Technical aspects of the new BYCROSSTM atherectomy device - preliminary results after 28 patients.

Percutaneous coronary intervention with peripheral artery disease in the contemporary era: Still life or limb?

[Figure: see text].

Symptomatic and asymptomatic peripheral artery disease and the risk of abdominal aortic aneurysm: The Atherosclerosis Risk in Communities (ARIC) study

Introduction: Cardiovascular disease (CVD) and cancer share risk factors, including smoking and obesity. Indeed, an increased cancer risk was reported among patients with CVD, such as myocardial infarction. Lower extremity peripheral artery disease (PAD) has also been explored in this context, but most previous studies included only Whites, had follow-up <10 years, or did not account for key confounders like smoking. Hypothesis: PAD is independently associated with long-term cancer risk in a bi-racial cohort. Methods: We studied 13,102 ARIC participants without prevalent cancer at visit 1 (1987-89) (mean age 54 [SD 6] years, 54% women, and 26% Black) (funding: NHLBI, NCI, and NPCR). Incident cancer was ascertained by linkage to cancer registries and medical record review. We categorized PAD status at visit 1 into symptomatic PAD (intermittent claudication or a history of lower extremity revascularization), asymptomatic PAD (ankle brachial index [ABI] ≤0.9), and other ABI categories of >0.9-1.0, >1.0-1.1, >1.1-1.2, >1.2-1.3 and >1.3. We ran multivariable Cox models. Results: During the median follow-up of 25 years (IQI 15-27 years), there were 4,142 incident cancer cases. 25-year cumulative cancer incidence was 48% in symptomatic PAD, 39% in asymptomatic PAD, and 31-34% in the other categories. When we adjusted for demographic factors, both symptomatic and asymptomatic PAD showed significant hazard ratios for incident cancer (1.79 [95%CI 1.33-2.43] and 1.39 [1.18-1.63], respectively, vs. ABI 1.1-1.2, Model 1 in Table ). After adjusting for additional potential confounders, including smoking and diabetes, these associations were somewhat attenuated but remained consistent (Models 2-4 in Table ). Conclusion: Both symptomatic and asymptomatic PAD were associated with an increased risk of cancer independently of smoking and diabetes. Although potential mechanisms should be explored, clinicians should be aware of this excess cancer risk among patients with PAD when considering cancer prevention and screening.

Innovations in PAD therapy

Vascular Disease Burden and In-Hospital Outcomes Among Patients Undergoing Percutaneous Coronary Intervention in New York State

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Clinical Pediatric Exercise Laboratories, Reactive Balance, Sleep, and Muscle Stimulation Considerations

Introduction: Peripheral artery disease (PAD) increases the risk of various adverse outcomes such as other cardiovascular diseases, lower-extremity amputation, and infection. However, its impact on kidney outcomes is yet to be characterized. Hypothesis: Both symptomatic and asymptomatic PAD will be associated with kidney outcomes. Methods: Using data from the ARIC study (1987-1989), we categorized 13,864 participants with estimated glomerular filtration rate (eGFR) &gt;15 mL/min (mean age 54 [SD 6 years]) into symptomatic PAD (clinical history or intermittent claudication); asymptomatic PAD (ankle-brachial index [ABI] ≤0.90 but not symptomatic PAD); and ABI categories of 0.91-1.00, 1.01-1.10, 1.11-1.20 (reference), 1.21-1.30, and &gt;1.30. Incident end-stage kidney disease (ESKD) was defined by the need for renal replacement therapy or death due to chronic kidney disease (CKD), and incident CKD was defined by ≥25% decline in eGFR to &lt;60 mL/min or hospitalizations with CKD diagnosis among those with ≥eGFR 60 at baseline. We ran multivariable Cox models. Results: There were 580 ESKD cases and 4,602 CKD cases over ~30 years of follow-up. Both symptomatic PAD and asymptomatic PAD were significantly associated with incident ESKD with hazard ratios (HR) of 2.21 (95%CI 1.16-4.22) and 1.59 (1.07-2.36), respectively, after adjusting for potential confounders such as other cardiovascular diseases and diabetes (Table). The corresponding HRs for incident CKD were 1.43 (1.05-1.95) and 1.60 (1.35-1.90). Borderline low ABI 0.91-1.00 showed an elevated risk of kidney outcomes in demographically- adjusted Model 1. Conclusions: Symptomatic PAD and asymptomatic PAD were independently associated with a higher long-term risk of ESKD and CKD. These results further support the close link between atherosclerosis and kidney prognosis and highlight the need for kidney monitoring in persons with PAD regardless of leg symptoms.

Letter: The Prevalence of Peripheral Arterial Disease in Korean Patients with Type 2 Diabetes Mellitus Attending a University Hospital (Diabetes Metab J 2011;35:543-50)

On the rise but still underutilized - why statins are the Achilles' heel of secondary prevention in peripheral arterial disease.

Peripheral Arterial Disease Prevention in Women: Awareness and Action.

Ce travail porte sur l'amélioration du processus de test, en offrant des moyens d'automatiser la génération des tests ainsi que l'évaluation de leur qualité, dans le cadre des systèmes embarqués spécifiés en Lustre/SCADE. D'une part, nous présentons une méthodologie de test basée sur l'outil Lutess qui génère automatiquement des données de test exclusivement à partir de la description de l'environnement du système. D'autre part, on se base sur le modèle SCADE du programme sous test et nous définissons des critères de couverture structurelle qui prennent en compte deux nouveaux aspects: l'utilisation des plusieurs horloges et le test d'intégration, permettant la mesure de couverture de systèmes de grande taille. Ces deux stratégies pourraient avoir un impact positif sur le test efficace des applications réelles. Des études de cas extraites du domaine de l'avionique sont employées pour démontrer l'applicabilité de ces méthodes et pour évaluer leur complexité.

Ankle brachial index for the diagnosis of lower limb peripheral arterial disease.

We thank Jaquinandi et al for their interest in our publication. We want to stress that the patient population of the AtheroGene study is not comparable with the patient populations reported in the articles from Lee et al and Kreitner et al, which included only patients with known advanced peripheral arterial disease.1,2 The AtheroGene study includes primarily patients with coronary artery disease, no patient had rest pain or peripheral ulcers and only 52 patients (6.3%) had intermittent claudication.3 In addition, …