Angiography and Endovascular Therapy for Below-the-Knee Artery Disease

Critical limb ischemia (CLI) is growing in global prevalence and is associated with high rates of limb loss and mortality. “Endovascular-first” approach is considered to be the current standard care for symptomatic infrainguinal atherosclerotic disease. Given the facts that many CLI patients have severe comorbidities and endovascular-first approach is a common practice and may reduce the magnitude of the surgical trauma and systemic complications. In this chapter, updated angiographic approach for below-the-knee disease is described with endovascular technique

Angiography and Endovascular Therapy for Peripheral Artery Disease

This textbook on Angiography and Endovascular Therapy for Peripheral Artery Disease provides a comprehensive angiographic approach to assess and determine optimal treatment strategies for peripheral artery disease (PAD). Each chapter focuses on angiography as it relates to the outcomes of endovascular work. It is an overview of the results obtained from a large number of actual cases with over 100 angiographic images of aortoiliac, femoropopliteal, below-the-knee, and below-the-ankle artery disease. Diagnostic and angiographic images of nonatherosclerotic PAD are also included. Anyone who is engaged in or preparing to engage in endovascular work for PAD should find this book useful as a reference and as an instruction material

A case of typical atrioventricular nodal (AVN) reentrant tachycardia confined to the compact AV node, showing a variety of rare electrophysiological findings, including eccentric AVN echoes

Herein, we report the case of a 49-year-old woman with typical atrioventricular nodal (AVN) reentrant tachycardia, confined to the compact atrioventricular node, showing numerous rare electrophysiological findings such as unique AVN reentrant echoes, double ventricular responses, latent retrograde dual AVN pathways, antegrade triple AVN pathways, and longitudinal dissociation within the lower final common pathway

Previously implanted mitral surgical prosthesis in patients undergoing transcatheter aortic valve implantation: Procedural outcome and morphologic assessment using multidetector computed tomography.

Transcatheter aortic valve implantation (TAVI) in the presence of a preexisting mitral prosthesis is challenging and its influence on the morphology of mitral prosthesis and the positioning of transcatheter heart valve (THV) is unknown. We assessed the feasibility of TAVI for patients with preexisting mitral prostheses, its influence on mitral prosthesis morphology, and the positional interaction between a newly implanted THV and mitral prosthesis using serial multidetector computed tomography (MDCT). Thirty-one patients with preexisting mitral prosthesis undergoing TAVI were included. MDCT was performed before and after TAVI. Thirty patients successfully underwent TAVI without interference from preexisting mitral prosthesis. Although opening disturbance of the mechanical mitral prosthesis by the THV edge was observed in 1 patient, the patient was managed conservatively. No THV embolization occurred. THV shift during deployment occurred in 9 patients and was predicted by a larger aortic annulus area (odds ratio: 1.24 per 10 mm2, 1.03-1.49, p = 0.02), possibly because of large THVs. The mitral mean pressure gradient was slightly higher after TAVI (3.7 vs. 4.3 mmHg, p = 0.002), whereas the mitral regurgitation grade was similar. MDCT showed that the size of the mitral prosthesis housing was unchanged after TAVI. The median distance between the mitral prosthesis and THV was 2.6 mm. The postprocedural angle between the mitral prosthesis and THV was larger than the preprocedural angle between the mitral prosthesis and the left ventricular outflow tract (64° vs. 61°, p = 0.03). Thus, TAVI is feasible in the case of preexisting mitral prosthesis. Serial MDCT demonstrated favorable THV positioning and unchanged mitral prosthesis morphology after TAVI