SCAI Publishes New Treatment Recommendations for Aortoiliac PAD

May 28, 2014—The Society for Cardiovascular Angiography and Interventions (SCAI) announced that new recommendations have been issued that provide new anatomic, clinical, and technical guidance for the endovascular treatment of aortoiliac peripheral artery disease (PAD). The article was published by Andrew J. Klein, MD, et al online in Catheterization and Cardiovascular Interventions.

SCAI advised that the article is the first in a series of appropriate-use expert consensus guidelines developed by the society to address PAD. The remainder of the series, addressing femoropopliteal and infrapopliteal PAD as well as renal artery stenosis, will be published in Catheterization and Cardiovascular Interventions in summer 2014.

According to SCAI, the article reviews strategies for vascular access; use of antiplatelet therapies; angioplasty and stenting, including stent selection; and hybrid procedures involving an open surgical procedure followed by stenting in patients with multiple blockages.

The article builds on existing American College of Cardiology/American Heart Association practice guidelines for the treatment of PAD, which recommend stenting as the preferred approach for patients with aortoiliac occlusive disease. The authors note that while several types of stents are available, clinical evidence does not support one type over another at this time. The article also discusses approaches to managing potential complications.

Dr. Klein, the lead author of the consensus statement, is Director of Endovascular Services and Cardiovascular Research at the St. Louis Veterans Administration in St. Louis, Missouri. In the SCAI press release, Dr. Klein commented, “Treating these blockages with open surgery is often a last approach due to the surgical risks and the requirement for an inpatient hospital stay. Endovascular treatment has a success rate of more than 90% and a low mortality rate, making it an appropriate treatment strategy when lifestyle approaches and exercise are no longer effectively controlling symptoms.”



SCAI 2013–2014 President Ted A. Bass, MD, added, “In keeping with SCAI’s mission, this document provides physicians with recommendations on issues to be considered when treating patients with aortoiliac disease. Our goal is to support appropriate patient selection as well as treatment strategies that are the safest and most effective for our patients.”