Chief Medical Editor's Page
The Many Facets of Venous Disease
We open this issue with an overview of chronic cerebrospinal venous insufficiency by Gary Siskin, MD; Kenneth Mandato, MD; and Meridith Englander, MD, including what is known and unknown about diagnosis and which patients may have the findings. They give a balanced discussion of the knowns, the unknowns, and the need for research based on data published to date. Michael D. Dake, MD, follows with an article in which he clarifies the questions that need to be answered to better understand chronic cerebrospinal venous insufficiency and the implications for patients with multiple sclerosis.
With the potential retrievability of most inferior vena cava filters on the market, placement of these devices has substantially increased during the last several years. Some have questioned where this is warranted. Matthew Johnson, MD, FSIR, discusses the goals of a new multispecialty inferior vena cava filter task force and explains the possible device-related complications to be aware of, the optimal design of a postmarket registry to study these filters and their best use, and his advice regarding placement, follow-up, and retrieval.
It is valuable to understand the characteristics of perforator vein incompetence and the impact it has on patients with chronic venous disease. Antonios P. Gasparis, MD, RVT, FACS, and Nicos Labropoulos, PhD, DIC, RVT, analyze the important elements of perforator vein function in this patient population.
Considering the high prevalence of venous thromboembolism in the United States, it has become imperative to combine the efforts of emergency department staff and interventionists. Charles V. Pollack Jr, MA, MD, FACEP, FAAEM, FAHA, provides an interesting perspective from the emergency department and discusses how cooperation between medical professionals can afford early intervention and more effective patient care.
As the scope of today's practice of cardiology continues to broaden, it is important to consider vascular issues and the way they contribute to patients' overall cardiovascular health. Ariel D. Soffer, MD, FACC, presents a history of vein disease and cardiology and provides steps for cardiologists who wish to begin integrating venous procedures into their practice.
Jose I. Almeida, MD, FACS, RPVI, RVT, and Cristal Boatright, MMS, PA-C, explain their method of screening patients with chronic venous disease and selecting the best candidates for percutaneous endovenous stenting to achieve symptom relief.
This month, we have an Imaging & Diagnostics article by Eli Atar, MD, FSIR, who provides an overview of the imaging and decision-making tools needed to treat patients with traumatic injuries in a timely and appropriate manner. We also have a Challenging Cases article by Satoshi Tateshima, MD, in which he describes the use of a large inner diameter distal access catheter to treat a case involving a complex-shaped middle cerebral artery aneurysm.
In our featured interview, Daniel McCormick, DO, shares how the outcomes of recent carotid artery stenting trials are affecting the field and device development, the importance of embolic protection, and a useful technology for training up-and-coming interventionists.
I'm sure you will find this month's issue to be informative, challenging, and valuable to your practice.