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Peripheral Artery Disease III: Interprofessional Care

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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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Intravascular Ultrasound Use is Associated with Improved Patency in Lower Extremity Peripheral Arterial

Anand Brahmandam1, Tanner I Kim2, Stephen Parziale3

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Annals of Vascular Surgery
|May 29, 2024
PubMed
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Intravascular ultrasound (IVUS) use in peripheral vascular interventions (PVIs) for lower extremity disease improves 1-year patency rates. Certain patient groups, including those with chronic limb-threatening ischemia (CLTI) and complex lesions, may see particular benefit.

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Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Medical Imaging

Background:

  • Intravascular ultrasound (IVUS) offers superior endoluminal visualization compared to conventional angiography.
  • The clinical benefit of IVUS in peripheral vascular interventions (PVIs) for peripheral arterial disease remains uncertain.

Purpose of the Study:

  • To assess the impact of IVUS on 1-year clinical outcomes following lower extremity PVIs within the Vascular Quality Initiative (VQI).

Main Methods:

  • A retrospective review of the VQI-PVI database (2016-2020) included patients with 1-year follow-up.
  • Propensity matching (1:1) compared outcomes between IVUS-assisted and non-IVUS PVI groups.
  • One-year major amputation and patency rates were analyzed, with subgroup analyses based on lesion characteristics and disease severity.

Main Results:

  • IVUS use was associated with significantly higher 1-year patency rates (97.7% vs. 95.2%, P=0.004).
  • Improved patency with IVUS was observed in patients with chronic limb-threatening ischemia (CLTI), TASC C/D lesions, and lesions >15 cm.
  • IVUS did not significantly affect 1-year amputation rates.

Conclusions:

  • Adjunctive IVUS use in lower extremity PVIs is linked to improved 1-year patency compared to angiography alone.
  • Patients with CLTI, long lesions (>15 cm), and TASC C/D classifications may particularly benefit from IVUS guidance.