Top Advances in Vascular Disease in 2008

This past year has been a very exciting year in advances toward fighting vascular disease. With over 40 million Americans affected by vascular disease in the United States, the Vascular Disease Foundation (VDF) is pleased that this awareness is growing! We would like to share some of the top advances with you. These selections were chosen from a survey of several vascular health professionals and are based on their opinions only. VDF does not endorse any of the below information and the selections are presented in random order.

Top Advance #1: The "Surgeon General's Call to Action for the Prevention of Deep Vein Thrombosis and Pulmonary Embolism." This historic announcement was made at the annual meeting of the Venous Disease Coalition, a coalition of over 30 organizations brought together by VDF to promote venous disease awareness and education.

The Surgeon General's report highlighted the need for more awareness to be brought to the major public-health problems of deep vein thrombosis (DVT) and pulmonary embolism (PE). Together DVT and PE may be responsible for more than 100,000 deaths each year. While PE may be under diagnosed, it is possible that these numbers could be substantially higher. Pulmonary embolism is a potentially life threatening problem: estimates suggest that, while one in five individuals with PE dies almost immediately, 40% will die within three months of diagnosis.

The Venous Disease Coalition has responded to this Call to Action with plans to create an awareness campaign for the general public and health-care providers. For more information, visit www.VenousDiseaseCoalition.org.

Top Advance #2: The P.A.D. Coalition's Best PAD Research Awards were awarded at the Coalition's annual meeting this past September. These research awards were presented to honor the work of investigators and acknowledge the creation of new clinical research relevant to the understanding and/or treatment of PAD.

• The Best PAD Research Award in Vascular Medicine was presented to John P. Cooke, MD, PhD, Professor of Medicine, Division of Cardiovascular Medicine, at Stanford University in Stanford, California. Dr. Cooke and his colleagues were recognized for their research that explores new tools to aid clinicians in diagnosing unrecognized PAD.
• The Best PAD Research Award in Epidemiology/ Preventive Medicine went to Danielle Laurin, PhD, associate professor at the Laval University Geriatrics Research Unit in Quebec City, Quebec. Dr. Laurin and her colleagues were recognized for their study which identified the association between a low ankle-to-brachial index (ABI) measure with the presence of Alzheimer's disease, vascular dementia, and other forms of dementia.
• Steven Marso, MD, received the Best PAD Research Award in Vascular Interventions. Dr. Marso is a Clinical Scholar at the Mid-America Heart Institute at Saint Luke's Hospital in Kansas City, Missouri. He and his colleagues were recognized for their research study which measured the extent to which peripheral endovascular revascularization (leg angioplasty and/or stents) improved the quality of life for patients with PAD one year after the procedure.

Top Advance #3: New guidelines were established by the American College of Chest Physicians as the recommended standards of care in the management of thromboembolic disorders, which includes DVT and PE. National standards of care for the prevention and management of DVT and PE were also established for hospital patients by the Joint Commission and the National Quality Forum.

Top Advance #4: New oral anticoagulants (blood thinners) were tested for patients undergoing major elective orthopedic surgery, such as knee or hip replacement. The new oral anticoagulants help to prevent the development of blood clots in the large veins of the legs. Researchers have found these new medications to be as effective as warfarin (commonly known as Coumadin®) at preventing leg clots, and they are easier to monitor.

Top Advance #5: Supervised exercise training improved cardiovascular mortality and morbidity in patients with peripheral arterial disease (PAD), which suggests that exercise training should be considered as a prevention strategy for those with PAD. This study adds to the large body of evidence that exercise training is one of the most important and effective treatments for patients with PAD.

Top Advance #6: Intensive glucose therapy reduces risk of heart attack and death in Type 2 Diabetes patients, according to a ten-year study conducted by British researchers. The results stress the importance of glucose-lowering therapy to reduce mortality and the risk of heart attack in these patients.

Top Advance #7: In the JUPITER study published in the New England Journal of Medicine which showed that statins significantly and dramatically reduced the rate of heart attack, stroke, and cardiovascular death in men and women with normal blood cholesterol levels. Statins are used to reduce cholesterol in patients with vascular disease, but may also prevent disease in certain healthy people.

Top Advance #8: Postthrombotic syndrome occurs frequently after DVT, according to a study published in the "Annals of Internal Medicine" by the American College of Physicians. Postthrombotic syndrome can cause discomfort and swelling of the legs and leg sores (ulcers). Patients with extensive DVT and those who experience more severe postthrombotic syndrome within one month after DVT have poorer long-term outcomes.

Top Advance #9: Advances in minimally invasive surgical procedures to repair abdominal and thoracic aortic aneurysms were highlighted in the Journal of Thoracic and Cardiovascular Surgery. These procedures have evolved over the past few years and have significantly reduced the morbidity of aortic aneurysm repair compared with the standard open surgical procedures. The study also presented new findings of clinical trials for devices used for these procedures and reviewed new techniques and approaches for the treatment of aortic aneurysms.

For a list of links with the complete survey information, please visit our Web site at www.vdf.org.