-dimensional slices; (2) the total tissue volume, soft tissue volume and calcified tissue volume from the three-dimensional data set.

Hemolytic effect of deformed intra-arterial stents and stent grafts in vitro.

Our objective was to evaluate the hemolytic effect of stents and stent grafts in an in vitro flow model. The model consisted of silicone tubings. Pulsatile flow was delivered at 1170 ml/min.

Percutaneous management of occlusive arterial disease associated with vasculitis: a single center experience.

The purpose of this study was to evaluate the safety and effectiveness of percutaneous transluminal angioplasty for occlusive arterial disease associated with vasculitis. Eleven patients (10 women, 1 man; ages 35-82 years) with the diagnosis of vasculitis of the large vessels underwent interventional treatment during intraarterial angiography. The causes included giant cell arteritis (n = 8) and Takayasu arteritis (n = 3).

Evaluation of hydroxyapatite implants in vertebral bodies and extremities by contrast-enhanced magnetic resonance imaging.

This pilot study evaluated hydroxyapatite (HA) implants (Endobon) into bone with magnetic resonance imaging (MRI). Nineteen patients (median age 57 years; range 18-67 years) have been evaluated. Eight received granulated HA into vertebral bodies after trauma, while 11 received HA blocks into extremity bones after trauma (n = 8) or fibrous dysplasia (n = 2).

Lower extremity occlusive disease: diagnostic imaging with a combination of cardiac-gated 2D phase-contrast and cardiac-gated 2D time-of-flight MRA.

Purpose: The goal of this work was to test the ability of a combination of 2D phase-contrast MR angiography (2D-PC-MRA) and triggered 2D time-of-flight MRA (2D-TOF-MRA) in comparison to intraarterial digital subtraction angiography (DSA) to correctly diagnose the location and shape of occlusive lesions in the iliac and femoral arteries and to determine whether 2D-TOF-MRA is helpful to clarify questionable lesions demonstrated by 2D-PC-MRA.

Methods: In 50 patients with claudication, 2D-PC-MRA was performed in three consecutive coronal positions from the aortic bifurcation to below the trifurcation. Axial 2D-TOF-MRA was performed additionally at the site of detected lesions of >50% and lesions in doubt to obtain more precise information about the stenosis.

Contrast-enhanced, K-space-centered, breath-hold MR angiography of the renal arteries and the abdominal aorta.

The purpose of this study was to evaluate the capability of contrast-enhanced breath-hold fast imaging with steady-state precession (FISP) three-dimensional MR angiography (MRA) to detect stenotic lesions of the abdominal aorta, the renal arteries, and the iliac arteries by using a K-space-centered 20-ml gadolinium-diethylene pentaacetic acid (Gd-DTPA) bolus. Fifty patients were studied before conventional x-ray angiography. Contrast-enhanced breath-hold FISP three-dimensional MRA was applied in the coronal view, centered at the renal arteries.

Prospective assessment of carotid bifurcation disease with spiral CT angiography in surface shaded display (SSD)-technique.

Purpose: To decide, whether spiral CT-angiography (CTA) in surface display (SSD)-technique is suitable for accurate quantification of carotid artery stenoses.

Material And Methods: Forty-four patients (25 male, 19 females) with a total of 80 symptomatic carotid artery were studied prospectively with selective cerebral angiography and spiral CTA in SSD-technique. The degree of stenosis was determined according to the NASCET-study.