Fundamentals of PTA and stenting for peripheral arterial disease (2021 – CME) – online course
Authors: K. Katsanos and D. Tsetis
Reviewer: S. Müller-Hülsbeck
This course corresponds to chapter 18.104.22.168.1 Peripheral Arterial Disease in the European Curriculum and Syllabus for IR.
Peripheral Arterial Obstructive Disease (PAOD) is at least as frequent as angina in the U.S. population; according to the results of the Framingham study the annual incidence of symptomatic PAOD is 26/10,000 in men and 12/10,000 in women. If asymptomatic patients are also taken into consideration by use of non-invasive testing, the prevalence of the disease is estimated to be 3% in middle-aged patients, increasing to 20% in patients >70 years of age. About one-third of PAOD lesions in the body affect the aorto-iliac segment. The most common clinical manifestation of PAOD is intermittent claudication (IC) involving the upper thigh, often in combination with lower limb claudication. The worst clinical manifestation of PAOD is critical limb ischemia (CLI) which is a limb- and life-threatening condition with a yearly incidence of around 220 new cases per million population. Patients presenting with CLI usually have multisegmental disease with involvement of the infrainguinal arteries. Typical below-the-knee (BTK) diabetic arterial disease is characterized by long, multilevel disease involving all three infrapopliteal vessels.
- To understand the causes of peripheral ischemia and recognize the risk factors for development and progression of PAOD.
- To know the arterial anatomy and recognize the collateral pathways for patients with PAOD.
- Describe the specific clinical features and categorize IC and CLI according to current systems i.e. SVS/ISVS
- To know the specific angiographic patterns and anatomical levels of disease involvement in patients with IC and CLI with a special focus on diabetes-related PAOD
- To understand strategies for imaging patients with PAOD including DSA, MRA, CTA and colour-doppler ultrasonography
- To learn how to plan optimal vascular access for percutaneous endovascular treatment of PAOD
- To learn correct selection and use of equipment including:
- Reentry devices
- Atherectomy devices
- Stents and stent-grafts
- To obtain technical competence in the performance of peripheral vascular interventions including:
- Crossing stenosis with selective catheters and guidewires
- Recanalisation techniques of total occlusions including subintimal recanalisation and use of re-entry devices
- Balloon angioplasty and stent placement including DCBs and DESs
- Percutaneous atherectomy
- Catheter-directed thrombolysis and Percutaneous Aspiration and Mechanical Thrombectomy
- Management of complications
This course covers a basic level of IR knowledge and is designed for trainees, students or young consultants aiming to acquire essential knowledge or prepare for the EBIR exam. Thereby, it is tailored to the European Curriculum and Syllabus for IR and corresponds to chapter 22.214.171.124.1 Peripheral Arterial Disease.
The format of the course is interactive and easy to use, including texts, graphics, videos and a quiz to support your learning. The course duration is around one hour and is accredited by the European Accreditation Council for Continuing Medical Education (EACCME) to award 1 European CME credit (ECMEC). The CME accreditation for this course will expire on February 18, 2023. A non-CME accredited version of the course will remain available for two more years.
Access to complete and revisit the course is granted for an enrolment period of 90 days.
The CME certificate will be available in the myCIRSE area past the enrolment period if the course is completed before February 18, 2023.
Release date: February 2021