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1.
Int Angiol ; 40(5): 395-408, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34236154

RESUMO

Even today thromboangiitis obliterans has disease features that remain misunderstood or underappreciated. The epidemiology, etiology and pathophysiology of the disease are still unclear. Biomarkers and disease activity markers are lacking, thus clinical assessment is difficult. We are still struggling to establish unique diagnostic, staging and treatment criteria. This is an academic-collaborative effort to describe the pathophysiology, the clinical manifestations, the diagnostic approach, and the challenges of management of patients with TAO. A systematic search for relevant studies dating from 1900 to the end of 2020 was performed on the PubMed, SCOPUS, and Science Direct databases. Given the intriguing nature of presentation of TAO, its management, to some extent is not only different in different regions of the world but also varies within the same region. Following this project, we discovered ambiguity, overlap and lack of clear-cut criteria for management of TAO. An international group of experts however came to one conclusion. They all agree that management of TAO needs a call for action for a renewed global look with multi-center studies, to update the geographical distribution of the disease and to establish a unique set of diagnostic criteria and a consensus-based guideline for best treatment based on current evidence.


Assuntos
Cardiologia , Tromboangiite Obliterante , Humanos , Tromboangiite Obliterante/diagnóstico , Tromboangiite Obliterante/epidemiologia , Tromboangiite Obliterante/terapia
2.
Vasc Med ; 26(6): 608-612, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34082620

RESUMO

Patients with chronic kidney disease may develop new or more severe anemia when treated with antiplatelet agents due to blood loss in conjunction with impaired erythropoiesis. Because anemia independently predicts limb amputation and mortality among patients with peripheral artery disease (PAD), we evaluated the relationship between estimated glomerular filtration rate (eGFR) and hemoglobin (Hb) levels in the EUCLID trial in which patients with symptomatic PAD were randomized to ticagrelor or clopidogrel. At baseline, 9025, 1870, and 1000 patients had eGFR ⩾ 60, 45-59, and < 45 mL/min/1.73 m2, respectively. The mean fall in Hb during the trial was 0.46 ± 1.68 g/dL and did not differ by baseline eGFR category, although Hb fall ⩾ 10% was more frequent among patients with lower eGFR (p for trend < 0.0001). On-study treatment with iron, erythropoiesis-stimulating agents, and/or red blood cell transfusion was reported for 479 (5.3%), 165 (8.8%), and 129 (12.9%) patients in the three eGFR categories, respectively (p for trend < 0.0001). After adjustment for baseline and post-randomization effects, those not receiving anemia treatment had a smaller reduction in Hb from baseline than those receiving anemia treatment (p < 0.0001). Other determinants of Hb reduction included absence of on-study myocardial infarction, coronary or peripheral revascularization, residence outside North America, male sex, and baseline eGFR. We conclude that among patients with PAD treated with P2Y12 inhibitors, lower baseline eGFR was associated with a greater reduction in Hb. ClinicalTrials.gov Identifier: NCT01732822.


Assuntos
Doença Arterial Periférica , Insuficiência Renal Crônica , Hemoglobinas , Humanos , Masculino , Doença Arterial Periférica/complicações , Doença Arterial Periférica/diagnóstico , Doença Arterial Periférica/tratamento farmacológico , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/tratamento farmacológico , Ticagrelor/efeitos adversos , Resultado do Tratamento
3.
Vasc Med ; 20(5): 465-78, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26268268

RESUMO

The Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC) guidelines were last updated in 2007 (TASC II) and represented the collaboration of international vascular specialties involved in the management of patients with peripheral arterial disease (PAD). Since the publication of TASC II, there have been innovations in endovascular revascularization strategies for patients with PAD. The intent of this publication is to provide a complete anatomic lower limb TASC lesion classification, including the infrapopliteal segment, and an updated literature review of new endovascular techniques and practice patterns employed by vascular specialists today.


Assuntos
Procedimentos Endovasculares , Isquemia/cirurgia , Extremidade Inferior/cirurgia , Doença Arterial Periférica/cirurgia , Artéria Poplítea/cirurgia , Humanos , Extremidade Inferior/irrigação sanguínea , Resultado do Tratamento
4.
Catheter Cardiovasc Interv ; 86(4): 611-25, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26256456

RESUMO

The Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC) guidelines were last updated in 2007 (TASC II) and represented the collaboration of international vascular specialties involved in the management of patients with peripheral arterial disease (PAD). Since the publication of TASC II, there have been innovations in endovascular revascularization strategies for patients with PAD. The intent of this publication is to provide a complete anatomic lower limb TASC lesion classification, including the infrapopliteal segment, and an updated literature review of new endovascular techniques and practice patterns employed by vascular specialists today.


Assuntos
Procedimentos Endovasculares/métodos , Doença Arterial Periférica/diagnóstico por imagem , Doença Arterial Periférica/terapia , Guias de Prática Clínica como Assunto , Procedimentos Cirúrgicos Vasculares/métodos , Consenso , Stents Farmacológicos , Feminino , Artéria Femoral/diagnóstico por imagem , Humanos , Claudicação Intermitente/diagnóstico , Claudicação Intermitente/terapia , Extremidade Inferior/irrigação sanguínea , Masculino , Estudos Observacionais como Assunto , Doença Arterial Periférica/classificação , Doença Arterial Periférica/fisiopatologia , Artéria Poplítea/diagnóstico por imagem , Prognóstico , Radiografia , Ensaios Clínicos Controlados Aleatórios como Assunto , Medição de Risco , Sociedades Médicas , Resultado do Tratamento , Grau de Desobstrução Vascular/fisiologia
5.
J Endovasc Ther ; 22(5): 663-77, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26239796

RESUMO

The Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC) guidelines were last updated in 2007 (TASC II) and represented the collaboration of international vascular specialties involved in the management of patients with peripheral arterial disease (PAD). Since the publication of TASC II, there have been innovations in endovascular revascularization strategies for patients with PAD. The intent of this publication is to provide a complete anatomic lower limb TASC lesion classification, including the infrapopliteal segment, and an updated literature review of new endovascular techniques and practice patterns employed by vascular specialists today.


Assuntos
Procedimentos Endovasculares/normas , Perna (Membro)/irrigação sanguínea , Doença Arterial Periférica/terapia , Padrões de Prática Médica/normas , Procedimentos Cirúrgicos Vasculares/normas , Competência Clínica/normas , Consenso , Constrição Patológica , Procedimentos Endovasculares/instrumentação , Humanos , Doença Arterial Periférica/diagnóstico , Stents/normas , Resultado do Tratamento
6.
Ann Vasc Dis ; 8(4): 343-57, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26730266

RESUMO

The Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC) guidelines were last updated in 2007 (TASC II) and represented the collaboration of international vascular specialties involved in the management of patients with peripheral arterial disease (PAD). Since the publication of TASC II, there have been innovations in endovascular revascularization strategies for patients with PAD. The intent of this publication is to provide a complete anatomic lower limb TASC lesion classification, including the infrapopliteal segment, and an updated literature review of new endovascular techniques and practice patterns employed by vascular specialists today.

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