SCAI expert consensus statement for aorto-iliac arterial intervention appropriate use.
Andrew J Klein1, Dmitriy N Feldman, Herbert D Aronow
1St. Louis VA Healthcare System/Saint Louis University School of Medicine, Department of Medicine, Division of Cardiology, Saint Louis, Missouri.
Summary
Aorto-iliac occlusive disease management increasingly favors endovascular intervention for TASC A-D lesions. This approach is preferred over open surgery, guiding physicians on contemporary endovascular techniques.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Endovascular Interventions
Background:
- Aorto-iliac arterial occlusive disease presents with symptoms ranging from intermittent claudication to critical limb ischemia.
- Treatment is considered for refractory symptoms or to facilitate other procedures like TAVR.
Purpose of the Study:
- To guide physicians in clinical decision-making for endovascular intervention in aorto-iliac arterial disease.
- To highlight the contemporary application of endovascular techniques for aorto-iliac occlusive disease.
Main Methods:
- Review of current endovascular management strategies for aorto-iliac occlusive disease.
- Discussion of TASC lesion classifications and their endovascular treatment implications.
- Emphasis on the role of chronic total occlusion devices in recanalization.
Main Results:
- Endovascular intervention is the preferred approach for TASC A, B, and C lesions.
- Most TASC D lesions can be managed endovascularly, especially with advanced devices.
- Interventional cardiologists require expertise in aorto-iliac anatomy for transfemoral procedures.
Conclusions:
- Aorto-iliac occlusive disease is increasingly treated with an endovascular-first strategy.
- Open surgery serves as a secondary option for aorto-iliac occlusive disease management.
- Physicians should be proficient in endovascular techniques for aorto-iliac interventions.
Related Concept Videos
01:26Aneurysm III: Interprofessional Care
478
Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
478
01:27Peripheral Artery Disease III: Interprofessional Care
655
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
655
01:26Atherosclerosis III: Management
741
Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
741