The year in cardiology 2014: peripheral circulation.

Area of Science:

• Vascular Medicine
• Cardiovascular Interventions
• Medical Biomarkers

Background:

• Ongoing debates in 2014 focused on carotid revascularization indications and long-term cardiac risks associated with surgical versus stenting interventions.
• Renal artery interventions, including denervation and stenting, yielded disappointing results in improving blood pressure management.
• Endovascular techniques showed promise as alternatives to surgery for lower extremity arterial disease, particularly with drug-eluting balloons.

Purpose of the Study:

• To review key advancements and ongoing debates in vascular medicine and interventions from 2014.
• To highlight new insights into endovascular treatments for peripheral artery disease.
• To discuss the evolving role of biomarkers in cardiovascular risk stratification.

Main Methods:

• Review of 2014 scientific literature and clinical trial outcomes.
• Analysis of guidelines and meta-analyses concerning vascular diseases.
• Synthesis of data on carotid, renal, lower extremity, and aortic artery interventions.

Main Results:

• Asymptomatic carotid disease revascularization indications remained debated; cardiac risk from surgery vs. stenting was scrutinized.
• Renal artery interventions failed to demonstrate significant benefits for blood pressure or outcomes.
• Endovascular approaches, including drug-eluting balloons, emerged as viable alternatives for lower extremity arterial disease.
• Aortic stiffness was identified as a valuable risk stratification biomarker, surpassing carotid intima-media thickness.
• New data suggested the utility of D-dimers and residual venous thrombosis in managing anticoagulation for deep vein thrombosis.

Conclusions:

• Vascular medicine saw significant developments in 2014, particularly in endovascular therapies and risk assessment biomarkers.
• Continued research is needed to clarify optimal revascularization strategies and refine the use of biomarkers.
• The findings underscore the dynamic nature of vascular disease management and the importance of evidence-based practice.