The Society of Interventional Radiology held its 2010 annual meeting from March 13 to 18 in Tampa, Florida. The features below highlight some of the news emerging from the meeting. For more information on these items and other research that was presented, go to www.sirmeeting.org.
» Preventing Strokes During Carotid Artery Stenting
» Abnormal ABI Indicative of Cardiovascular Events
» Vertebroplasty Relieves Pain for Osteoporotic VCFs
Preventing Strokes During Carotid Artery Stenting
The Particulars:Until recently, most carotid artery stenting procedures have been performed with filters in order to remove debris. The FDA has cleared a proximal cerebral protection device (Mo.Ma, Invatec) for use during carotid artery stenting. It suspends blood flow and prevents debris from traveling to the brain.
Data Breakdown:Investigators evaluated the safety and effectiveness of the proximal cerebral protection device in 262 patients with carotid artery disease considered high risk. The 30-day major adverse cardiac and cerebrovascular events rate was 2.7%, a finding below the performance goal of 13% set before the start of the study. The major stroke rate was 0.9% through to the end of the trial; the death rate was also 0.9%.
Take Home Pearls: Use of a proximal cerebral protection device may be able to prevent strokes during carotid stenting procedures. Results add to the body of data to support stenting as an alternative to surgery.
Abnormal ABI Indicative of Cardiovascular Events [back to top]
The Particulars:The ankle-brachial index (ABI) test is a noninvasive blood pressure reading in the ankle used to screen for peripheral artery disease (PAD). The ABI may provide another way to identify cardiovascular risks in older patients not considered at high risk for future myocardial infarctions.
Data Breakdown:Data was examined from a study involving 822 people (mean age, 64) who were screened for PAD with an ABI. None of the patients had known cardiovascular disease or diabetes. The Framingham Risk Score (FRS) was used to determine 10-year risk for coronary heart disease. Overall, 10% of the trial participants had abnormal ABIs but were otherwise at low-to-intermediate risk according to FRS and would not be considered for aggressive risk factor management.
Take Home Pearl: An abnormal ABI appears to predict an increased risk for future cardiovascular events in elderly people with low-to-intermediate FRS.
Vertebroplasty Relieves Pain for Osteoporotic VCFs [back to top]
The Particulars:During percutaneous vertebroplasty (PV), medical cement is injected through a needle into a fractured vertebral body to stabilize vertebral compression fractures (VCFs). Studies on the efficacy of vertebroplasty for VCFs have been inconclusive.
Data Breakdown:A study of 202 patients (mean age, 75) with VCFs were randomized to receive PV or conservative therapy. After patients underwent PV, there was an immediate decrease in pain scores that continued over time. About 25% of the patients who received conservative therapy still had pain after 1 year, compared with a 6.5% rate for those receiving PV. Overall, PV was found to be safe with no increase in secondary infections and had an acceptable cost.
Take Home Pearls: PV appears to decrease pain immediately for patients with acute osteoporotic VCFs and relieve pain for up to 1 year. Results were better than those with the provision of standard conservative therapy for the control group.