Long-term event-free survival, amputation rates, and changes in Rutherford-Becker class after treatment of focal infrapopliteal lesions are significantly improved with SES in comparison with BMS. (YUKON-Drug-Eluting Stent Below the Knee-Randomised Double-Blind Study [YUKON-BTX]; NCT00664963).

The data do not show superiority of a short-term regimen of low-molecular-weight heparin and compression therapy in comparison with compression therapy alone in patients with ICMVT in a rather low-risk population.

CJ, Engstrom BI, et al. J Vasc Interv Radiol 2012;23: 69-74 Conclusion: Covered stent exclusion of intragraft dialysis access graft pseudoaneurysms is correlated with a high rate of eventual graft infection.Summary: Prosthetic arteriovenous (AV) grafts are prone to develop pseudoaneurysms that are thought related to graft material degeneration secondary to repeated cannulation at specific sites. Such pseudoaneurysms may be particularly prone to develop infection in the face of outflow obstruction. Endovascular treatment can be used to treat prosthetic AV graft pseudoaneurysms with reports of high technical success and acceptable patency rates (Vesely TM, J Vasc Interv Radiol 2005;16:1301-7; Najibi S et al, J Surg Res 2002;106:15-19). However, the authors of this report indicated an anecdotal impression that incorporating this technique into their practice resulted in a higher incidence of prosthetic AV graft infection. They therefore sought to study whether stent graft treatment of prosthetic AV graft pseudoaneurysms influenced the incidence of AV graft infection. The authors reviewed their interventional radiology database for prosthetic AV graft interventions involving stent deployment anywhere within the AV graft and found 235 interventions in 174 patients between November 2004 and December 2008. The incidence of AV graft infection was analyzed by stent type (bare metal vs covered), location, and indication for stent deployment on a per-stent, per-procedure, and per-graft basis. Eventually, 16.3% of AV grafts with stents implanted required surgical excision for graft infection. When covered stents were used to treat intragraft pseudoaneurysms, the subsequent rate of graft infection increased compared with bare-metal stents or covered stents deployed within the graft for other reasons (42.1% vs 18.2%, P ϭ .011). When stents were deployed at an intragraft location, there was a higher incidence of graft infection compared with those deployed at a venous anastomosis or in an outflow vein (26.9% vs 6.9%, P Ͻ .001).Comment: Pseudoaneurysms of prosthetic dialysis grafts are usually associated with a history of repeated punctures at the site where the pseudoaneurysm developed. More punctures in a specific site will likely increase the risk of contamination, and the more the risk of contamination the more the risk of infection. It follows, as shown here, that placing an additional prosthetic under such circumstances is not likely to have favorable outcomes. Cognition After Carotid Endarterectomy or Stenting: A Randomized ComparisonAltinbas A, van Zandvoort MJ, van den Berg E, et al. Neurology 2011;77: 1084-90.

Long-term technical and clinical results after directional atherectomy of femoro-popliteal lesions are in favor of de novo lesions compared with restenotic lesions.

Endovenous laser treatment of varicose veins in the great saphenous vein with the 1470-nm diode laser is safe and highly effective. The lower energy level needed using the radial laser fiber significantly minimized adverse effects compared with the bare laser fiber.

The use of the Pathway PV System in atherosclerotic lesions appears to be safe and effective in improving stenosis severity, even in the presence of challenging lesion conditions. Vessel patency following intervention appears to be good up to 12 months, and these results translate into clinical benefit.

This randomized trial in symptomatic patients with peripheral arterial disease who underwent endovascular treatment for long femoropopliteal lesions demonstrated significant clinical and patency benefits for heparin-bonded covered stents compared with BMS in lesions ≥20 cm and for all lesions in the TPP analysis. In the ITT analysis for all lesions, which was flawed by major protocol deviations in 8.5% of the patients, the difference was not significant. (GORE VIABAHN® endoprosthesis with bioactive propaten surface versus bare nitinol stent in the treatment of TASC B, C and D lesions in superficial femoral artery occlusive disease; ISRCTN48164244).

Treatment of femoropopliteal ISR with paclitaxel-eluting stents results in favorable acute, midterm, and long-term outcomes. (Zilver PTX Global Registry [ZILVER-PTX]; NCT01094678).