Article overview
What is the objective/main point of the article?
In this article, the author’s aim is to discuss the importance of endovascular intervention therapies, especially in peripheral arterial occlusive disease. According to the author, the socioeconomic prominence associated with heart diseases is the reason for considerable motivations for the designing and developing of noninvasive radiologic tools for treating the coronary arteries. According to Mahnken (2012), endovascular interventions in the last few decades have gained prominence and represent the majority of arterial treatments. In this article, the author begins by explaining the relevance of endovascular interventions as a first line therapy procedure for conditions such as Iliac and occlusive diseases. The author also aims to reveal to the reader that patient evaluation after endovascular procedures is an important step and requires vascular interventions such as Duplex Ultrasound (DU).
What supporting evidence/data is presented?
To explain the relevance of these procedures through examples, the author presents a case involving a patient with lower-extremity arterial stent. However, since the patient presented a vague history of his condition, the best procedure for detecting the condition could not be established immediately. A multiple set of laboratory experiments were employed. The physicians used ultra sound machines and the short-axis approach. These procedures were necessary because the condition of the patient was not apparent and such situations; the article recommends the use of multiple approaches to determine the condition. The management of patients after endovascular interventions is not always easy. This is because assessing arterial stents presents challenges for the physicians in identifying their exact locations and the type of treatment to employ. In the article, (Figures 1-3) attests to this fact where DU failed to generate PA images that could be used in diagnosis. However, the article outlines the multiple specialties such as interventional cardiology to be used in peripheral vascular intervention.
What outcome/change does the author propose?
The article seems to strongly suggest the use of noninvasive procedures in the cardiovascular interventions because they are easy to access and relatively superficial. The noninvasive nature of this procedure also makes it appropriate as an ideal surveillance tool. The author is however, quick to note that some rare complications are difficult to detect. Unlike significant stenotic lesions, PA complications cannot be established and detected through a single imaging plane. This implies that DU alone cannot be used visualize them. This calls for the use of transducers and multiple projections. The use three dimensional approaches in DU seem to be the one preferred method by the author because of its ability to traverse images using multiple planes. It generates a long-term patency and stent integrity (Ota, et al., 2004).
How will this article/topic/idea affect you in your profession as a cardiovascular technologist?
I find this article important to me in the way the author has arranged and presented the information. The author of this article arranged his arguments in a systematic manner, which makes it easy for any reader to read and comprehend its contents. The article begins with an abstract that clearly summarizes the author’s concern. This is followed by an introduction which gives the reader a background on endovascular intervention and the various approaches employed to treat the conditions associated with this disease. I find the patient history to be important in helping the reader understand how the endovascular intervention can be applied in treating artery stent –related cases and how the symptoms presented by the patient can help the physicians use an approach that would help in treating the condition. The image findings section indicates that the patients presented a vague history, which prevented the physicians from identifying the right treatment approach; hence they were forced to employ multiple strategies. Based on the findings of the case, the author recommends the use of multiple post intervention visualizations such as three-dimensional approaches to DU to give a multiple view of the stent. As a cardiovascular technologist, this article presents useful information that is relevant to my practice. This article is relevant to this field in that it discusses an imaging technique that can be used in endovascular intervention. It has provided me with knowledge on the alternatives I can choose in the event that a condition presents results that are deviant from what is expected during diagnosis.
References
Mahnken, A. (2012). CT Imaging of Coronary Stents: Past, Present, and Future. Volume 2012 (2012), Article ID 139823
Goodwin, J. (2013). Importance of multi-planar imaging for the evaluation of arterial stents. The Journal of Vascular Ultrasound (371):29-31.
Ota, H. et al. (2004). MDCT Compared with Digital Subtraction Angiography for Assessment of Lower Extremity Arterial Occlusive Disease: Importance of Reviewing Cross-Sectional Images. AJR:182.
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