Interview with Dr Andrew M. Goldsweig

Posted Sun, Nov, 15,2015

This author interview is by Dr Andrew M. Goldsweig, of Yale University School of Medicine. Dr Goldsweig's full paper, Tools of the Trade: Adjunctive Tools for Lesion Crossing in Critical Limb Ischemia, is available for download in Medical Equipment Insights.

Please summarise for readers the content of your article.

This review describes advanced tools for crossing long, calcified peripheral vascular lesions in patients with critical limb ischemia. We review mechanical atherectomy, laser atherectomy, crossing devices, and luminal re-entry devices, highlighting the relevant literature for each device.

How did you come to be involved in your area of study?
As a Yale interventional cardiology fellow, my work extends far beyond the coronary arteries. Our department at Yale has a very active peripheral vascular interventional program, and I am lucky to participate very actively in this program.

What was previously known about the topic of your article?
Previous reviews articles are now out of date. Our review summarizes the latest data for every lesion crossing device that is FDA-approved for use in the United States. The relevant data about the devices is neatly presented in a summary table.

How has your work in this area advanced understanding of the topic?
Readers who perform endovascular interventions will want to familiarize themselves with many of these devices, which will help them to cross the most difficult, calcified, atherosclerotic obstructive vascular lesions.

What do you regard as being the most important aspect of the results reported in the article?
The most important aspects of this review are its limitations. Despite the most advanced tools, the severe lesions that result in critical limb ischemia remain extremely challenging for the even the most advanced operators. Furthermore, the device-related data result from small, industry-sponsored trials. In the future, we can only hope for the development of even better devices with large studies to demonstrate their efficacy.

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