The year in cardiology 2014: peripheral circulation

Eur Heart J. 2015 Mar 7;36(10):591-7. doi: 10.1093/eurheartj/ehu515. Epub 2015 Jan 2.

Abstract

In 2014, the debate on the indication of revascularization in case of asymptomatic carotid disease continued, while another one regarding the use of surgery vs. stenting addressed some new issues regarding the long-term cardiac risk of these patients. Renal arteries interventions trials were disappointing, as neither renal denervation nor renal artery stenting was found associated with better blood pressure management or outcome. In contrast, in lower-extremities artery disease, the endovascular techniques represent in 2014 major alternatives to surgery, even in distal arteries, with new insights regarding the interest of drug-eluting balloons. Regarding the aorta, the ESC published its first guidelines document on the entire vessel, emphasizing on the role of every cardiologist for screening abdominal aorta aneurysm during echocardiography. Among vascular wall biomarkers, the aorta stiffness is of increasing interest with new data and meta-analysis confirming its ability to stratify risk, whereas carotid intima-media thickness showed poor performances in terms of reclassifying patients into risk categories beyond risk scores. Regarding the veins, new data suggest the interest of D-dimers and residual venous thrombosis to help the decision of anti-coagulation prolongation or discontinuation after the initial period of treatment for deep vein thrombosis.

Publication types

  • Review

MeSH terms

  • Anticoagulants / therapeutic use
  • Aortic Aneurysm, Abdominal / surgery
  • Aspirin / therapeutic use
  • Biomarkers / metabolism
  • Carotid Artery Diseases / surgery
  • Endovascular Procedures / trends
  • Fibrin Fibrinogen Degradation Products / metabolism
  • Humans
  • Kidney Diseases / surgery
  • Lower Extremity / blood supply
  • Peripheral Arterial Disease / surgery*
  • Platelet Aggregation Inhibitors / therapeutic use
  • Practice Guidelines as Topic
  • Randomized Controlled Trials as Topic
  • Renal Artery
  • Stents
  • Sympathectomy / trends
  • Venous Thrombosis / diagnosis*
  • Venous Thrombosis / drug therapy

Substances

  • Anticoagulants
  • Biomarkers
  • Fibrin Fibrinogen Degradation Products
  • Platelet Aggregation Inhibitors
  • fibrin fragment D
  • Aspirin