Endovascular Therapy of TASC-D Lesion in Critical Limb Ischemia

CLI (Rutherford class IV-VI) is a terminal stage of peripheral artery disease (PAD); it is defined by the presence of resting pain and/or tissue loss for at least two weeks that may require urgent revascularization to promote healing and prevent limb loss.For patients with infrarenal aortoiliac occlusive disease, the revascularization options are surgery like aortofemoral bypass and axillofemoral bypass or percutaneous intervention. Aortoiliac and aortofemoral bypass procedures are associated with 74% to 95% 5-year patency rates, respectively, which are comparable but not superior to percutaneous therapies.These operations may imply a significant morbidity and mortality on CLI patients who usually have multiple comorbid conditions and are considered high risk patients

Percutaneous Transluminal Balloon Venoplasty: A Less Invasive Technique for Implantation of Cardiac Leads in Patients with Limited Venous Access to the heart

Since its inception, cardiac pacing has made a significant advancement in cardiology. As new therapies and devices emerge, the number of implantations is steadily increasing which requires up-to-date clinical guidelines for management. Although advanced, these mechanical devices often require maintenance and revisions to achieve optimal performance. One of the most common deteriorations is the lead failure. In the case of lead failure requiring revision, new lead implant, or upgrading to a more advanced pacing system, venous stenosis resulting in partial or complete obstruction of the vessel can pose a real problem. This case series report introduces the technique of percutaneous transluminal balloon venoplasty in the setting of venous stenosis as an alternative to more invasive procedures such as lead extraction for lead revision or device upgrade

Left Ventricular Noncompaction Syndrome: A Rare Congenital Cardiomyopathy

Isolated left ventricular noncompaction cardiomyopathy (LVNC) is a rare congenital condition occurring due to arrest of myocardial compaction in the first trimester, resulting in a thin layer of compacted epicardium and thick hypertrabeculated myocardium containing deep recesses. This article presents a 44-year-old female with progressive dyspnea, orthopnea, paroxysmal nocturnal dyspnea, and pleuritic chest pain. Examination revealed elevated jugular venous distention, lower extremity edema, and bibasilar crackles on lung auscultation, while the electrocardiogram (EKG) exhibited left bundle branch block. Two-dimensional echocardiography (2D-Echo) showed a dilated left ventricle (LV) with ejection fraction (EF) of 25% and severe diffuse hypokinesia. Cardiac magnetic resonance imaging (MRI) confirmed the diagnosis of LVNC. Thereafter, she developed atrial fibrillation with rapid ventricular rate. Conservative treatment was initiated with Tikosyn, Xarelto, Lasix, Toprol XL, Lisinopril, statin and life vest. Eventually, a cardiac resynchronization therapy defibrillator (CRT-D) was implanted to prevent sudden cardiac death and reduce heart failure complications

Percutaneous Transluminal Balloon Venoplasty: A Less Invasive Technique for Implantation of Cardiac Leads in Patients with Limited Venous Access to the heart

Since its inception, cardiac pacing has made a significant advancement in cardiology. As new therapies and devices emerge, the number of implantations is steadily increasing which requires up-to-date clinical guidelines for management. Although advanced, these mechanical devices often require maintenance and revisions to achieve optimal performance. One of the most common deteriorations is the lead failure. In the case of lead failure requiring revision, new lead implant, or upgrading to a more advanced pacing system, venous stenosis resulting in partial or complete obstruction of the vessel can pose a real problem. This case series report introduces the technique of percutaneous transluminal balloon venoplasty in the setting of venous stenosis as an alternative to more invasive procedures such as lead extraction for lead revision or device upgrade