Research and clinical trials are critical to creating advances in the detection, treatment and care of vascular diseases. Here's a look at outstanding developments in the fields of vascular medicine and vascular surgery that have occurred in the past year.

Peripheral Artery Disease
For four years, the P.A.D. Coalition has been honoring the best clinical research on the topics of treating and understanding peripheral artery disease (PAD). Each year, the top three studies are presented with recognition. This year, the Best PAD Research Awards went to:

Epidemiology/Preventive Medicine
St. Hilaire, C., et. al. "NT5E Mutations and Artery Calcifications." New England Journal of Medicine. 2011.

In a study of three families, mutations in the NT5E gene were found to be the cause of symptomatic lower-extremity (lower leg) artery calcifications. An understanding of this genetic defect will help researchers develop better corrective treatments for artery calcifications going forward.

Vascular Medicine
Langham, M. C., et. al. "Evaluation of Cuff-Induced Ischemia in the Lower Extremity by Magnetic Resonance Oximetry." Journal of the American College of Cardiology. Feb. 9, 2010.

This study evaluated lower-extremity (lower-leg) vascular function during cuff-induced ischemia, or obstruction of blood flow, in people with PAD, as well as healthy individuals. Vascular competence was reduced in patients with abnormal ankle-brachial index readings. This finding suggests that measurement of oxygen saturation during cuff-induced ischemia may provide a way for better detecting atherosclerosis before symptoms set in.

Vascular Interventions
Belch, J. J. F., et. al. "Results of the randomized, placebocontrolled clopidogrel and acetylsalicylic acid in bypass surgery for peripheral artery disease (CASPAR) trial." Journal of Vascular Surgery. Oct. 2010.

Researchers found that the combination of clopidogrel and aspirin administered during bypass surgery for PAD does not improve limb outcomes in patients who require bypass grafting below the knee. However, it does seem to benefit patients who are receiving prosthetic grafts, without significantly increasing major bleeding risk.

Venous Disease
Much like the P.A.D. Coalition, the Venous Disease Coalition recognizes top studies in the field of venous disease research in an effort to forward the understanding and treatment of venous conditions. This year's award winners were as follows:

Basic Science
Fuchs, T., et. al. "Extracellular DNA traps promote thrombosis." Proceedings of the National Academy of Sciences. 2010.

Neutrophil extracellular traps (NETs) are an immune response to infection. It has been observed that NETs stimulate thrombus formation. In a study of baboons with deep vein thrombosis, markers of these DNA traps were detected. This discovery indicates a previously unrecognized link between inflammation and thrombosis, and may also explain a link between infection and thrombosis.

Clinical Outcomes
Kahn, S. R., et. al. "Six-month exercise training program to treat post-thrombotic syndrome: a randomized controlled two-centre trial." Canadian Medical Association Journal. 2011.

To determine whether or not exercise training would improve post-thrombotic syndrome, study participants were placed in a six-month, trainer-supervised program. The exercise training was shown to improve a quality of life score (VEINESQOL). A large multicenter trial is now recommended.

Research Related to Implementation of Quality Improvement, or Public Awareness of the Impact of Venous Disease

Douketis, J., et. al. "Risk of recurrence after venous thromboembolism in men and women: patient level meta-analysis. British Medical Journal. 2011.

This study found that in patients with a first unprovoked venous thromboembolism (deep vein thrombosis or pulmonary embolism), men have a 2.2-fold higher risk of recurrent venous thromboembolism than do women. Even after adjustment for hormone-associated venous thromboembolism in women, the risk of recurrence for men was still 1.8-fold higher. In first provoked venous thromboembolism, it was noticed that the risk of recurrence doesn't seem to differ between the sexes.

Douketis, J., et. al. "Patient-level meta-analysis: effect of measurement timing, threshold, and patient age on ability of D-dimer testing to assess recurrence risk after unprovoked venous thromboembolism." Annals of Internal Medicine. 2010.

The goal of this study was to examine whether or not timing, patient age and the cut point used to define a positive or negative result affect the ability of D-dimer testing. D-dimer is a protein fragment that remains in the blood after a blood clot. Tests that check for this protein are meant to help diagnose blood clots and venous thromboembolism (VTEs). The research found that in patients with a first unprovoked VTE who have had their D-dimer level checked after stopping anticoagulation, the timing of the testing along with patient age and cut point did not affect the ability of the D-dimer test to predict higher or lower risk for recurrent VTE.