By: Lowell S. Kabnick, MD
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
Choosing the Appropriate Truncal Vein Closure DeviceVein Global
By: Steve Elias, MD, FACS
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
Future of Non Thermal Ablation: Is the Future of Endovenous AblationVein Global
By: Steve Elias, MD, FACS
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
Review of Randomized Controlled Trials Comparing Endovenous Thermal and Chemi...Vein Global
By: Edward G. Mackay, MD
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
The document discusses VNUS ClosureFast, a procedure for treating venous reflux disease. It describes how ClosureFast uses radiofrequency ablation to seal veins, diverting blood flow to deep veins. The procedure is simple, with segmental ablation allowing consistent treatment. Patients experience fast recovery with minimal pain and bruising. Long-term results show high occlusion rates, making ClosureFast an effective and cost-efficient option for treating varicose veins.
The document describes several clinical studies that evaluated the outcomes of using titanium-nitride-oxide coated stents in patients undergoing percutaneous coronary intervention (PCI). A randomized trial found that the coated stents significantly reduced late lumen loss and restenosis at 6 months compared to uncoated stents. A large registry of over 500 patients treated with the coated stents found low rates of major adverse cardiac events, target lesion revascularization, and stent thrombosis up to 1 year. The studies suggest the coated stents provide effective treatment with only short-term dual antiplatelet therapy, but direct comparison to drug-eluting stents is still needed.
Tryton Pivotal: Randomized Trial and Confirmatory Study - Key Messagestrytonmedical
Martin B. Leon discloses financial interests and relationships with several medical device companies, including Abbott, Boston Scientific, Edwards Lifescience, Medtronic, and St. Jude Medical. He then summarizes the design and results of the Tryton pivotal randomized controlled trial comparing the Tryton side branch stent strategy to a provisional stent strategy in coronary bifurcation lesions. The Tryton strategy was associated with better angiographic outcomes in the side branch but did not meet the primary endpoint of reducing target vessel failure. However, in a large side branch subgroup and confirmatory study, the Tryton strategy showed benefits over provisional stenting.
This document summarizes a presentation on techniques for transradial cardiac catheterization. It discusses common problems encountered such as unsuccessful puncture, radial artery spasm, and wire advancement issues. It provides tips for successful puncture including proper patient preparation, local anesthesia techniques, and treating spasm. Causes of failed wire advancement like radial loops and tortuosity are reviewed. Solutions emphasized are avoiding force, using contrast to understand the anatomy, hydrophilic wires, and external compression.
The DEFLECT I trial evaluated the safety and performance of the TriGuard embolic deflection device in patients undergoing TAVR. The study found:
1) The TriGuard device was successfully deployed and retrieved in most cases without any device-related complications.
2) Rates of new brain lesions following TAVR with TriGuard were similar to historical controls, but the average and total volumes of new lesions were significantly lower (reduced by 65% and 57% respectively) compared to historical data.
3) The results provide preliminary evidence that the TriGuard device may help reduce the volume of cerebral embolic material and ischemic brain injuries during TAVR without increasing safety risks. Larger studies are still needed
Choosing the Appropriate Truncal Vein Closure DeviceVein Global
By: Steve Elias, MD, FACS
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
Future of Non Thermal Ablation: Is the Future of Endovenous AblationVein Global
By: Steve Elias, MD, FACS
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
Review of Randomized Controlled Trials Comparing Endovenous Thermal and Chemi...Vein Global
By: Edward G. Mackay, MD
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
The document discusses VNUS ClosureFast, a procedure for treating venous reflux disease. It describes how ClosureFast uses radiofrequency ablation to seal veins, diverting blood flow to deep veins. The procedure is simple, with segmental ablation allowing consistent treatment. Patients experience fast recovery with minimal pain and bruising. Long-term results show high occlusion rates, making ClosureFast an effective and cost-efficient option for treating varicose veins.
The document describes several clinical studies that evaluated the outcomes of using titanium-nitride-oxide coated stents in patients undergoing percutaneous coronary intervention (PCI). A randomized trial found that the coated stents significantly reduced late lumen loss and restenosis at 6 months compared to uncoated stents. A large registry of over 500 patients treated with the coated stents found low rates of major adverse cardiac events, target lesion revascularization, and stent thrombosis up to 1 year. The studies suggest the coated stents provide effective treatment with only short-term dual antiplatelet therapy, but direct comparison to drug-eluting stents is still needed.
Tryton Pivotal: Randomized Trial and Confirmatory Study - Key Messagestrytonmedical
Martin B. Leon discloses financial interests and relationships with several medical device companies, including Abbott, Boston Scientific, Edwards Lifescience, Medtronic, and St. Jude Medical. He then summarizes the design and results of the Tryton pivotal randomized controlled trial comparing the Tryton side branch stent strategy to a provisional stent strategy in coronary bifurcation lesions. The Tryton strategy was associated with better angiographic outcomes in the side branch but did not meet the primary endpoint of reducing target vessel failure. However, in a large side branch subgroup and confirmatory study, the Tryton strategy showed benefits over provisional stenting.
This document summarizes a presentation on techniques for transradial cardiac catheterization. It discusses common problems encountered such as unsuccessful puncture, radial artery spasm, and wire advancement issues. It provides tips for successful puncture including proper patient preparation, local anesthesia techniques, and treating spasm. Causes of failed wire advancement like radial loops and tortuosity are reviewed. Solutions emphasized are avoiding force, using contrast to understand the anatomy, hydrophilic wires, and external compression.
The DEFLECT I trial evaluated the safety and performance of the TriGuard embolic deflection device in patients undergoing TAVR. The study found:
1) The TriGuard device was successfully deployed and retrieved in most cases without any device-related complications.
2) Rates of new brain lesions following TAVR with TriGuard were similar to historical controls, but the average and total volumes of new lesions were significantly lower (reduced by 65% and 57% respectively) compared to historical data.
3) The results provide preliminary evidence that the TriGuard device may help reduce the volume of cerebral embolic material and ischemic brain injuries during TAVR without increasing safety risks. Larger studies are still needed
BioNIR/EluNIR eDES: 1 Year Outcomes of BIONICS and NIREUS studiesMedinol Ltd
Dr. David Kandzari's overview of the 1 year outcomes of the BIONICS and NIREUS pivotal & randomized studies of the EluNIR elastomer DES by Medinol (formerly BioNIR). Presented during TCT 2016
This document summarizes evidence from multiple studies comparing endovenous ablation techniques (EVLT, RFA, UGFS) to conventional surgery for treating varicose veins. Meta-analyses found endovenous techniques had lower risks of wound infection, hematoma and postoperative pain, and faster recovery times compared to surgery. However, long-term outcomes like recurrence rates were similar. A large randomized controlled trial found EVLT, RFA and surgery all effectively treated varicose veins, but RFA and UGFS had less pain and faster recovery. After 5 years, recurrence and reflux rates remained similar between EVLT and surgery. Guidelines now recommend endovenous ablation over high ligation and stripping due to shorter recovery and
M.Lesiak, eu perspective on left main - the final frontiertrytonmedical
This document discusses percutaneous coronary intervention (PCI) of the left main coronary artery (LMCA). It provides an overview of guidelines recommending CABG or PCI for LMCA lesions depending on risk. Data is presented from registries on the use of the Tryton stent for LMCA PCI showing good safety and efficacy outcomes. The importance of optimal side branch protection during LMCA stenting is discussed. A new shorter design of the Tryton stent is presented as facilitating PCI of more distal LMCA lesions.
The document discusses quality control in colorectal cancer surgery through the use of national registries in Sweden. It describes how the Swedish model requires mandatory participation, population-based data from all hospitals. This allows for transparent reporting that can be used to evaluate outcomes, compare units, and identify unexpected findings. Examples are provided of how the Swedish Rectal Cancer Registry has been used to improve outcomes and reduce local recurrence rates over time.
1) The document discusses a case of a 76-year-old woman with severe aortic stenosis, left ventricular dysfunction, and no contractile reserve on stress echocardiography.
2) Tests including aortic valve calcium scoring by CT and low/high-dose dobutamine stress echocardiography were used to further evaluate the severity of stenosis and operative risk.
3) Based on the results, transapical transcatheter aortic valve replacement (TAVR) was performed and led to improvements in symptoms, valve hemodynamics, and left ventricular function at one-year follow-up.
This document discusses TRI (transradial intervention) in patients with chronic kidney disease (CKD). It notes that CKD patients have accelerated atherosclerosis and are at high risk for coronary artery disease. While PCI can help treat CAD, CKD patients face higher risks of bleeding complications and renal impairment from the procedures. The document recommends hydration, low-osmolar contrast agents, and limiting contrast load when performing PCI in CKD patients to protect kidney function. It argues that TRI may reduce bleeding risks compared to transfemoral approaches but must be used cautiously in end-stage renal disease to avoid compromising existing or future arteriovenous fistulas needed for hemodialysis access.
This document discusses various treatment options for chronic venous insufficiency (CVI), including endovenous ablation techniques (radiofrequency ablation (RFA) and endovenous laser ablation (EVLA)) and surgical treatment. It provides data on the increasing use of RFA and EVLA compared to surgery based on number of procedures performed in the US from 2002-2008. It summarizes evidence that RFA and EVLA provide similar clinical results as surgery with less post-operative pain, faster recovery times, and earlier return to normal activities. However, long-term data on recurrence rates beyond 3 years is still limited.
This document summarizes the Compare Trial, which compared the Taxus Liberté and Xience V drug-eluting stents. The trial included 1,800 patients and found that at the 2-year follow up:
1) Xience V was superior to Taxus Liberté for reducing the primary endpoint of death, heart attack, and repeat procedures.
2) Xience V also significantly reduced the risks of heart attack, repeat procedures, and stent thrombosis compared to Taxus Liberté.
3) While both stents significantly reduced risks overall, neither showed a significant difference for diabetic patients specifically.
Impact of access site on bleeding and ischemic events in patients with non-ST-segment elevation myocardial infarction treated with prasugrel at the time of percutaneous coronary intervention or as pretreatment at the time of diagnosis: the ACCOAST access substudy
Eluting balloons, the mechanism of action, indications for use Ivan. G. HorvathChaichuk Sergiy
1) Eluting balloons deliver antiproliferative drugs locally via a balloon catheter to prevent restenosis without the need for a permanent stent.
2) Early studies showed eluting balloons significantly reduced late lumen loss and restenosis compared to uncoated balloons in treating small vessel disease and in-stent restenosis.
3) Subsequent randomized trials found eluting balloons were non-inferior and in some cases superior to drug-eluting stents in preventing restenosis, with fewer risks of stent thrombosis and need for long-term dual antiplatelet therapy.
This single-center randomized controlled trial compared outcomes of STEMI patients treated with bivalirudin (n=907) versus unfractionated heparin (n=905) during primary percutaneous coronary intervention (PPCI). At 28 days, the primary efficacy outcome (composite of death, stroke, reinfarction, unplanned revascularization) occurred more frequently in the bivalirudin group (8.7% vs 5.7%, p=0.01). The increased risk was driven by a higher rate of stent thrombosis with bivalirudin (3.4% vs 0.9%, p=0.001). Major bleeding rates were similar between groups (3.5% vs
The RESOLUTE International study evaluated the Resolute stent in a large "real-world" patient population across multiple centers internationally. It found that use of the Resolute stent was associated with a low rate of major cardiac events such as death, heart attack and stent thrombosis, consistent with results from the RESOLUTE All Comers trial. The study enrolled over 2,300 patients across various countries and baseline characteristics and outcomes were similar between monitored and unmonitored patients, supporting the generalizability of prior RESOLUTE trial results.
This document summarizes the results of the SAFE-PCI for Women Trial, which compared radial versus femoral approaches for percutaneous coronary intervention (PCI) in women. The trial was terminated early due to lower than expected rates of bleeding and vascular complications. In both the total randomized cohort and PCI cohort, radial access was associated with significantly lower rates of bleeding/vascular complications and procedural failure compared to femoral access. Secondary endpoints showed no significant differences in outcomes between approaches. The results suggest an initial strategy of radial access is reasonable for PCI in women.
The document discusses radial artery angiography and complications. It provides questions and answers on topics like Allen's test, predictors of radial artery spasm, medications used to prevent spasm like verapamil and nitroglycerine, heparin doses for anticoagulation, and techniques for patent hemostasis after sheath removal to prevent radial artery occlusion. The document is a guide for physicians on best practices when performing radial artery catheterization to minimize complications.
This study assessed the feasibility of reducing radiation exposure during coronary CT angiography (CCTA) using only modified acquisition parameters on a 64-slice CT scanner. Over 85% of patients were able to undergo prospective CCTA, which significantly reduced radiation dose compared to historical levels and conventional angiography. Image quality remained high, with over 97% of coronary segments evaluated as having either excellent, good, or fair quality. The study demonstrated that very low dose CCTA is possible using standard equipment by optimizing acquisition settings.
J.Lassen, importance of side branch ostial scaffoldingtrytonmedical
This document is the transcript from a presentation given by Dr. Jens Flensted Lassen on establishing new standards for treating complex bifurcation lesions. Dr. Lassen discusses the limitations of current drug-eluting stents for bifurcation lesions and the variety of techniques that are used. He then presents data showing the Tryton stent was designed specifically for bifurcations, with the ability to provide ostial scaffolding over 3.5mm and accommodate different vessel angles and calibers with one technique. Dr. Lassen concludes the Tryton stent has potential to be used in all bifurcations if the side branch is sufficiently large.
The document describes the venous drainage system of the lower extremity, including the long saphenous vein (LSV), short saphenous vein (SSV), deep veins, and perforating veins. It provides details on the anatomy and course of the LSV and SSV. Surgical procedures for varicose veins are discussed such as ligation and stripping, ligation of incompetent perforators, and newer minimally invasive techniques like foam sclerotherapy, endovenous laser ablation, and radiofrequency ablation. Post-operative care and potential complications are also summarized.
This document discusses various treatment options for varicose veins, including conservative management using compression bandages and stockings, medications to improve lymph flow and protect veins, sclerotherapy to harden problematic veins, and surgical procedures such as vein ligation and stripping. More minimally invasive options like endovenous laser ablation and radiofrequency ablation are also covered, which involve inserting a laser or radiofrequency catheter into the vein to cause thermal damage and occlusion. All treatments have potential complications like pain, bruising, bleeding, or deep vein thrombosis.
BioNIR/EluNIR eDES: 1 Year Outcomes of BIONICS and NIREUS studiesMedinol Ltd
Dr. David Kandzari's overview of the 1 year outcomes of the BIONICS and NIREUS pivotal & randomized studies of the EluNIR elastomer DES by Medinol (formerly BioNIR). Presented during TCT 2016
This document summarizes evidence from multiple studies comparing endovenous ablation techniques (EVLT, RFA, UGFS) to conventional surgery for treating varicose veins. Meta-analyses found endovenous techniques had lower risks of wound infection, hematoma and postoperative pain, and faster recovery times compared to surgery. However, long-term outcomes like recurrence rates were similar. A large randomized controlled trial found EVLT, RFA and surgery all effectively treated varicose veins, but RFA and UGFS had less pain and faster recovery. After 5 years, recurrence and reflux rates remained similar between EVLT and surgery. Guidelines now recommend endovenous ablation over high ligation and stripping due to shorter recovery and
M.Lesiak, eu perspective on left main - the final frontiertrytonmedical
This document discusses percutaneous coronary intervention (PCI) of the left main coronary artery (LMCA). It provides an overview of guidelines recommending CABG or PCI for LMCA lesions depending on risk. Data is presented from registries on the use of the Tryton stent for LMCA PCI showing good safety and efficacy outcomes. The importance of optimal side branch protection during LMCA stenting is discussed. A new shorter design of the Tryton stent is presented as facilitating PCI of more distal LMCA lesions.
The document discusses quality control in colorectal cancer surgery through the use of national registries in Sweden. It describes how the Swedish model requires mandatory participation, population-based data from all hospitals. This allows for transparent reporting that can be used to evaluate outcomes, compare units, and identify unexpected findings. Examples are provided of how the Swedish Rectal Cancer Registry has been used to improve outcomes and reduce local recurrence rates over time.
1) The document discusses a case of a 76-year-old woman with severe aortic stenosis, left ventricular dysfunction, and no contractile reserve on stress echocardiography.
2) Tests including aortic valve calcium scoring by CT and low/high-dose dobutamine stress echocardiography were used to further evaluate the severity of stenosis and operative risk.
3) Based on the results, transapical transcatheter aortic valve replacement (TAVR) was performed and led to improvements in symptoms, valve hemodynamics, and left ventricular function at one-year follow-up.
This document discusses TRI (transradial intervention) in patients with chronic kidney disease (CKD). It notes that CKD patients have accelerated atherosclerosis and are at high risk for coronary artery disease. While PCI can help treat CAD, CKD patients face higher risks of bleeding complications and renal impairment from the procedures. The document recommends hydration, low-osmolar contrast agents, and limiting contrast load when performing PCI in CKD patients to protect kidney function. It argues that TRI may reduce bleeding risks compared to transfemoral approaches but must be used cautiously in end-stage renal disease to avoid compromising existing or future arteriovenous fistulas needed for hemodialysis access.
This document discusses various treatment options for chronic venous insufficiency (CVI), including endovenous ablation techniques (radiofrequency ablation (RFA) and endovenous laser ablation (EVLA)) and surgical treatment. It provides data on the increasing use of RFA and EVLA compared to surgery based on number of procedures performed in the US from 2002-2008. It summarizes evidence that RFA and EVLA provide similar clinical results as surgery with less post-operative pain, faster recovery times, and earlier return to normal activities. However, long-term data on recurrence rates beyond 3 years is still limited.
This document summarizes the Compare Trial, which compared the Taxus Liberté and Xience V drug-eluting stents. The trial included 1,800 patients and found that at the 2-year follow up:
1) Xience V was superior to Taxus Liberté for reducing the primary endpoint of death, heart attack, and repeat procedures.
2) Xience V also significantly reduced the risks of heart attack, repeat procedures, and stent thrombosis compared to Taxus Liberté.
3) While both stents significantly reduced risks overall, neither showed a significant difference for diabetic patients specifically.
Impact of access site on bleeding and ischemic events in patients with non-ST-segment elevation myocardial infarction treated with prasugrel at the time of percutaneous coronary intervention or as pretreatment at the time of diagnosis: the ACCOAST access substudy
Eluting balloons, the mechanism of action, indications for use Ivan. G. HorvathChaichuk Sergiy
1) Eluting balloons deliver antiproliferative drugs locally via a balloon catheter to prevent restenosis without the need for a permanent stent.
2) Early studies showed eluting balloons significantly reduced late lumen loss and restenosis compared to uncoated balloons in treating small vessel disease and in-stent restenosis.
3) Subsequent randomized trials found eluting balloons were non-inferior and in some cases superior to drug-eluting stents in preventing restenosis, with fewer risks of stent thrombosis and need for long-term dual antiplatelet therapy.
This single-center randomized controlled trial compared outcomes of STEMI patients treated with bivalirudin (n=907) versus unfractionated heparin (n=905) during primary percutaneous coronary intervention (PPCI). At 28 days, the primary efficacy outcome (composite of death, stroke, reinfarction, unplanned revascularization) occurred more frequently in the bivalirudin group (8.7% vs 5.7%, p=0.01). The increased risk was driven by a higher rate of stent thrombosis with bivalirudin (3.4% vs 0.9%, p=0.001). Major bleeding rates were similar between groups (3.5% vs
The RESOLUTE International study evaluated the Resolute stent in a large "real-world" patient population across multiple centers internationally. It found that use of the Resolute stent was associated with a low rate of major cardiac events such as death, heart attack and stent thrombosis, consistent with results from the RESOLUTE All Comers trial. The study enrolled over 2,300 patients across various countries and baseline characteristics and outcomes were similar between monitored and unmonitored patients, supporting the generalizability of prior RESOLUTE trial results.
This document summarizes the results of the SAFE-PCI for Women Trial, which compared radial versus femoral approaches for percutaneous coronary intervention (PCI) in women. The trial was terminated early due to lower than expected rates of bleeding and vascular complications. In both the total randomized cohort and PCI cohort, radial access was associated with significantly lower rates of bleeding/vascular complications and procedural failure compared to femoral access. Secondary endpoints showed no significant differences in outcomes between approaches. The results suggest an initial strategy of radial access is reasonable for PCI in women.
The document discusses radial artery angiography and complications. It provides questions and answers on topics like Allen's test, predictors of radial artery spasm, medications used to prevent spasm like verapamil and nitroglycerine, heparin doses for anticoagulation, and techniques for patent hemostasis after sheath removal to prevent radial artery occlusion. The document is a guide for physicians on best practices when performing radial artery catheterization to minimize complications.
This study assessed the feasibility of reducing radiation exposure during coronary CT angiography (CCTA) using only modified acquisition parameters on a 64-slice CT scanner. Over 85% of patients were able to undergo prospective CCTA, which significantly reduced radiation dose compared to historical levels and conventional angiography. Image quality remained high, with over 97% of coronary segments evaluated as having either excellent, good, or fair quality. The study demonstrated that very low dose CCTA is possible using standard equipment by optimizing acquisition settings.
J.Lassen, importance of side branch ostial scaffoldingtrytonmedical
This document is the transcript from a presentation given by Dr. Jens Flensted Lassen on establishing new standards for treating complex bifurcation lesions. Dr. Lassen discusses the limitations of current drug-eluting stents for bifurcation lesions and the variety of techniques that are used. He then presents data showing the Tryton stent was designed specifically for bifurcations, with the ability to provide ostial scaffolding over 3.5mm and accommodate different vessel angles and calibers with one technique. Dr. Lassen concludes the Tryton stent has potential to be used in all bifurcations if the side branch is sufficiently large.
The document describes the venous drainage system of the lower extremity, including the long saphenous vein (LSV), short saphenous vein (SSV), deep veins, and perforating veins. It provides details on the anatomy and course of the LSV and SSV. Surgical procedures for varicose veins are discussed such as ligation and stripping, ligation of incompetent perforators, and newer minimally invasive techniques like foam sclerotherapy, endovenous laser ablation, and radiofrequency ablation. Post-operative care and potential complications are also summarized.
This document discusses various treatment options for varicose veins, including conservative management using compression bandages and stockings, medications to improve lymph flow and protect veins, sclerotherapy to harden problematic veins, and surgical procedures such as vein ligation and stripping. More minimally invasive options like endovenous laser ablation and radiofrequency ablation are also covered, which involve inserting a laser or radiofrequency catheter into the vein to cause thermal damage and occlusion. All treatments have potential complications like pain, bruising, bleeding, or deep vein thrombosis.
1. Despite prior endovenous thermal ablation of saphenous veins, varicose veins were present in 162 out of 197 limbs (82%).
2. Patients presented a median of 36 months after their initial endovenous ablation procedure. The majority were middle-aged females.
3. Recurrence of varicose veins was associated with recanalized saphenous veins in 36% of cases, perforator vein reflux in 31% of cases, and accessory vein reflux in 30% of cases.
This document discusses endovenous laser ablation (EVLA) for treating varicose veins. It begins with definitions of different types of abnormal veins like telangiectasias, reticular veins, and varicose veins. It then discusses patient assessment, which involves medical history, physical examination, and duplex ultrasound scan. For patients with superficial venous reflux and varicose veins, treatment options discussed include conservative management, sclerotherapy, and thermal ablation techniques like EVLA. EVLA involves using laser energy to close off diseased veins. The document provides details on patient selection, procedural technique, and outcomes of EVLA for varicose vein treatment.
Outcomes of Venous Interventions in C5-6 DiseaseVein Global
By: Mark H. Meissner, MD
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
By: Mark J. Garcia MD, MS, FSIR
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
When is MR Venography Useful? What makes it so Operator Dependent?Vein Global
By: Constantino S.Peña
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
This document discusses varicose veins (VV), including their definition, anatomy, pathophysiology, etiology, clinical presentation, investigations, treatment options, and management approach. VV are dilated, tortuous superficial veins in the lower limbs. Treatment involves initial conservative measures for 3 months, including compression therapy and pharmacologic agents for symptomatic patients or those with reflux. Refractory patients may undergo ablative therapies like sclerotherapy, radiofrequency ablation, or laser ablation to treat refluxing veins. The goals of treatment are improved symptoms and appearance.
The Important Nerves During Venous AblationVein Global
By: John Mauriello, M.D.
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
Who Needs More Testing Beyond Venous Duplex?Vein Global
By: William Marston, MD
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(1) 4% of patients evaluated for leg vein problems had previously undergone vein "stripping" surgery, with recurrent varicose veins present in 71 patients. (2) Recurrence was often due to residual or accessory saphenous veins, perforator veins, or neovascularization. (3) 73% of patients were treated with endovenous laser ablation (EVLA) of saphenous veins, with the majority reporting symptomatic improvement and vein closure at follow-up.
Venous Leg Ulcers: Wound Preparation & Adjuvants to HealingVein Global
By: William Marston, M.D.
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
Endovenous Laser Ablation in the Treatment of Recurrent Varicose VeinsMinnesota Vein Center
Aims:
Determine how many patients presented to a single center Vein Specialty Clinic with varicose veins despite prior surgical intervention.
Identify the site and cause of varicose veins in patients with prior surgical intervention.
Assess the role of endovenous laser ablation in the retreatment of varicose veins in patients with prior intervention.
By: Seshadri Raju, MD, FACS
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Radio Frequency Ablation (RFA Treatment ) -Modern Technology for management l...SafeMedTrip
Safemedtrip india's number one company of medical treatment, which provide low cost treatment package for international patient. if you have any problem Please scan and email your medical reports to us at hospitalindia@gmail.com or help@safemedtrip.com or call us at +91-9899993637 and we shall get you a Free, No Obligation Opinion from India's leading Specialist Doctors.
This document discusses varicose vein surgery. It provides an overview of the indications for varicose vein surgery, including pain, swelling, skin changes, ulceration, and appearance. It describes the importance of preoperative evaluation using duplex ultrasound mapping to identify refluxing veins and develop a surgical plan. Finally, it outlines procedural considerations for varicose vein treatment, including the goals of ablating reflux from deep to superficial veins and removing all branch varicosities.
Should C2 Disease Classification Be Broken Down Further? Who Progresses to C4?Vein Global
By: Nick Morrison, MD, FACS, FACPh, RPhS
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By: Steve Elias MD FACS
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What's New In Glaucoma Surgery [OD CE 2 credit hours] - PPT Slides and VideosDr David Richardson
What's New In Glaucoma Surgery Presentation. A Continuing Education course for Optometrists presented by Patient-Focused Ophthalmologist, Dr. David Richardson.
At the end of the presentation audience participants became familiar with the main benefits and risks of currently available glaucoma treatments as well as had awareness of the most promising potential future surgical glaucoma treatments.
This OD CE Course was held at Green Street Tavern, Pasadena, CA last May 20, 2015.
=========================
[Glaucoma Surgeon, California] Dr. David Richardson is a board certified Ophthalmologist and Eye Surgeon in California specializing in the treatment of Cataract and Glaucoma. He is the Medical Director of San Marino Eye (Vision Center), located in San Marino, California. He’s the former Chief of Surgery and now Vice Chief of Staff at San Gabriel Valley Medical Center. Dr. Richardson has performed thousands of advanced cataract and Canaloplasty glaucoma procedures with excellent results.
More information about Dr. Richardson: http://David-Richardson-MD.com
New Glaucoma Treatments is a GLAUCOMA HealthHub maintained by David Richardson, M.D. It’s primary purpose is to provide valuable information to glaucoma patients and their caregivers worldwide about the latest developments and treatments for glaucoma, while providing answers to commonly asked questions about glaucoma, care and treatment options.
More information about new glaucoma treatments here: http://new-glaucoma-treatments.com
VICTORIA MARTIN - LONG TERM FOLLOW-UP WITH BVS IN CTOEuro CTO Club
This document summarizes several studies on the long-term follow-up of bioresorbable vascular scaffolds (BVS) for the treatment of chronic total occlusions (CTO). It describes the baseline characteristics, procedural details, and follow-up results of patients in the studies. The conclusions state that more long-term follow-up of 3-5 years is still needed to fully understand the long-term performance of BVS in CTOs, including risks of late thrombosis and restenosis. Proper lesion preparation, appropriate vessel sizing, high pressure post-dilation, and antiplatelet therapy are recommended to help guarantee long-term results and avoid device thrombosis.
This document describes the case of a 52-year-old male who presented with vomiting and was found to have a pituitary adenoma. An MRI showed a 2.3x1.6 cm dumbbell shaped lesion in the sella turcica extending suprasellarly and compressing the optic chiasm. The patient underwent endoscopic transphenoidal resection, with near total excision. Post-op MRI showed residual tissue in the right and left sides of the sella. The patient was planned for stereotactic radiotherapy with 25Gy in 5 fractions to treat the residual tumor. Target and organ at risk volumes were delineated on planning MRI and CT scans. Treatment planning was performed to optimize dose distribution and minimize
Small AVMs that are deep or in eloquent areas are often treated with radiosurgery instead of surgery. Radiosurgery uses a single high dose of radiation and has an obliteration rate of 70-80% at 2 years. Frame-based radiosurgery requires invasive head fixation for imaging and treatment, while frameless radiosurgery with the Cyberknife does not require an invasive frame. Preliminary studies show frameless radiosurgery has obliteration rates similar to frame-based radiosurgery but is better tolerated as an outpatient procedure without head frame fixation.
Device Based Approaches For Heart Failure Ventricular ReshapingCardio Kinetix
In this presentation titled "Device Based Approaches For Heart Failure: Ventricular Reshaping" Alexandra Lansky, MD explains some of the device-based approaches for heart-failure being used by companies such as Cardio Kinetix (http://www.cardiokinetix.com/)
MR guided focused ultrasound (MRgFUS) is a non-invasive technique that uses focused ultrasound guided by MRI to thermally ablate targeted tissues. It has been used to treat various conditions including uterine fibroids, adenomyosis, facet joint pain, bone metastases, osteoid osteoma and prostate cancer. The document discusses several case studies from a hospital in Mumbai where MRgFUS was used to treat facet joint pain, bone metastases and osteoid osteoma. In the facet joint pain cases, 25 patients were treated with an average reduction in pain scores of 60.2% immediately following treatment. For bone metastases treatment, 9 patients were treated with improved pain scores and no adverse events. MRgFUS is presented
Werner - Session 1 Radiation management in CTO PCIEuro CTO Club
This document discusses strategies for reducing radiation exposure during complex coronary interventions. It summarizes data on radiation use from various studies and registries. Key findings include that radiation skin injuries are rarely reported, but potential effects include transient erythema, permanent epilation, and dermal necrosis. Radiation exposure increases with lesion complexity and use of retrograde approaches. Modifications like lowering fluoroscopy frame rates can reduce dose but individual variability remains high. The document emphasizes continuously monitoring dose rates, using minimum needed imaging, and changing angulations over increasing dose. It also notes that exceeding 5 Gy limits seen in some cases must be avoided going forward. Further optimization of radiation use by operators is still needed.
Endovenous Ablation of Varicose Veins. Treat painful varicose veins by Laser ...Saurabh Joshi
Varicose Veins is a very common medical condition affecting more than 30 % of the population. If left untreated, this can cause painful skin ulceration and a significant loss of quality of life.
Treatment is an office procedure, a small needle prick is all that is needed to position the Laser / RFA fiber within the vein and treat this disease once and for all.
Find out more and contact Dr.Joshi for details.
This document discusses techniques for vitreous surgery using 25G instruments. It describes how bimanual 25G vitrectomy allows for simultaneous control of two instruments with better visual control compared to single hand vitrectomy. The techniques emphasized include lifting and cutting membranes under direct visualization, simultaneous fluid-air-silicone oil exchange, soft tip evacuation to control hemorrhage, and peripheral laser treatment. The author reports results from 142 cases using these 25G bimanual techniques showing 35% fewer iatrogenic tears, 50% better vision after silicone oil removal, and 40% less early rebleeding compared to earlier cases using single hand 25G vitrectomy.
This document discusses the surgical management of complications from proliferative diabetic retinopathy. It provides an overview of the pathogenesis and surgical treatment of tractional retinal detachment. Pars plana vitrectomy is the procedure of choice for treating vitreous hemorrhage and tractional retinal detachment. Advances in surgical instrumentation including illuminated instruments, wide-angle viewing systems, perfluorocarbon liquids, and smaller gauge vitrectomy cuts have improved surgical outcomes. The document reviews surgical techniques for removing fibrovascular membranes and achieving hemostasis.
3. VNVDAII - Venous diseases of lower extremitiesssuser787e5c1
This document discusses venous diseases of the lower extremities, including common conditions like varicose veins and deep vein thrombosis (DVT). It describes signs and symptoms, investigations like duplex venous scans, and treatment options for various conditions. Treatment may include compression stockings, sclerotherapy, surgery, laser ablation, radiofrequency ablation (RFA), mechanical occlusion and chemical ablation (MOCA). Endovascular options for DVT include catheter-directed thrombolysis, ultrasound-accelerated thrombolysis, percutaneous mechanical thrombectomy, and venoplasty or stenting. Preventing venous thromboembolism and reducing long-term morbidity from DVT involves considering endovascular treatments in addition to anticoagulation for
Three-Years Results After Femtosecond Laser-Assisted Circular Keratotomy As a Treatment for Keratoconus Stages I-II:
Comparison with (Iontophoresis-Assisted) CXL, presented at ASCRS 2018 – by Detlev Breyer, H. Kaymak, K. Klabe, P. Hagen, T. Ax, F. Kretz, G. Auffarth
This lecture reviews the role of laser therapy in dentistry in particular for Periodontal treatment. Dr. Smith reviews many of his own cases with the audience.
Please contact Dr. Smith with questions.
drsmith@cpident.com
Доклад на Пятой научно-практической конференции с международным участием «Основные тенденции в современной офтальмологии», организованной клиникой профессора Эскиной Э.Н. «Сфера», совместно с кафедрой офтальмологии ФГБОУ ДПО ИПК ФМБА России —→ http://www.sfe.ru/information/ophthalmology-news/conference2015.html
1) Peripheral artery disease (PAD) is common in patients with diabetes and a leading cause of lower limb amputation.
2) Endovascular therapy is now the preferred initial approach for revascularization in diabetic foot patients with PAD, as it is less invasive and risky compared to surgery.
3) Techniques like balloon angioplasty and stenting have high success rates for revascularization and allow salvaging over 90% of threatened limbs, even in high-risk patients, when combined with good diabetic control, wound debridement, and antibiotics.
This study compared the efficacy and safety of holmium laser versus cold knife for treating short segment urethral strictures. 66 male patients were randomized into two groups undergoing either cold knife or holmium laser internal urethrotomy. Both groups showed significant improvement in IPSS, PVR, and Qmax scores postoperatively. At 1 year follow up, the holmium laser group had statistically better scores and a lower stricture recurrence rate compared to the cold knife group. The holmium laser procedure also had a shorter operative time and lower complication rate. The study concluded that holmium laser internal urethrotomy is an effective and safer treatment for short urethral strictures compared to cold knife.
This document discusses various techniques for repairing retinal detachments, including cryotherapy, laser photocoagulation, pneumatic retinopexy, scleral buckling, and vitrectomy. Cryotherapy uses temperature to induce inflammation and seal retinal breaks, while laser photocoagulation uses targeted burns. Pneumatic retinopexy employs an intravitreal gas bubble. Scleral buckling places an explant on the sclera to push the retina back into position. Vitrectomy surgically removes the vitreous gel to relieve traction on retinal breaks. Each technique has benefits and risks, and the optimal approach depends on factors like break location and extent of detachment. Advances in small-gauge
This document discusses pressure ulcers and presents a solution called the Dolphin Pressure Redistribution System. It begins with background on the incidence and costs of pressure ulcers in the US. It then discusses conventional solutions like low air loss beds and their limitations. The Dolphin System is introduced as a dynamic 3D pressure redistribution system that prevents and heals pressure ulcers at all stages through a full mattress and wheelchair pad allowing continuity of care during transport. Comparative data shows it significantly outperforms other systems in reducing pressure and healing time, thereby reducing costs of treatment. In closing, it argues the Dolphin System delivers innovative medical devices that both improve patient care and provide financial benefits to healthcare facilities.
Polidocanol Endovenous Microfoam: Where Are We?Vein Global
By: Nick Morrison, MD, FACS, FACPh, RPhS
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
Future of RF Ablation: Continuous or Segmental?Vein Global
By: Alan M. Dietzek, MD, RVT, RPVI, FACS
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
Does All Saphenous Reflux Need Ablation?Vein Global
By: Paul M. McNeill, MD, FACS
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
By: Mark Meissner, M.D.
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
Thigh, Calf & Ankle Perforators: Are They Different?Vein Global
By: Nicos Labropoulos, PhD, RVT
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
Diagnosis of Llio-caval Venous Obstruction: Causes of Venous ObstructionVein Global
By: William Marston, M.D.
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
Detecting Deep Venous Disease with Duplex UltrasoundVein Global
By: Joseph Zygmunt, Jr., RVT, RPhS
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
How do Laser Wavelengths & Fibers Differ Clinically?Vein Global
By: Thomas M. Proebstle, M.D.
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
Deep Vein Pathophysiology: Reflux & ObstructionVein Global
By: Peter J. Pappas, M.D.
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
By: Lowell S. Kabnick, MD, FACS, FACPh, RPhS
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
1. The document discloses that Dr. Elias has financial relationships as a consultant for Covidien Inc. and Vascular Insights LLC.
2. It provides information on the anatomy of the small saphenous vein and discusses techniques for endovenous laser ablation of the small saphenous vein, including access points, positioning, and avoiding injury to nerves.
3. Potential complications of endovenous laser ablation of the small saphenous vein discussed include nerve injury and deep vein thrombosis.
By: Joseph Zygmunt, Jr., RVT, RPhS
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
This document discusses thermal ablation as an alternative to surgery for treating great saphenous veins. It notes that randomized trials show thermal ablation is at least non-inferior to surgery for procedural success and clinical outcomes, with improved patient quality of life. The advantages of thermal ablation are outlined as being totally outpatient, avoiding sutures and reducing risks of infection, lymphatic damage, and limitations from anticoagulation. Key steps for performing thermal ablation are described, including patient selection, setting, ultrasound use, catheter placement skills, tumescent anesthesia, and ensuring sufficient heat delivery to the vein wall for durable success. Various technologies for heat delivery are mentioned, and segmental ablation is noted to allow faster patient recovery compared
By: Paul M. McNeill, M.D.
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
Non-Thrombotic Iliac Vein Lesions: Permissive Role in CVD PathogenicityVein Global
By: Seshadri Raju, M.D.
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
Future of Laser Ablation: New Wavelength or Fiber Tips?Vein Global
By: Thomas M. Proebstle, MD
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
Does Multiple Axial Vein Incompetence Increase The Clinical Severity of Venou...Vein Global
By: Lowell S. Kabnick, MD, FACS
Visit VeinGlobal at http://www.veinglobal.com/ for more presentations and videos on this topic, or for more information on venous disease news, education and research.
Adhd Medication Shortage Uk - trinexpharmacy.comreignlana06
The UK is currently facing a Adhd Medication Shortage Uk, which has left many patients and their families grappling with uncertainty and frustration. ADHD, or Attention Deficit Hyperactivity Disorder, is a chronic condition that requires consistent medication to manage effectively. This shortage has highlighted the critical role these medications play in the daily lives of those affected by ADHD. Contact : +1 (747) 209 – 3649 E-mail : sales@trinexpharmacy.com
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
10 Benefits an EPCR Software should Bring to EMS Organizations Traumasoft LLC
The benefits of an ePCR solution should extend to the whole EMS organization, not just certain groups of people or certain departments. It should provide more than just a form for entering and a database for storing information. It should also include a workflow of how information is communicated, used and stored across the entire organization.
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
Kosmoderma Academy, a leading institution in the field of dermatology and aesthetics, offers comprehensive courses in cosmetology and trichology. Our specialized courses on PRP (Hair), DR+Growth Factor, GFC, and Qr678 are designed to equip practitioners with advanced skills and knowledge to excel in hair restoration and growth treatments.
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
6. Physician
‣ Can reduce procedural time
‣ Allows treatment of multiple areas of incompetence
in a single session
‣ No capital expense
‣ USG skill known
‣ Minimal post-intervention care
‣ Can be coupled with other procedures-ex. chemical
‣ CHIVA
Potentials
7. Patient
‣ Local anesthesia (not tumescent)
‣ Minimal discomfort
‣ No recovery period
‣ No compression therapy needed
Potentials
8. ▶ Small Saphenous Vein Reflux
▶ Refluxing Junctional Tributaries
▶ Perforator Reflux
▶ Reflux in Large Tributaries
▶ Recurrent Reflux after Ablation
Therapies
▶ Veins too tortuous to ablate
▶ Prevention of Chemical Creep
▶ Ligation in conjunction with
chemical therapies, sclerosants,
glues
▶ CHIVA AVMs
Indications