Jose A Echeverri

Interests

Teaching

Vascular & Interventional Radiology, Neuroradiology.

Research

PVD.

Courses

No activities entered.

Scholarly Contributions

Journals/Publications

• Echeverri, J. (2020). Long-Term Outcomes after Endovascular Stent Placement for Long-Segment Superficial Femoral Artery Lesions. Annals of Vascular Surgery.
• Arsanjani, R., Echeverri, J., & Movahed, M. R. (2012). Successful coil embolization of pericardiacophrenic artery perforation occurring during transradial cardiac catheterization via right radial artery.. The Journal of invasive cardiology, 24(12), 671-4.
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  The transradial approach for percutaneous coronary intervention (PCI) has gained increasing popularity as an alternative site for coronary angiography and intervention. The transradial approach has safely been used in patients with contraindications to the transfemoral approach. Despite its overall lower complication rates compared with the transfemoral approach, the transradial approach has its own inherent complications. The risk of arterial perforation with the transradial approach is less than 1%, primarily involving the radial artery with the incidence of compartment syndrome at approximately 0.004%. In addition, the risk of significant bleeding requiring transfusion with transradial approach is extremely rare, occurring in about 1/1000 patients. In this report, we present a case of pericardiacophrenic artery perforation occurring during wire advancement into the aorta via right radial artery approach, which was treated with coil embolization for treatment of significant hemorrhage. This case emphasizes the importance of recognizing this artery in order to prevent similar complications in the future. This artery can be confused with the aorta, since it has a similar course paralleling the aortic arch, and as such it can be inadvertently mistaken for the ascending aorta during wire advancement.
• Khoubyari, R., Arsanjani, R., Habibzadeh, M. R., Echeverri, J., & Movahed, M. R. (2012). Successful removal of an entrapped and kinked catheter during right transradial cardiac catheterization by snaring and unwinding the catheter via femoral access.. Cardiovascular revascularization medicine : including molecular interventions, 13(3), 202.e1-3. doi:10.1016/j.carrev.2012.01.001
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  Since its introduction by Campeau in 1989, the transradial approach for coronary angiography has gained significant popularity among interventional cardiologists due to its lower access site complication rates, cost-effectiveness, and shorter hospital course. Although the transradial approach is much safer than the transfemoral approach, it has its own inherent rare complications including radial artery occlusion, thrombosis, nonocclusive radial artery injury, vasospasm, and compartment syndrome. Herein, we present an unusual case of entrapment and kinking of a catheter in the radial artery, which was successfully removed by using a gooseneck snare via the transfemoral route. The distal and proximal tips were then simultaneously rotated in opposite directions, allowing for the unkinking and removal of the catheter. To our knowledge, this is the first report of this rare complication.
• Mills, J. L., Goshima, K. R., Arslan, B., Duong, S. T., Echeverri, J. A., Ihnat, D. M., Leon, L. R., & Taylor, Z. C. (2008). Contemporary outcomes after superficial femoral artery angioplasty and stenting: the influence of TASC classification and runoff score.. Journal of vascular surgery, 47(5), 967-74. doi:10.1016/j.jvs.2007.12.050
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  A recent randomized trial suggested nitinol self-expanding stents (SES) were associated with reduced restenosis rates compared with simple percutaneous transluminal angioplasty (PTA). We evaluated our results with superficial femoral artery (SFA) SES to determine whether TransAtlantic InterSociety Consensus (TASC) classification, indication for intervention, patient risk factors, or Society of Vascular Surgery (SVS) runoff score correlated with patency and clinical outcome, and to evaluate if bare nitinol stents or expanded polytetrafluoroethylene (ePTFE) covered stent placement adversely impacts the tibial artery runoff..A total of 109 consecutive SFA stenting procedures (95 patients) at two university-affiliated hospitals from 2003 to 2006 were identified. Medical records, angiographic, and noninvasive studies were reviewed in detail. Patient demographics and risk factors were recorded. Procedural angiograms were classified according to TASC Criteria (I-2000 and II-2007 versions) and SVS runoff scores were determined in every patient; primary, primary-assisted, secondary patency, and limb salvage rates were calculated. Cox proportional hazard model was used to determine if indication, TASC classification, runoff score, and comorbidities affected outcome..Seventy-one patients (65%) underwent SES for claudication and 38 patients (35%) for critical limb ischemia (CLI). Average treatment length was 15.7 cm, average runoff score was 4.6. Overall 36-month primary, primary-assisted, and secondary rates were 52%, 64%, and 59%, respectively. Limb salvage was 75% in CLI patients. No limbs were lost following interventions in claudicants (mean follow-up 16 months). In 24 patients with stent occlusion, 15 underwent endovascular revision, only five (33%) ultimately remained patent (15.8 months after reintervention). In contrast, all nine reinterventions for in-stent stenosis remained patent (17.8 months). Of 24 patients who underwent 37 endovascular revisions for either occlusion or stenosis, eight (35%) had worsening of their runoff score (4.1 to 6.4). By Cox proportional hazards analysis, hypertension (hazard ratio [HR] 0.35), TASC D lesions (HR 5.5), and runoff score > 5 (HR 2.6) significantly affected primary patency..Self-expanding stents produce acceptable outcomes for treatment of SFA disease. Poorer patency rates are associated with TASC D lesions and poor initial runoff score; HTN was associated with improved patency rates. Stent occlusion and in-stent stenosis were not entirely benign; one-third of patients had deterioration of their tibial artery runoff. Future studies of SFA interventions need to stratify TASC classification and runoff score. Further evaluation of the long-term effects of SFA stenting on tibial runoff is needed.