iset and cio abstracts

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International Symposium on Endovascular Therapy (ISET) 2011 January 16 – 20, 2011, Miami Beach, Florida Best of ISET Abstracts All ISET abstracts and posters are graded via blinded peer review based on scientic merit, originality, relevance and clarity. Aorto UNI-iliac sTEnt Gra Clinical Trial (UNITE) K. Kasirajan PURPOSE: To evaluate the safety and e cacy of the UniFit (LeMaitre Vascular, Inc. Burlington, MA) aorto-uni-iliac stent gra system in patients deemed at high risk for traditional open surgery and not anatomical candidates for FDA approved bifurcated endogra s. MATERIALS AND METHODS: Data are being prospectively collected as part of the Aorto UNI-iliac sTEnt Gra (UNITE) phase II clinical trial. Overall plan is to enroll 90 patients at 22 sites. Currently 61 patients have been enrolled in the study. This interim analysis presents 1-year data. RESULTS: 61 patient (males 42[68.9%]) were evaluated on an intent to treat analysis. Failure to implant was observed in 7 patients. The mean aneurysm diameter was 55±10-mms. Anatomical reasons for exclusion from bifurcated devices include; high neck angulation (31.1%), narrow aortic bifurcation (23.0%), unilateral occluded iliac (26.2%), large neck diameter (11.5%), tortuous iliac (11.5%), and short neck length (3.3%). All patients were considered high risk for open surgery (American Society of Anesthesiologists grade 3 [75.4%], and grade 4[24.6%]). The majority of the patients had signicant coronary artery disease (45.9%), chronic obstructive pulmonary disease (49.2%), or chronic renal failure (32.8%). Mean duration of surgery was 236 minutes with average blood loss of 668 ml. Average implants per patient were 2.0 ± 0.8 devices. Currently, 46 patients have completed the 1-year follow-up with 8 reported deaths due to nonaneurysmal etiology. At 1-year 96% of patients were free of secondary aneurysm- related interventions with an average aneurysm diameter change of -1.6 ±6.2 mm. Type II endoleaks were noted in 16.7% of patients at the 1-year follow-up. CONCLUSION: Preliminary results of the UniFit stent gra in high-risk patients appear promising. Aorto-uni- iliac devices once approved may increase the patient pool available for endovascular therapy. Are We Compliant with Inferior Vena Cava Filter Placement Guidelines? A.S. Baadh, S. Rivoli, J.E. Ansell, R.E. Graham PURPOSE: Inferior vena cava (IVC) lter placement has increased signicantly over the past few decades, due to expanding indications. Indications vary widely depending on which professional society’s recommendations are followed. Our objectives were to record the number of IVC lters placed in our medium-sized, metropolitan teaching hospital, assess the e ect of medical specialty on placement, and evaluate compliance with accepted standards as set by the American College of Chest Physicians (ACCP) and Society of Interventional Radiology (SIR). MATERIALS AND METHODS: Single-center, retrospective medical record review of all patients who received an IVC lter over a 26 month period. Inclusion criteria included all inpatients with filter placement by interventional radiology within the aforementioned period. A total of 443 IVC lters were placed in our institution over the studied dates, with 213 meeting the above criteria. Of these, 187 were reviewed with 26 excluded due to incomplete records. RESULTS: The average age was 75.3 years, and 43.9% of the patients were males. Regarding lters, 87.2% were recommended by medicine and its subspecialties and 12.8% by nonmedical specialties. SIR guidelines were met by 79.1% of lters placed whereas ACCP guidelines were met by only 43.3%. No documentation was available to assess compliance for 20.9% of lters. ACCP criteria were met by 46% of lters placed by internal medicine and its subspecialties, but only by 25% of lters recommended by non-medicine specialties (P = 0.039; CI, 95%). SIR guidelines were met by physicians within internal medicine and its subspecialties for 84% of the filters placed, but only by 46% of nonmedicine physicians (P = 0.001; CI, 95%). Of the total number of lters placed, 35.8% met SIR criteria but did not meet ACCP guidelines. CONCLUSION: Less than half of filters placed met ACCP guidelines, yet over three-fourths met criteria set by the SIR, especially when comparing medicine and non-medicine specialties. In analyzing the lters that meet indications set by SIR but not ACCP, it becomes apparent that most of these are placed for patients classied as “fall risks”, failures of anticoagulation, limited cardiopulmonary reserve and medication noncompliance. This study strongly suggests a need for harmonization of current guidelines. Carotid Angioplasty and Stenting in Octogenarians Is as Safe as Surgery I. Henry, M. Henry, A. Polydorou, A. Polydorou, M. Hugel PURPOSE: Recent studies, registries, and the Carotid Revascularization Endarterectomy (CREST) trial have shown that carotid angioplasty stenting (CAS) is at higher risk than surgery carotid endarterectomy (CEA) in elderly patients. This study aim was to evaluate if CAS performed in octogenarians is as safe as surgery with be er indications, choice of devices, experienced operators. MATERIALS AND METHODS: 1004 patients (m:733) mean age 70.9 ± 9.4y underwent 1064 CAS for de novo lesions (n = 982) restenoses (n = 56) post radiation (n = 14) inammatory arteritis (n = 10) pos rauma aneurysms (n = 2) Indications for treatment: symptomatic carotid stenosis > 70% (63%) or asymptomatic stenosis > 80 %. 1925

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Page 1: ISET and CIO Abstracts

International Symposium on Endovascular Therapy (ISET) 2011January 16 – 20, 2011, Miami Beach, Florida

Best of ISET AbstractsAll ISET abstracts and posters are graded via blinded peer review

based on scienti c merit, originality, relevance and clarity.

Aorto UNI-iliac sTEnt Gra Clinical Trial (UNITE)K. Kasirajan

PURPOSE: To evaluate the safety and e cacy of the UniFit (LeMaitre Vascular, Inc. Burlington, MA) aorto-uni-iliac stent gra system in patients deemed at high risk for traditional open surgery and not anatomical candidates for FDA approved bifurcated endogra s.

MATERIALS AND METHODS: Data are being prospectively collected as part of the Aorto UNI-iliac sTEnt Gra (UNITE) phase II clinical trial. Overall plan is to enroll 90 patients at 22 sites. Currently 61 patients have been enrolled in the study. This interim analysis presents 1-year data.

RESULTS: 61 patient (males 42[68.9%]) were evaluated on an intent to treat analysis. Failure to implant was observed in 7 patients. The mean aneurysm diameter was 55±10-mms. Anatomical reasons for exclusion from bifurcated devices include; high neck angulation (31.1%), narrow aortic bifurcation (23.0%), unilateral occluded iliac (26.2%), large neck diameter (11.5%), tortuous iliac (11.5%), and short neck length (3.3%). All patients were considered high risk for open surgery (American Society of Anesthesiologists grade 3 [75.4%], and grade 4[24.6%]). The majority of the patients had signi cant coronary artery disease (45.9%), chronic obstructive pulmonary disease (49.2%), or chronic renal failure (32.8%). Mean duration of surgery was 236 minutes with average blood loss of 668 ml. Average implants per patient were 2.0 ± 0.8 devices. Currently, 46 patients have completed the 1-year follow-up with 8 reported deaths due to nonaneurysmal etiology. At 1-year 96% of patients were free of secondary aneurysm-related interventions with an average aneurysm diameter change of -1.6 ±6.2 mm. Type II endoleaks were noted in 16.7% of patients at the 1-year follow-up.

CONCLUSION: Preliminary results of the UniFit stent gra in high-risk patients appear promising. Aorto-uni-iliac devices once approved may increase the patient pool available for endovascular therapy.

Are We Compliant with Inferior Vena Cava Filter Placement Guidelines?A.S. Baadh, S. Rivoli, J.E. Ansell, R.E. Graham

PURPOSE: Inferior vena cava (IVC) lter placement has increased signi cantly over the past few decades, due to expanding indications. Indications vary widely depending on which professional society’s recommendations are followed. Our objectives were to record the number of IVC lters placed in our medium-sized, metropolitan teaching hospital, assess the e ect of medical specialty on placement, and evaluate compliance with accepted standards as set by the American College of Chest Physicians (ACCP) and Society of Interventional Radiology (SIR).

MATERIALS AND METHODS: Single-center, retrospective medical record review of all patients who received an IVC lter over a 26 month period. Inclusion criteria included all inpatients with filter placement by interventional radiology within the aforementioned period. A total of 443 IVC lters were placed in our institution over the studied dates, with 213 meeting the above criteria. Of these, 187 were reviewed with 26 excluded due to incomplete records.

RESULTS: The average age was 75.3 years, and 43.9% of the patients were males. Regarding lters, 87.2% were recommended by medicine and its subspecialties and 12.8% by nonmedical specialties. SIR guidelines were met by 79.1% of lters placed whereas ACCP guidelines were met by only 43.3%. No documentation was available to assess compliance for 20.9% of lters. ACCP criteria were met by 46% of lters placed by internal medicine and its subspecialties, but only by 25% of lters recommended by non-medicine specialties (P = 0.039; CI, 95%). SIR guidelines were met by physicians within internal medicine and its subspecialties for 84% of the filters placed, but only by 46% of nonmedicine physicians (P = 0.001; CI, 95%). Of the total number of lters placed, 35.8% met SIR criteria but did not meet ACCP guidelines.

CONCLUSION: Less than half of filters placed met ACCP guidelines, yet over three-fourths met criteria set by the SIR, especially when comparing medicine and non-medicine specialties. In analyzing the lters that meet indications set by SIR but not ACCP, it becomes apparent that most of these are placed for patients classi ed as “fall risks”, failures of anticoagulation, limited cardiopulmonary reserve and medication noncompliance. This study strongly suggests a need for harmonization of current guidelines.

Carotid Angioplasty and Stenting in Octogenarians Is as Safe as SurgeryI. Henry, M. Henry, A. Polydorou, A. Polydorou, M. Hugel

PURPOSE: Recent studies, registries, and the Carotid Revascularization Endarterectomy (CREST) trial have shown that carotid angioplasty stenting (CAS) is at higher risk than surgery carotid endarterectomy (CEA) in elderly patients. This study aim was to evaluate if CAS performed in octogenarians is as safe as surgery with be er indications, choice of devices, experienced operators.

MATERIALS AND METHODS: 1004 patients (m:733) mean age 70.9 ± 9.4y underwent 1064 CAS for de novo lesions (n = 982) restenoses (n = 56) post radiation (n = 14) in ammatory arteritis (n = 10) pos rauma aneurysms (n = 2) Indications for treatment: symptomatic carotid stenosis > 70% (63%) or asymptomatic stenosis > 80 %.

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Patients separated into two age groups: > 80 years of age (144 patients, 147 CAS) and < 80 years of age (860 patients, 917 CAS). A total of 188 CAS were performed without protection (N.P-)6 in patients > 80 years of age; 876 CAS were performed with protection (NP+) (occlusion balloon:334, lters:537, reversal ow:6)—141 in patients > 80 years of age. Data analysis included neurological complications, death and myocardial infarction (MI) rate at 30 days, and anatomical particularities. Technical points will be described depending on the patient age.

RESULTS: Technical success for patients < 80 years of age: 915/917 for patients >80 years of age: 146/147.

30-Day Outcomes

>80y <80y 1064 CAS TOTAL NP- NP+ TOTAL NP- NP+NB 147 6 141 917 182 735Transient ischemic a ack 2 /1.3% 1 /17% 1 /0.7% 10 /1.1% 3 /1.6% 7 /1%Minor Stroke 1 /0.7% 1 /17% 0 6 /0.7% 3 /1.6% 3 /0.4%Major Stroke 0 0 0 3 /0.3% 2 /1.1% 1 /0.1%Retinal Embolus 0 0 0 4 /0.4% 0 4 /0.5%Hyperperfusion syndrome 0 0 0 3 /0.3% 0 3 /0.4%Death 0 0 0 5 /0.5% 2 /1.1% 3 /0.4%Fatal Stroke 0 0 0 4 /0.4% 2 /1.1% 2 /0.3%Nonfatal Stroke 0 0 0 1 /0.1% 0 1 /0.1%MI 0 0 0 1 /0.1% 0 1 /0.1%Death/Stroke 1 /0.7% 1 /17% 0 14 /1.5% 7 /2.8% 7 /1%Death/Stroke/MI 1 /0.7% 1 /17% 0 15 /1.6% 7 /3.8% 8 /1.1%

CONCLUSION: CAS can be performed in elderly patients without higher risk than in youngers. Good indications, meticulous technique, protection devices are mandatory and some technical points must be pointed out to avoid neurological complications and failures.

Long-Term Outcomes of Drug-Eluting Stents for Treatment of Renal Artery Stenosis Less than 4 mmR. Pannu, S. Misra

PURPOSE: Drug-eluting stents (DES) have been used for treatment of stenosis involving the coronary arteries and are associated with lower restenosis rates. We present the clinical outcomes and primary patency rates of patients treated with DES for atherosclerotic renal artery stenosis (RAS) in arteries ≤ 4 mm of diameter.

MATERIALS AND METHODS: A retrospective chart review of patients treated with DES for RAS from July 1, 2004 to February 23, 2010 was performed. The primary endpoints included death, loss of primary patency, change in blood pressure (BP), number of antihypertensive medications, hemodialysis (HD), or renal transplantation during the time of follow-up.

RESULTS: 34 patients (22 females), mean age 71 years ± 10) underwent treatment of 58 RAS for worsening renal function (n = 26) and uncontrolled hypertension (n = 22). Forty six renal arteries(RA) with ≤ 4 mm diameter were treated with DES (28 sirolimus coated stents, 13 paclitaxel- coated stents, and 5 everolimus coated stents) with a mean diameter of 3.44± 0.05 mm and a mean length of 16.02±5.67 mm. Twelve RAS were treated with bare metal stents (9 Herculink plus, 1 Omnilink and 2 Genesis) with a mean diameter of 5.31 ± 0.56 mm and the mean length of 15.0 ± 2.32 mm. The average follow-up was 33 ± 21 months. Post procedure, mean systolic BP decreased by 27 mmHg (P < 0.0001), mean diastolic BP decreased 6 mmHg (P = 0.0078), and the mean of number of antihypertensive

medications decreased by 0.5 medication (P = 0.0037). When measured pre and post intervention, there was no signi cant changes in mean serum creatinine, kidney size, or resistive index as measured by ultrasound. By Kaplan-Meier estimates, the primary patency of DES was 69.8% at 54 months (SE= 0.0998). Of the 34 patients, 4 died due to cardiovascular events (1 < 30 days, 3 > 30 days); 1 patient developed postintervention RA spasm and was started on chronic HD; 2 patients were started on chronic HD 6 months post intervention; 1 patient was on HD for less than 30 days; two developed transient acute renal failure a er intervention, likely contrast related.

CONCLUSION: Treatment of RAS with DES is a viable option with acceptable long-term patency rates. In this population, treatment with DES in smaller renal arteries leads to the reduction of blood pressure and decreases the number of medications used to control BP.

Nine-Month Results of the REFORM Study: Evaluation of the Formula™ Balloon-Expandable Stent for Renal Artery StenosisR. Bersin

PURPOSE: The REFORM study was designed to evaluate the safety and e ectiveness of the Formula™ Balloon-Expandable Renal Stent (Cook Medical, Bloomington, IN) for treatment of atherosclerotic renal artery stenosis following suboptimal angioplasty.

MATERIALS AND METHODS: This prospective, single-arm study enrolled 100 patients (115 lesions/123 stents) at seven investigative sites in the United States. Patients with de novo or restenotic ostial atherosclerotic lesions ≤ 18 mm in length and with baseline stenoses > 70% were treated with Formula™ stents following suboptimal angioplasty. The primary endpoint was the 9-month primary patency rate, as assessed by duplex ultrasound or angiography, compared with a performance goal of > 60%.

RESULTS: The Formula™ stent was successfully deployed (technical success) in 97% (97/100) of the patients, with < 30% residual stenosis (procedural success) in 96% (109/114) of the lesions. The 9-month primary patency rate was 89.6%, which met the performance goal (P<0.01). No major adverse events (MAE, de ned as device- or procedure-related death, Q-wave myocardial infarction, clinically driven target lesion revascularization, or signi cant embolic event) occurred within 30 days of the study procedure. The 9-month MAE rate was 2.2%. Systolic blood pressure decreased from 150 ± 21 mmHg (mean ± SD) at baseline to 141 ± 21 mmHg at 9 months (P<0.01), with no change in antihypertensive medications. Renal function (indicated by estimated glomerular ltration rate (eGFR)) was unchanged through 9 months with a ≥ 25% decrease in eGFR in only 3% and 6% of patients at 1 and 9 months, respectively.

CONCLUSION: Patients enrolled in the REFORM study experienced a clinically signi cant reduction in systolic blood pressure, a high long-term patency rate, a very low MAE rate, and no worsening of renal function. These results demonstrate the safety and e ectiveness of the use of the Formula™ stent a er failed PTA for the treatment of ostial renal artery disease.

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Randomized Comparison of Polyvinyl Alcohol and Tris-Acryl Gelatin Microspheres for Uterine Fibroid EmbolizationR. Shlansky-Goldberg, M. Rosen, J. Mondschein, S.W. Stavropoulous, S.O. Trerotola, et. al

PURPOSE: To evaluate two embolic agents for treatment of symptomatic fibroids. Though benign, fibroids can produce significant symptoms. Uterine fibroid embolization (UFE) is the leading minimally invasive treatment for symptomatic broids. Recently, there has been considerable discussion related to the most e ective type and shape of embolic material. We will present 24-hour and 3-month outcomes after treatment with polyvinyl-alcohol (sPVA) versus tris-acryl gelatin (EMS) microspheres.

MATERIALS AND METHODS: Sixty women with symptomatic broids were randomized and treated at a single center in this prospective study. Patients were treated with either sPVA (Contour SE N = 30; 700-900μ and 900-1200μ using a near stasis or stasis endpoint) or EMS (Embosphere N = 30; 500-700μ using a “pruned tree” endpoint). The primary endpoint was ≥91% broid devascularization 24 hours postprocedure measured by contrast-enhanced magnetic resonance imaging (MRI). An independent and blinded physician assessed all MRIs.

RESULTS: No differences in baseline characteristics were found between groups. The primary endpoint was met; broid devascularization 24 hours postprocedure was comparable between treatments (≥ 91% fibroid infarction: sPVA 29/29 patients vs EMS 28/30 patients, P < 0.001). Infarction at 3 months was comparable between treatments overall. No di erence in symptom reduction between groups was found (-48.4% vs -41.4%, P = 0.16). Analysis of additional 24-hour and 3-month outcomes will be presented.

CONCLUSION: Uterine broid devascularization at 24 hours a er treatment with sPVA microspheres or EMS microspheres was found to be similar in this patient population when using stasis as an endpoint with sPVA. The clinical effects were maintained at the 3-months follow-up.

Renal Angioplasty and Stenting. Limitations. Role of Embolic Protection DevicesI. Henry, M. Henry, A. Polydorou, M. Hugel

PURPOSE: Despite good immediate and long-term results, post procedural deterioration of the renal function (RF) may occur a er renal artery angioplasty and stenting (RAAS) in 20-40 % of the patients, which limits the immediate bene ts of the technique. Atheroembolism seems to play an important role. We evaluate feasibility and safety of RAAS under a distal protection device (DPD) to reduce the risk of atheroembolism and avoid deterioration of the RF.

MATERIALS AND METHODS: 151 RAAS performed under DPD in 131 hypertensive patients (M:91). Mean age: 64.8±11.9 yrs with atherosclerotic renal artery stenosis (20 bilateral). 11 patients had solitary kidneys, 52 renal insu ciencies. We used occlusion balloon (n = 46) or

lters (n = 105). We recently experimented and treated 12 patients with a new lter the Fibernet (Lumen Biomedical Plymouth MN) which can capture particles of 40 without compromising the flow. Generated debris removed and analyzed. Blood pressure and serum creatinine levels followed. Techniques of RAAS under protection, limitations will be discussed.

RESULTS: Immediate technical success: 100%. Visible debris aspirated with Percusurge from all patients. Mean particle number: 98.1±60.00. Mean diameter: 201.2±76 (38-6206). With current lters debris removed in 80% of the cases. With the Fibernet visible debris removed in all cases. Mean debris surface area: 121 mm2. Mean number of particles 28-60 : 2136 ± 776, > 60 : 5918 ± 1362. We observed one acute RF deterioration. Mean follow-up: 29.8 ± 16 months. Mean creatinine level remains constant during follow-up. At 6 months (111 patients) 82 patients stabilized, 28 with baseline renal insu ciency improved and we had only one RF deterioration (1%) in a patient with moderate renal insu ciency. At 2 years (92 patients) 66 stabilized, 22 improved and we had only 4 RF deterioration (5%).

CONCLUSION: This study demonstrates the feasibility and safety of DPD during renal interventions to protect against atheroembolism and seems to avoid RF deterioration a er the procedure and in the long-term. Indications will be discussed. Improvements in DPD for renal stenting are mandatory. Randomized studies are awaited.

Safety and E cacy of Permanent and Retrievable SVC Filters in the Prevention of Pulmonary EmbolismA. Sundblad, S. Amberson, J. Gerding, T. Dykes, D. Mi leider, et. al

PURPOSE: While upper extremity DVT are a known risk factor for pulmonary embolism (PE), the usefulness and safety of SVC lters remain controversial. The purpose of this study is to report a single-center experience of placing SVC lters, including the largest series of SVC lters successfully retrieved reported to date based on review of the existing medical literature.

MATERIALS AND METHODS: From 2005–2009, 21 SVC lters were placed. All 21 patients had documented upper extremity DVT based on ultrasound with 4 patients also having documented PE on CT scans. Of the total number of patients, 19 had contraindications to anticoagulation: 4 patients with intracranial hemorrhage, 9 patients with recent or ongoing GI bleeding, 3 patients with recent or impending surgery, 3 patients with multiple traumatic injuries. Two patients had repeat thromboembolic events despite therapeutic anticoagulation. Eleven retrievable IVC lters were used in the SVC (9 Optease, 1 Celect, 1 Option), and 10 permanent IVC filters were used (TrapEase). Follow-up was performed with clinical assessment via medial records, communication with the primary care physician’s o ce or imaging follow-up. Overall survival post-SVC lter placement was calculated using Kaplan-Meier analysis. Complications were recorded and graded (CTCAE v 4.0). Incidence of pulmonary embolism post-SVC lter placement was recorded.

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RESULTS: Based on Kaplan-Meier analysis, overall survival was 79% during the follow-up period (mean 616 days, range 17–1626). All 21 SVC lters were successfully placed. There was one documented pulmonary embolism post-SVC lter placement (1/21, 4.7%) which occurred 9 days post-SVC lter placement in a patient with bilateral upper extremity DVT. During the follow-up period, there were no SVC lter-related complications. Four SVC lters (Optease) were a empted to be retrieved (mean dwell time 19.8 days, range 5-29). All four retrievals were technically successful without complication.

CONCLUSION: Although the utilization of SVC lters for prevention of PE in the se ing of upper extremity DVT remains controversial, this single-center experience suggests that both permanent and retrievable IVC lters may be used in the SVC with acceptable PE prevention rates and safety pro le.

Three-Year Outcomes of Excimer Laser-Assisted Angioplasty and Balloon Angioplasty in Tibial Arterial Occlusion TASC DE

S. Sultan, W. Taw ck, N. Hynes

PURPOSE: Endovascular revascularization is the gold standard for critical limb ischaemia (CLI). However, there is still concern over its capability to treat complex tibial lesions. We aim to compare Cool Excimer laser-assisted angioplasty (CELA) vs tibial balloon angioplasty (TBA) in patients with CLI, TASC-II DE.

MATERIALS AND METHODS: Of the 1506 patients referred with peripheral vascular disease from June 2005 to October 2009, 572 had CLI. Of these patients, 80 underwent 89 endovascular revascularizations for tibial TASC-II DE; TBA was used on 47 patients, and CELA was used on 42. A technical success of 81% was scored for CELA vs of 74% for TBA. Improvement to Rutherford category ≤3 occurred in 90% of CELA vs 70% of TBA patients, with hemodynamic success in 95% of CELA vs 70% of TBA patients.

RESULTS: Three-year sustained clinical improvement was signi cantly enhanced with CELA at 81%, compared TBA at 63.8%, (P = 0.013, HR = 0.36, 95%CI [0.16–0.80]). Three-year amputation-free survival rates were also signi cantly improved at 95.2% for CELA vs 89.4% for TBA P = 0.0165, HR = 0.16, 95%CI [0.04–0.72]). Three-year freedom from binary restenosis was improved with CELA at 83.3%, compared with TBA at 55.3% (P = 0.005). Three-year freedom from target lesion revascularization (TLR) was also augmented with CELA at 95.2%, compared with TBA at 63.8% (P = 0.872, HR = 1.08, 95%CI [0.43–2.69]). Three-year freedom tibial endovascular revascularization (TER) was signi cantly superior with CELA (92.9% vs 78.7%, P = 0.026, HR = 0.29, 95% CI = 0.10–0.86]). Revascularization for progress of arteriosclerosis at 3 years was reduced with CELA (P = 0.0006). Three-year freedom from major adverse cardiac events (MACEs) was improved with CELA (85.7% vs 57.4%, P= 0.455, HR = 0.74, 95% CI [0.34–1.62]), but this did not reach statistical signi cance. However, CELA patients experienced signi cant improvement in quality of life at 3 years with a quality-adjusted time without

symptoms of disease or toxicity treatment (Q-TWiST) of 10.5 months. Incremental cost e ectiveness ratio of €2,073.19 per quality-adjusted life year (QALY) was gained in favor of CELA.

CONCLUSION: CELA ameliorated percutaneous transluminal angioplasty (PTA), if used primarily in instances where the wire can cross the lesion but not the balloon. Tibial endovascular revascularization bestows exceptional outcome in CLI TransAtlantic InterSociety Consensus (TASC) DE. CELA and TBA enhance anatomical, clinical and technical success rates in complex tibial vessel lesions. However, CELA has superior freedom from binary restenosis, freedom from TLR and 3 years survival from MACE, with enhanced cost e ectiveness.

Ultrasound Accelerated Thrombolysis for the Treatment of Pulmonary EmbolismT.C. Engelhardt, A.J. Taylor, L. Simprini

PURPOSE: Treatment selection for pulmonary embolism (PE) is based on evidence of right heart dysfunction on CT scan, electrocardiogram or echocardiography, clot burden visible on CT scans, severity of symptoms at presentation and underlying medical conditions that could contribute to a poor prognosis if the PE is le untreated. Based on our experience, ultrasound-accelerated thrombolysis has become the standard of care in our institution for endovascular management of intermediate risk and critically ill PE patients.

MATERIALS AND METHODS: Between February 2009 and July 2010, 22 PE patients were treated using the EKOS EkoSonic Endovascular System (EKOS Corporation, Bothell, WA) and recombinant tissue-type plasminogen activator (rt-PA). Preliminary and pos reatment CT scans were performed on 21 patients. One patient was treated based on echocardiography and ventilation/perfusion scanning. The primary endpoint in this retrospective evaluation was mortality. Secondary endpoints were improvement in the right ventricular end diastolic diameter to le ventricular end diastolic diameter ratio (RV/LV ratio) and reduction in clot burden.

RESULTS: All 22 treated patients survived. In the 21 patients with CT scans, the average RV/LV ratio pretreatment was 1.33 ± 0.23 and 1.00 ± 0.13 pos reatment (P < 0.001). Clot burden, calculated from the CT scans using the modified Miller score (maximum 36), was reduced from 17.8 ± 7.4 to 10.0 ± 4.0. Major bleeding complications occurred in 4 patients, all 4 requiring transfusion. Minor bleeding complications occurred in 2 patients. No other complications were observed. All of the bleeding complications were reported in the rst 14 patients treated, who received an average of 47.6 mg of rt-PA delivered over 22 hours. The dosing regimen for rt-PA was reconsidered and reduced in the remaining 8 patients to an average dose of 20.8 mg of rt-PA over 14.3 hours. No further bleeding complications were reported in the patients treated with the lower rt-PA dose.

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CONCLUSION: Ultrasound-accelerated thrombolysis is a viable option for the treatment of PE. The technique was demonstrated to be safe and e ective with no mortality and improved clinical outcomes, even with reduced total dose of rt-PA to 21 mg.

Use of CO2 Angiography for Fenestrated and Branched Endovascular Aneurysm RepairJ.E. Cross, D.V. Simring, K. Ivancev, O. Agu, P. Harris, et. al

PURPOSE: The development of fenestrated and branched endovascular aneurysm repair (EVAR) is associated with increased usage of contrast, and a signi cant incidence of post operative renal dysfunction and renal failure has been reported. We describe the use of CO2 as the primary contrast agent in patients undergoing complex EVAR.

MATERIALS AND METHODS: Two cohorts of patients undergoing fenestrated and branched EVAR were compared at a regional vascular unit. Between 2008 and 2010, 61 complex endogra s were implanted; 38 procedures were completed with only iodinated contrast media (group 1) and in 23, CO2 was used as the primary contrast agent (group 2). Endpoint assessed was renal impairment, de ned as an increase in creatinine of > 25%.

RESULTS: Baseline creatinine was similar between group 1 (mean 109, range 44–282) and group 2 (mean 117, range 74–310). There was signi cant di erence in the incidence of postoperative renal dysfunction; 7 (18%) in group 1 required temporary dialysis, compared to just 2 (9%) in group 2 (P=0.056). No patients required permanent dialysis. Further analysis between the groups demonstrated a reduction in mean volume of contrast used from 234 ml to 138 ml.

CONCLUSION: Renal impairment is a common postoperative complication amongst patients undergoing complex EVAR. The incidence of dialysis-dependent renal impairment is reduced by the use of CO2 as a contrast medium.

Zilver PTX Randomized Trial of Paclitaxel-Eluting Stents for Femoropopliteal Artery Disease: Twenty-Four Month UpdateM.D. Dake, G.M. Ansel

PURPOSE: The Zilver® PTX® stent with polymer-free paclitaxel coating is the rst drug-eluting stent approved (currently CE-marked, investigational in the United States and Japan) for the super cial femoral artery (SFA). This multicenter, prospective, randomized trial compared the safety and e ectiveness of the Zilver PTX stent to balloon angioplasty (PTA) and bare metal stenting (BMS).

MATERIALS AND METHODS: Symptomtaic patients with SFA lesions (de novo] or non-in-stent restenosis) were randomized to PTA or Zilver PTX stent placement. PTA patients experiencing acute failure (eg ≥ 30% residual stenosis) underwent secondary randomization to provisional stenting with Zilver BMS or Zilver PTX. Follow-up included event-free survival (EFS), and primary patency by Duplex ultrasound core laboratory analysis (peak systolic velocity ratio < 2.0).

RESULTS: A total of 479 patients were enrolled at 55 institutions in the United States, Japan, and Germany, with 241 patients randomized to the Zilver PTX group and 238 to the PTA group. Demographics and lesion characteristics (eg, lesion length 66 mm and 63 mm, respectively) were similar for the groups. Approximately half the PTA group experienced acute failure and underwent secondary randomization, assigning 59 and 61 patients to provisional stenting with Zilver BMS and Zilver PTX, respectively. The study results met the 12-month primary endpoint goals showing non-inferior EFS (90.4% vs 82.6%, P < 0.01) and superior primary patency (83.1% vs. 32.8%, P < 0.01) for the Zilver PTX compared to PTA. The randomized comparison of provisional stenting with Zilver PTX versus Zilver BMS also showed signi cant paclitaxel coating bene t, with 12-month patency rates of 89.9% and 73.0% respectively (P = 0.01). Currently, 24-month follow-up is available for 278 patients, showing an 86.6% EFS rate and a 74.8% patency rate. The randomized comparison of provisional stenting with Zilver PTX versus Zilver BMS also continues to demonstrate signi cant paclitaxel coating bene t at 24 months, with patency rates of 81.2% and 62.7%, respectively (P < 0.01).

CONCLUSION: The results of this randomized, multicenter study support the safety and e ectiveness of the Zilver PTX Drug-Eluting Peripheral Stent.

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Clinical Interventional Oncology (CIO) 2011January 15 – 16, 2011, Miami Beach, Florida

Best of CIO AbstractsAll CIO abstracts and posters are graded via blinded peer review

based on scienti c merit, originality, relevance and clarity.

Cryoablation of Metastatic Lesions from Colorectal Cancer: Initial Cost and Survival ObservationsH.J. Bang, P.J. Littrup, D.J. Goodrich, B.P. Currier, H.D. Aoun, et. al

PURPOSE: To assess the e ectiveness of cryoablation in the palliative treatment of metastatic colorectal cancer by addressing survival, cost, and ablation zone resorption considerations, while also monitoring complications and recurrences in our patient group.

MATERIALS AND METHODS: One hundred and four CT and/or ultrasound (US)-guided, percutaneous cryoablation procedures were performed for 45 patients on 104 metastases located in the liver, 36 tumors in 11 patients located in the lung, and 8 tumors in 6 patients in three so tissue locations: intraperitoneal, retroperitoneal, and bone. Median survival for patients was determined using the Kaplan-Meier method. The incremental cost e ectiveness ratio was calculated into cost per life year saved based on median survival times and liberal estimates of procedural costs. Resorption was calculated from ablation zone measurements grouped into 1, 3, 6, 12, 18, and 24+ month statistical bins. Complications were graded according to Common Toxicity Criteria for Adverse Events Version 3.0 (CTCAE).

RESULTS: The cryoablation zone was well de ned by CT as a hypodense ice ball with an average ablation diameter of 5.4 cm, while average tumor diameter was 2.8 cm. Application of the Kaplan-Meier estimator determined that the median survival rate of patients in this study was 35 months. The incremental cost e ectiveness ratio for cryoablation procedures was calculated to be $11,657 per life year saved. By 12 months the average ablation volume involution was 72% and at 24 months, 89%. A Major complication (CTCAE grade > 3) occurred during 6 procedures (6%). A er an average follow-up of 12 months (range: 1-80), a total of 17 local recurrences of 148 tumor sites (11%) were noted and 11 (65%) of those recurrences were satellite lesions (ie, <10 mm beyond ablation zone).

CONCLUSION: Preliminary calculations of high patient survival and cost e ectiveness suggest that cryoablation could e ectively and economically augment the palliative care of metastatic disease.

Iceball Growth Kinetics during Percutaneous Renal AblationJ. Walsh, T.W. Clark

PURPOSE: Percutaneous cryoablation is an effective treatment of small renal neoplasms in nonsurgical candidates. Iceball formation during percutaneous cryoablation procedures is commonly monitored with imaging, but there is limited characterization of iceball growth kinetics. The objective of our study was to retrospectively measure iceball kinetics and determine

predictors of iceball growth rate in a cohort of patients who underwent percutaneous renal cryoablation.

MATERIALS AND METHODS: Retrospective analysis of 26 percutaneous cryoablation procedures was performed in 19 different patients. Procedures performed with Endocare Perc 15, 17, and 24 cryoprobes. Multidetector CT was used for accessing the tumor and monitoring each ablation. As per our institution’s standard of care, iceball size and location were evaluated every 3-4 minutes during active freezing. Iceball volumes during the rst active freeze in each procedure was measured from CT datasets in orthogonal dimensions at each time point using an independent workstation. Probe size, probe number (single vs multiple), tumor location (exophytic vs parenchymal), and tumor size were examined as predictors of iceball growth using univariate linear regression.

RESULTS: Mean iceball growth was linear at 1.4 cm3/min during the rst freeze cycle. Larger (diameter =2.4 mm) probes showed trend toward more rapid growth compared to smaller (diameter =1.5/1.7 mm) probes (1.7 cm3/min vs 1.2 cm3/min, P = NS). Iceball formation rate was similar with multiple probes (1.5 cm3/min) compared to single probes (1.3 cm3/min, P = NS). Iceballs within exophytic tumors formed at same rate as parenchymal (P = NS). No di erence in growth was seen in tumors < 2 cm vs > 2 cm in size (P = NS).

CONCLUSION: Iceball volume increases at a linear rate during the first cycle of active freezing in renal cryoablation. Neither technical (probe size, or multiple probes) nor anatomic factors (size/location of tumors) were signi cant determinants of iceball growth velocity. Larger probes demonstrate a trend toward faster iceball growth. Our data suggest that imaging protocols regarding monitoring of iceball growth should take into account the lack of a plateau e ect on iceball growth and the e ect of large cryoprobes.

Percutaneous Magnetic Resonance Imaging (MRI)-Guided Cryoablation of Solitary Kidney TumorsB. Dave, S. Lewis, D. Smith, T. McCowan, C. Pound

PURPOSE: To report our experience regarding percutaneous magnetic resonance imaging (MRI)-guided cryoablation technique feasibility, safety and short-term outcomes of solitary kidney tumors.

MATERIALS AND METHODS: We performed a retrospective study of 23 patients who had solitary kidney tumors treated with percutaneous MRI-guided cryoablation. A total of 2 of tumors were treated in 23 patients. There were 17 men and 6 women with an average age of 55 years (range, 42–79 years). By using 0.5-T open MRI system and general anesthesia in patients, 1 to 5 (mean, 2) needlelike cryoprobes were placed and lesions

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were ablated by using real-time MRI for intraprocedural monitoring of ice balls. Tumors were considered successfully ablated if they demonstrated no contrast enhancement at follow-up computed tomography or MRI (mean, 4 months; range, 1–27 months). Pre procedure and post procedure GFR (glomerular ltration rate) was recorded.

RESULTS: Twenty-four of 24 tumors were successfully ablated, 19 of which required only one treatment session. Second treatment sessions were required by 5 tumors because of residual tumor as per follow-up 3 month imaging study. There were 4 complications encountered, all of which were minor. There was no significant di erence in pre- and postprocedure GFR values.

CONCLUSION: Solitary kidney tumors are challenge to treat. MRI-guided cryoablation shows promise for the treatment of solitary kidney tumors, and MRI can be used to monitor the treatment intraprocedurally. It is safe and e ective however, more studies with long term follow up are needed.

Predictors of Tumor Recurrence Using Positron Emission Tomography/Computed Tomography (PET/CT) a er Radiofrequency Ablation of Lung MalignanciesC. Meade, M. Quinn, R. Pezzuti, T. Dykes, J. Gerding, et. al

PURPOSE: There are characteristic changes on computed tomography (CT) and positron emission tomography (PET) imaging after lung ablation procedures. The purpose of this study was to identify risk factors for tumor recurrence.

MATERIALS AND METHODS: Retrospective review was performed on patients undergoing lung ablation radiofrequency ablation (RFA) or cryoablation (Cryo) from 2007-2010. Patients received preprocedure PET/CT followed by postprocedure imaging: chest CT at 1 month, PET/CT at 3 months and 6 months. Further imaging was then performed at 3-6 month intervals. Imaging was considered positive for local tumor recurrence when there was evidence of disease progression (RECIST v 1.1) using the 1 month post-ablation scan as baseline or persistent SUV of > 2.5 at 6 months within the treated site. Overall survival and time to local progression was calculated (Kaplan-Meier method). Univariate analysis of the following variables (size >2.5 cm, diagnosis (primary lung cancer vs metastatic), post-ablation SUV > 2.5 at 3 months, lack of partial response (PR) by 6 months using the 1 month post-ablation CT as baseline (RECIST v1.1) was performed using logistic regression.

RESULTS: Forty lung ablation procedures (37 RFA, 3 Cryo) were performed between 2007-2010 on 33 patients. Mean follow-up period was 6.9 months (range 1 - 30 months). 6 patients had metastatic disease (colorectal, carcinoid, adrenocortical, osteosarcoma); 27 patients had non-small cell lung cancer. Kaplan-Meier analysis demonstrated median time to local progression was 15 months. During the follow-up period, overall survival was 95%. Out of potential risk factors, only the lack of PR by 6 months

was found to be a predictor of tumor recurrence based on logistic regression (odds ratio 14.3). Diagnosis, size > 2.5cm, and SUV > 2.5 at 3 months post-ablation were not found to be signi cant predictors.

Predictors of Tumor Recurrence

Variable Odds Ratio p ValueNSCLC diagnosis 2.1 0.998Size > 2.5 cm 4.6 0.28Lack of PR by 6 months 14.3 0.04SUV>2.5 at 3 months postablation 5.4 0.35

CONCLUSION: Out of the potential risk factors for tumor recurrence (diagnosis, tumor size, SUV>2.5 at 3 months post-ablation), the lack of partial response (RECIST) by 6 months a er lung ablation was the only signi cant predictor of tumor recurrence.

SIRTUXIRI: Y rium-90 Radioembolotherapy with Cetuximab and Irinotecan in Colorectal Metastases (NCT00766220) Initial ResultsR. Murthy, A. Mahvash, R. Avritscher, D. Madoff, C. Garre , et. al

PURPOSE: Unresectable colorectal cancer hepatic metastases (CRCHM) are a major cause of morbidity and mortality. Application of systemic chemobiologic therapies have resulted in multiple permutations of sequential therapy, but eventually therapy refractory disease progression occurs. Development of novel synergistic strategies that may retard this outcome is paramount. In that light, the FDA approved hepatic artery Y rium-90 radioembolotherapy (90Y RE) for CRCHM with adjuvant oxuridine on the basis of a clinical trial in predominantly chemotherapy naïve patients; a currently non-existent cohort. 90Y RE responses in chemobiologic therapy refractory CRC are inferior in the chemotherapy naïve setting, however, with similar toxicity. The application of 90Y RE before chemobiologic therapy refractoriness may be a reasonable synergistic approach to potentially synergize this therapy. The combination of an image-guided intervention (IGI) within “standard of care” systemic therapy and the study conduct will also assist in elucidating logistics hurdles that accompany multimodality, multidisciplinary IGI.

MATERIALS AND METHODS: Eligibility: K-ras wild type CRCHM patients who have previously been treated with irinotecan. Design: Randomized Ph II, 30 per arm (IDE G060207) Primary Objective: To determine the progression free survival for CRCHM patients treated with the combination 90Y RE followed by systemic chemobiologic therapy with cetuximab and irinotecan. Correlative Imaging: 18FDG PET for response.

RESULTS: Updated will be presented in poster format as this trial is actively accruing.

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Selected Poster Presentations from ISET 2011

A New Concept of Stent: The Multilayer Stent. First Human Study in Arterial AneurysmsM. Henry, A. Benjelloun, A. Polydorou, I. Henry, M. Hugel

A New Concept of Stent: The Multilayer Stent. First Human Study in Thoraco Abdominal and Abdominal Aortic AneurysmsM. Henry, A. Benjelloun, I. Henry, M. Hugel

A Novel Approach to Chronic Paget-Schroetter Syndrome: Subclavian Vein Stent Placement a er Decompression SurgeryD. D’Souza, J.E. Molina, J. Golzarian

A Novel Technique for Thrombolytic Delivery in Life-Threatening Pulmonary EmbolusP.D. Edwards, J.D. Goodman

Abdominal Aortic Aneurysm Repair: The Carotid ApproachS.E. Jacob, J. Ghosh, F. Farquharson, D. Murray, F. Serracino-Inglo

Advances in Radioembolization: Embolics and IsotopesJ. Burrill, D. Liu, S. Kee, E. Lee, S. Ho, et. al

Analysis of Cost in Patients with Critical Limb Ischemia Treated with Open vs Endovascular ProceduresN.J. Gargiulo

Aorto UNI-iliac sTEnt Gra Clinical Trial (UNITE)K. Kasirajan

Are We Compliant with Inferior Vena Cava Filter Placement Guidelines?A.S. Baadh, S. Rivoli, J.E. Ansell, R.E. Graham

Carotid Angioplasty and Stenting in Octogenarians Is as Safe as SurgeryI. Henry, M. Henry, A. Polydorou, A. Polydorou, M. Hugel

Carotid Angioplasty/Stenting (CAS) Underprotection Is Becoming the Gold Standard Treatment of a Carotid Stenosis in High- and Low-Risk PatientsM. Henry, I. Henry, A. Polydorou, M. Hugel

Catheter-Directed-Thrombolysis with Monteplase for Acute Massive Pulmonary EmbolismK. Kondo, H. Yokoi, M. Iwabuchi

Clinical E ectiveness of Endovascular Repair without Fenestration for Para-Renal Abdominal Aortic Aneurism (AAA) Compared with Open RepairS. Sultan, N. Hynes

Cold Leg? No Lytics? No Problem! Endovascular Arterial Declot without the Use of LyticsT.M. Loper, J. Ma eo

Complex Aortic Endografting Requires a New Classification System: A Proposed New Zonal SystemD,V. Simring, J.E. Cross, K. Ivancev, O. Agu, T. Richards, et. al

Cryoballoon Angioplasty for Critical Limb Ischemia: A Four-Year Retrospective StudyK.R. Kollmer, S. Ahn, F. Hays, C. Ferrara, R.W. Feldtman

Determinants and Frequency of Stent Fracture in the Super cial Femoral Artery in KoreaW.Y. Kang, W. Kim, J.T. Kim, J.S. Ban, S.H. Hwang, et. al

Endogra ing Popliteal Artery Aneurysms as First Choice: Personal Experience with Viabahn and NewViabahnG. Boselli, A. Benincasa

Endovascular Repair of Abdominal Aortic Aneurysm (AAA) with Short and/or Angulated Necks: Infrarenal Sealing Is Not a Safe OptionJ.E. Cross, D.V. Simring, K. Ivancev, O. Agu, P. Harris, et. al

Endovascular Repair of Iatrogenic Arterial Injuries Resulting from A empted Central Venous CatheterizationW.J. Grande, B. Lerner, P. Rossi, W.S. Rilling, R.A. Hieb, et. al

Endovascular Treatment of Popliteal Artery Aneurysms: A Single-Center ExperienceJ. Fuller, S. Wong, C. Pena, J. Benenati, N. Diehm, et. al

Ethnic Di erences in Critical Limb IschemiaN.J. Gargiulo, J. Cynamon

Experience with Covered Stents for the Management of Infected Arteriovenous Gra sN.J. Gargiulo, J. Cynamon

Fate of Self-Expandable Mitinol Stents Placed in the Popliteal Arterial P2 and P3 Segments in Asian PatientsS.W. Park, I.S. Chang, H.K. Chee, J.J. Hwang, I.J. Yun, et. al

Femoral Access Complications Following Endovascular Interventions for Peripheral Vascular DiseaseA. Nanjundappa, N. Kalakota, C. Trotter, E. Hal Ali, S. Thompson

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Flow Diverter Neuroendovascular Stents : Reconstructive Endovascular Treatment of Intracranial AneurysmsF. Petra, R. Girish, K. Kadziolka, L. Pierot

Hybrid Endovascular Treatment in the Acute Aortic DissectionsG. Arslan, A.T. Yilmaz, A. Ucak, I. Alp, I. Selcuk

In Vitro Placement and E ectiveness of the Angel™ Vena Cava Filter and Catheter (VCFC)L.F. Angel, R. Guerra, J. Steinmetz, B.E. Escobar, J. Kaufman

In uence of Industry Sales Representatives Presence in Cardiovascular Catheterization Laboratory on Device UsageK. Kaid, V. Yaganti, A. Weinberg, M. Feinberg, M. Cohen, et. al

Initial Experience with Eight French Angio-Seal V-Twist Integrated Platform (VIP) in Closing Large Caliber ArteriotomiesS.N. Sarin, A.C. Venbrux, A.K. Chun

Interventional Radiological Management of Renal Artery Pseudoaneurysm Following Partial NephrectomyA. Patel, S. Athreya, M. Voss

Is There a Lengthening Effect on the Aorta Post Endovascular Stenting? A Single Center 4-Year Retrospective ReviewI. Syed, G. Arora, A.M.S. Abeysekara, M. Munshi, A. Hussain, et. al

Long-Term Outcomes of Drug-Eluting Stents for Treatment of Renal Artery Stenosis Less than 4 mmR. Pannu, S. Misra

Multidetector Computed Tomography (MDCT) of Partial Anomalous Pulmonary Venous Return: A Pictorial ReviewA.A. Khankan, S. Lout , M.F. Mohammad, S. Ghanim, M. Al Moaiqel

Nine-Month Results of the REFORM Study: Evaluation of the Formula™ Balloon-Expandable Stent for Renal Artery StenosisR. Bersin

Outcomes of Recanalization and Stenting of Chronically Thrombosed Iliac and Femoral Veins: Single-Center ExperienceA.K. Kurklinsky, H. Bjarnason

Percutaneous Transluminal Angioplasty of the Subclavian Arteries: Long-Term Follow-UpI. Henry, M. Henry, A. Polydorou, M. Hugel

Pharmacomechanical Thrombolysis of Ilio-Caval Deep Vein Thrombosis (DVT): Chronic and AcuteR.W. Feldtman, K.R. Kollmeyer, S. Ahn

PolarCath Balloon Angioplasty of Venous Anastomotic Stenosis in Arteriovenous Gra s: A Review of 25 CasesB.S. Kapoor, M. Flick, S. Osman, J. Soni, M. Lockhart

Prevalence of Malignancy a er Abdominal Aortic Aneurysm (AAA) Repair: Eight-Year Longitudinal Study of Endovascular Aortic Repair (EVAR) vs Open Repair in a Tertiary CenterS. Sultan, W. Taw ck

Prophylactic Inferior Vena Cava Filters in Trauma Patients: A Review of Complications and Retrieval RatesS.D. Samuelson, D. Mi leider

Radiofrequency Guidewire Recanalization of Venous Obstruction in Malignant Superior Vena Cava (SVC) SyndromeR. Davis, E. David, D. Durant, R. Pugash, G. Annamalai

Randomized Comparison of Polyvinyl Alcohol and Tris-Acryl Gelatin Microspheres for Uterine Fibroid EmbolizationR. Shlansky-Goldberg, M. Rosen, J. Mondschein, S.W. Stavropoulous, S.O. Trerotola, et. al

Renal Angioplasty and Stenting Underprotection. Limitations. First Human Study with a 3D Filter: The FibernetI. Henry, M. Henry, A. Polydorou, M. Hugel

Renal Angioplasty and Stenting. Limitations. Role of Embolic Protection DevicesI. Henry, M. Henry, A. Polydorou, M. Hugel

Renal Artery Aneurysms. First Human Treatment with the Multilayer StentM. Henry, A. Polydorou, I. Henry, A. Benjelloun, A. Polydorou, et. al

Retrograde Subintimal Angioplasty Via Popliteal Artery Approach in CTO of SFA: Current Technical Tips and BarriersY.J. Kim, Y.K. Cho, Y.S. Choi, J.J. Woo, H.S.K. Kim

Risk of Pneumothorax in Post Lung Biopsy Patients: Is Short-Term Follow-Up Necessary?R.G. Hayter, T. Berkman, L. Pan, M. Johnson

Safety and Efficacy of a Modified Technique for Deploying Extravascular Sealant (MYNX™) for Vascular ClosureZ. Iqbal, M. Cohen, N. Balani, N. Wasty

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Safety and E cacy of Permanent and Retrievable SVC Filters in the Prevention of Pulmonary EmbolismA. Sundblad, S. Amberson, J. Gerding, T. Dykes, D. Mi leider, et. al

Saving Lower Limb Critical Ischemia with a Medicated Balloon in Occluded or Stenotic Infrainguinal ArteriesJ.H. Velez, J.P. Martinez, J.M. Gonzalez, V. Calle

Single-Center Experience with the Option Inferior Vena Caval FilterD.W. Trost, B. Ching, J. Funderburk, Y. Dang, M. Shi man, et. al

Successful Endovascular Treatment of Infrarenal Aortic Rupture in the Course of Chemotherapy of Ductal CarcinomaJ. Michalak, M. Janas, R. Bilski, P. Szopinski

Temporary Bypass Using Enterprise Stent for Treatment of Acute Proximal Middle Cerebral Artery ThrombosisF. Petra, W. Mustafa, K. Kadzioloka, L. Pierot, L. Estrade, et. al

Three-Year Outcomes of Excimer Laser-Assisted Angioplasty and Balloon Angioplasty in Tibial Arterial Occlusion TASC DE

S. Sultan, W. Taw ck, N. Hynes

Ultrasound Accelerated Thrombolysis for the Treatment of Pulmonary EmbolismT.C. Engelhardt, A.J. Taylor, L. Simprini

Use of CO2 Angiography for Fenestrated and Branched Endovascular Aneurysm RepairJ.E. Cross, D.V. Simring, K. Ivancev, O. Agu, P. Harris, et. al

Usefulness of Vasovist-Enhanced Steady State Magnetic Resonance Angiography in the Detection of Renal Artery StenosisD. Durant, G. Annamalai, E. David, R. Pugash, R. Davis, et. al

Virtual Histology IVUS in Carotid Artery StentingB.M. Winston, G.M. Siewiorek, E.A. Finol, M.H. Wholey

Zilver PTX Randomized Trial of Paclitaxel-Eluting Stents for Femoropopliteal Artery Disease: Twenty-Four Month UpdateM.D. Dake, G.M. Ansel

Selected Poster Presentations from CIO 2011

Alveolar Soft Part Sarcoma of the Tongue Base: Palliation of an Unresectable Tumor with Percutaneous CryoablationJ.D. York

Cost Analysis of Percutaneous Radiofrequency Ablation vs Cryoablation of Renal Tumors Less Than 3 cmJ.R. Hogg, J.L. Friese, C.A. Porter, T.D. Atwell, M.R. Callstrom, et. al

Cryoablation of Metastatic Lesions from Colorectal Cancer: Initial Cost and Survival ObservationsH.J. Bang, P.J. Littrup, D.J. Goodrich, B.P. Currier, H.D. Aoun, et. al

Drug-Eluting Transarterial Chemoembolization for the Treatment of Multicentric Hepatocellular Carcinoma: A Three-Year ExperienceG. Rivera-Sanfeliz, T.B. Kinney

Efficacy and Safety of Chemoembolization with Doxorubicin-Eluting Beads in the Treatment of Liver MetastasesA. Sundblad, T. Dykes, J. Gerding, S. Amberson, P. Harrod-Kim

How To Do Kidney Tumor Cryoablation with Percutaneous Ablative Technique under Computed Tomography (CT) GuidanceB. Dave, K. Tumminello, T. McCowan, C. Pound

Iceball Growth Kinetics during Percutaneous Renal AblationJ. Walsh, T.W. Clark

I m p e d a n c e - B a s e d v s Te m p e r a t u r e - B a s e d Radiofrequency Ablation (RFA) Systems: Comparison of Safety and Efficacy in the Treatment of Lung CancerV. Nguyen, J. Gerding, T. Dykes, P. Harrod-Kim

Magnetic Resonance Imaging (MRI)-Guided Cryoablation of Solid Renal TumorsB. Dave, C. Pound, J. Banahan, J. Gatlin, T. McCowan

Percutaneous Magnetic Resonance Imaging (MRI)-Guided Cryoablation of Solitary Kidney TumorsB. Dave, S. Lewis, D. Smith, T. McCowan, C. Pound

Predictors of Tumor Recurrence Using Positron Emission Tomography/Computed Tomography (PET/CT) a er Radiofrequency Ablation of Lung MalignanciesC. Meade, M. Quinn, R. Pezzuti, T. Dykes, J. Gerding, et. al

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Safety and E cacy of Irreversible Electroporation Using Nanoknife: The Initial American ExperienceG. Narayanan, J. Yrizarry, D. Levi, E. Perez-Rojas, N. Qazi, et. al

SIRTUXIRI: Y rium-90 Radioembolotherapy with Cetuximab and Irinotecan in Colorectal Metastases (NCT00766220) Initial ResultsR. Murthy, A. Mahvash, R. Avritscher, D. Madoff, C. Garre , et. al

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