Dual Antiplatelet Therapy for Coronary and Peripheral Arterial Disease is a complete reference containing updated information on the advantages and disadvantages of dual antiplatelet therapy, its duration, composition and anticipated changes. The basis for DAPT in arterial disease is discussed, allowing readers to understand platelet physiology and its relevance to ischemic events. Data on shorter than usual duration of DAPT, and on extended therapy beyond the recommendation of current guidelines is presented in great detail, summarizing a large body of evidence into concrete, relevant recommendation that is readily adaptable by practicing clinicians. A clinically relevant and updated compendium of data pertaining to this field is also presented, as well as the anticipated trends and innovations likely to occur in the next 3-5 years. Summarizes a large body of evidence into concrete, relevant recommendations that is readily adapted by practicing clinicians Explores the current status of DAPT, controversial topics, and future developments and trends in this field Edited and contributed by renowned cardiologists in the field
Dual Antiplatelet Therapy for Coronary and Peripheral Arterial Disease is a complete reference containing updated information on the advantages and disadvantages of dual antiplatelet therapy, its duration, composition and anticipated changes. The basis for DAPT in arterial disease is discussed, allowing readers to understand platelet physiology and its relevance to ischemic events. Data on shorter than usual duration of DAPT, and on extended therapy beyond the recommendation of current guidelines is presented in great detail, summarizing a large body of evidence into concrete, relevant recommendation that is readily adaptable by practicing clinicians. A clinically relevant and updated compendium of data pertaining to this field is also presented, as well as the anticipated trends and innovations likely to occur in the next 3-5 years. Summarizes a large body of evidence into concrete, relevant recommendations that is readily adapted by practicing clinicians Explores the current status of DAPT, controversial topics, and future developments and trends in this field Edited and contributed by renowned cardiologists in the field
Peripheral and Cerebrovascular Intervention draws upon experts from diverse fields to provide readers with a comprehensive foundation for understanding and performing endovascular procedures—from the basic steps to the most current and advanced techniques. Individual chapters focus on primary intervention sites, including lower extremity, renal/mesenteric, subclavian/upper extremity, carotid/vertebral, intracranial and venous interventions. Additionally, chapters covering critical limb ischemia and abdominal and thoracic aortic aneurysms are included. By incorporating valuable clinical information, such as indications, contraindications, complications and discussions of surgical techniques and procedures, this book is a valuable resource for the busy practitioner and will be of interest to all interventional and general cardiologists, radiologists and neurologists; vascular surgeons; internists and residents and fellows.
Includes a new chapter addressing the management of patients who are treated with anti-coagulants or anti-platelet drugs Provides a detail summary to each chapter, documenting the therapeutic recommendations Updates on important clinical trials since last edition
This book provides a comprehensive, up-to-date summary of drug-coated balloon (DCB) technology and the role of DCBs in the treatment of coronary and peripheral arterial disease. In addition to clear explanation of how DCBs works, readers will find an enlightening analysis of the mistakes and successes of the past decade and the emergence of the latest delivery systems, which combine a more deliverable device with much improved drug delivery to the vessel wall. The full range of current applications of DCBs are reviewed in detail, drawing on the latest scientific evidence. Due attention is paid to newer devices, with provision of technical insights and documentation of the available clinical data. Ongoing research projects, remaining technical challenges, likely future directions, and reimbursement issues are also carefully considered. This book will be a useful tool for any interventional cardiologist, interventional radiologist, or vascular surgeon who wishes to acquire a deep knowledge of this technology and its application in both coronary and peripheral interventions.
Clinical application of antithrombotic therapy in both arterial disease (acute coronary syndromes, acute MI, peripheral arterial disease, valvular heart disease, atrial fibrillation) and venous disease, (venous thromboembolic disease and pulmonary embolism). Results of major clinical trials and their implications for clinical practice.
This book focuses on the coronary bioresorbable scaffold, a new interventional treatment for coronary artery disease, differentiated from a permanent metallic stent. The book provides an overview of the technology including non-clinical studies and clinical evidences in order to help clinicians understand the appropriate application of the technology and the optimal techniques of implantation. It covers the basics of bioresorbable scaffolds; bench test results; preclinical studies; clinical evidences; and tips and tricks of implantation.
Edited by a team of the world’s leading interventional cardiologists and educators, this new book is created with an eye to giving the reader a solid, practical, and clinically focused understanding of this important class of drugs, from basic science to a clear-headed discussion of complex topics such as combination therapies, drug-to-drug interactions, and resistance to antiplatelet agents. This important new book: Begins with a concise but thorough discussion of platelet biology and pathophysiology so that readers understand how antiplatelet agents work and why they produce such a varied range of complications, from minor GI upset to potentially life-threatening conditions such as neutropenia, a critical shortage of white blood cells. Thoroughly covers platelet function testing, including novel techniques. Clarifies current best practice regarding the use of antiplatelet agents in both chronic and acute cardiovascular disease. Reviews all types of antiplatelet agents – from aspirin to recently approved drugs – including indications, clinical outcomes, and side effects. Written by an international “who’s who” of experts in the field, Antiplatelet Therapy in Cardiovascular Disease also includes an entire section covering the use of antiplatelet drugs in PCIs, including percutaneous valve repair, which makes this text particularly essential to interventional cardiologists.
A comprehensive review the state-of-the-art in atherosclerosis of the arteries of the legs and feet. The authors discuss in detail the primary symptom-claudication-an intermittent pain in the leg or foot while walking, its predisposing factors, the current diagnostic methodologies, the impressive advances in the therapeutic armamentarium, and the need to screen for co-existing coronary artery disease. Additional chapters describe cutting-edge noninvasive angiography and vascular flow studies, specific drug therapy for claudication, regression of atherosclerosis therapy, gene therapy, and drug eluting stents for peripheral arterial disease. The authors also examine the epidemiology of LEAD, the effects of smoking and effective smoking cessation programs, its pathogenesis and its association with lipid abnormalities and hypertension, aggressive risk factor modification, and the need to measure the ankle brachial index of every patient over 45.
Platelets play a role in the development of atherosclerotic vascular diseases such as acute and chronic coronary artery disease, ischemic cerebrovascular disease (i.e., ischemic stroke or transient ischemic attack), and peripheral arterial disease. Specifically, platelet activation and aggregation, and the interaction of platelets with blood cells and the endothelium, contribute to the pathophysiology of these diseases. Furthermore, platelets participate in thrombus formation in the setting of atrial fibrillation. Because of the importance of platelets in disease processes that often culminate in major adverse clinical events (e.g., myocardial infarction, ischemic stroke, or cardiovascular death), there is a strong rationale for the development of therapies specifically targeting platelet function for the primary and secondary prevention of cardiovascular disease. Because patient response to antiplatelet treatments is variable, there is also great interest in developing biomarkers to predict treatment response and guide treatment selection. Approximately 82 million Americans currently suffer from some form of cardiovascular disease. Randomized controlled trials have established dual antiplatelet treatment with clopidogrel and aspirin as the current standard of care for medical and interventional management of acute coronary syndromes. Dual antiplatelet treatment is also recommended for patients undergoing PCI with placement of stents (either bare metal or drug eluting). Randomized controlled trials support the use of clopidogrel in patients who have experienced acute cardiovascular events (e.g., stroke) and those with peripheral arterial disease. For patients with atrial fibrillation and contraindications to vitamin K antagonists, the ACTIVE A (Atrial Fibrillation Clopidogrel Trial with Irbesartan for Prevention of Vascular Events) trial suggested that the combination of clopidogrel and aspirin is more effective than aspirin alone for preventing thromboembolic disease. Since the approval of clopidogrel by the U.S. Food and Drug Administration (FDA) for routine clinical use, the drug has become one of the most commonly prescribed agents in the United States. However, patient response to clopidogrel-based antiplatelet therapy is variable both between patients and across multiple measurements within a patient, with some patients showing no or minimal platelet response to clopidogrel administration (often termed clopidogrel “nonresponsiveness” or “resistance”). Alternatives to standard clopidogrel treatment include higher dose clopidogrel regimens and the use of other antiplatelet agents, such as prasugrel or ticagrelor. Given the availability of alternative antiplatelet strategies and concern about adverse clinical outcomes in clopidogrel nonresponders, research has focused on methods to identify patients who are unlikely to benefit from clopidogrel-based treatment. The question of identifying the optimal antiplatelet therapy may also carry cost implications because generic clopidogrel products are now available in the United States.