New Findings in Vascular Surgery

Vikram Kashyap, MD, of the Heart & Vascular Institute, and his team have made several important findings:

A Better Anticoagulant

Dr. Kashyap was the first to demonstrate the safety and effectiveness of using the anticoagulant bivalirudin in patients undergoing lower extremity bypass. This small study suggests that bivalirudin is a beneficial alternative to heparin as an anticoagulant in lower extremity bypass.

Stent as Good as Bypass for Pelvic Blockages

Blockage of the large blood vessels in the pelvis (aorta and iliac arteries) can starve the lower extremities of blood and lead to the need for amputation. Traditionally, this condition is treated with major surgery: the grafting of a y-shaped synthetic tube to bypass the blockage. Less invasive alternatives are available, but it has not been known for certain how well they compare to the bypass graft. Now, in a retrospective review of cases performed at Cleveland Clinic, 
Dr. Kashyap has shown that outcomes from percutaneous angioplasty and stenting for this condition compare favorably to bypass grafting — a step forward for patients who hope to avoid major surgery for pelvic blockages.