Symptomatic PAD patients have increased gait variability at the ankle, knee, and hip joints at baseline ambulation in the absence of claudication pain. Our findings indicate significant baseline deterioration in the locomotor system of symptomatic PAD patients. This deterioration results in increased noise and instability of gait and is a potential contributing factor to the falls and mobility problems experienced by symptomatic PAD patients.

PAD patients with claudication demonstrate significant gait alterations in the ankle joint that are present prior to the onset of claudication pain. In contrast, the joint motion of the hip and knee did not differ in PAD patients when compared with controls. Further research is needed to verify our findings and assess the impact of more proximal disease in PAD patients as well as the effect of revascularization on joint kinematics.

TEVAR for TTAI has superior survival outcomes and has replaced OR. SRC requiring reintervention is associated with malapposition and the use of TSG. Until TTAI-specific endografts become available, use of AEC may minimize malapposition and reduce reinterventions. Routine overstenting of the LSA is not necessary and may increase SRC.

No abstract

Objective To determine the incidence and characteristics of recurrent disease after femoropopliteal angioplasty, following either selective or routine stenting of diseased site(s). Methods Retrospective analysis of a prospectively maintained database for femoropopliteal interventions from 6/03 to 7/10 was performed. Interventions during this period were from a single institution, followed at 1, 3 and 6 months after initial intervention and on a semiannual basis thereafter with clinical examination and duplex ultrasound. Two groups were identified, Group RS (all diseased areas are routinely stented) versus Group SS (selective stenting for only segments which exhibited compromised flow from residual stenosis or significant dissection). Those patients who developed recurrent symptoms (claudication, rest pain, etc.), decrease in ABI (>0.2), or duplex documentation of a significant (> 80%) recurrent stenosis, underwent re-intervention. Patient demographics, co-morbidities, TASC II classification, run off, and degree of calcification (none, mild, moderate, severe) at initial intervention were recorded. Time to re-intervention and recurrence pattern were recorded for both groups. Results 746 endovascular interventions in 477 patients were performed during the study period. Total re-intervention rate, including bypass, amputation, and asymptomatic occlusion after initial intervention, was 36.48 % (Group SS = 42.9% Group RS 33.1% p= 0.04). Of all initial interventions, 182 endovascular re-interventions in 165 patients for recurrent femoropopliteal disease were identified (Group SS=70, Group RS=95). No differences were noted among the groups in terms of gender, comorbidities, initial TASC II classification, run off, calcification scores, or statin/clopidrogel use. Time to recurrence was not different between the RS and SS groups. TASC II classification, run off score, and degree of calcification were not different between the two groups (Table 1). Although not statistically significant, analysis of recurrence pattern demonstrated denovo stenosis was more common in the SS group (50.0% vs. 34.7% p=0.06). Conclusion In this single-center retrospective study, a significant difference in the incidence of recurrence requiring re-intervention between patients treated with selective stenting and routine stenting for femoropopliteal disease is found. Analysis of endovascular re-interventions, however, reveals no significant different in recurrence time or recurrence pattern between the two groups. No significant differences in time to recurrence, TASC II classification, runoff, and calcification of endovascular re-interventions between the two groups’ end points are identified. Additional prospective studies to evaluate the roles of routine and selective stenting in symptomatic femoropopliteal PAD and to investigate recurrence lesion characteristics and the patency of multiple endovascular interventions between these two groups are needed.