Vascular Medicine
- Having the COURAGE to include PCI in shared decision-making for stable angina
In a select group, a PCI-first strategy does not reduce the risk of death, but it does relieve angina sooner.
- A 75-year-old with abdominal pain, hypoxia, and weak pulses in the left leg
Workup revealed the patient had both arterial and venous thrombosis. What was the cause?
- When cold-induced vasospasm is the tip of the iceberg
For a minority of patients, Raynaud phenomenon may be the presenting sign of a systemic disorder.
- Acute monocular vision loss: Don’t lose sight of the differential
An 83-year-old man woke up one morning unable to see out of his left eye; 6 hours earlier it had been normal.
- Treating Raynaud phenomenon: Beyond staying warm
Avoidance of cold and stress are fi rst-line measures, but if these fail, vasodilator agents are used.
- Severely frail elderly patients do not need lipid-lowering drugs
Statins have no role as primary prevention in this population, and a minor role as secondary prevention.
- Statin therapy in the frail elderly: A nuanced decision
Clinicians—and patients—may reasonably feel there is value in statin therapy—even in advanced frailty.
- Bleeding esophageal varices: Who should receive a shunt?
A transjugular intrahepatic portosystemic shunt can prevent repeated variceal bleeding and control refractory ascites.
- Imaging suggestive, but symptoms atypical
Pseudosubarachnoid hemorrhage is an artifact of CT imaging.