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Limb ischaemia

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https://www.readbyqxmd.com/read/28340289/remote-ischaemic-conditioning-decreases-blood-flow-and-improves-oxygen-extraction-in-patients-with-early-complex-regional-pain-syndrome
#1
T Hegelmaier, N Kumowski, T Mainka, J Vollert, O Goertz, M Lehnhardt, P K Zahn, C Maier, J Kolbenschlag
BACKGROUND: Remote ischaemic conditioning (RIC) is the cyclic application of non-damaging ischaemia leading to an increased tissue perfusion, among others triggered by NO (monoxide). Complex regional pain syndrome (CRPS) is known to have vascular alterations such as increased blood shunting and decreased NO blood-levels, which in turn lead to decreased tissue perfusion. We therefore hypothesized that RIC could improve tissue perfusion in CRPS. METHOD: In this proof-of-concept study, RIC was applied in the following groups: in 21 patients with early CRPS with a clinical history less than a year, in 20 age/sex-matched controls and in 12 patients with unilateral nerve lesions via a tourniquet on the unaffected/non-dominant upper limb...
March 24, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28336529/toe-imaging-of-a-large-aortic-mass-an-unusual-cause-of-systemic-embolization-in-a-septic-patient
#2
Sarah R Blake, Jamal Khan, Adrian Chenzbraun
A 72-year-old woman presented with sepsis and lower limb ischaemia. Transoesophageal echocardiography (TOE) for suspected endocarditis revealed no cardiac pathology or source of emboli but a large thrombus-like mass was noted in a normal size descending aorta (Fig. 1A, Video 1). Repeat TOE after two weeks of anticoagulation showed two new masses and no change in the size of the original one (Fig. 1B). The patient died following bilateral leg amputation. There was no PM to provide pathology confirmation but the most likely diagnosis was of a thrombus, possibly infected...
March 23, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28329231/cardiac-protective-effects-of-remote-ischaemic-preconditioning-in-children-undergoing-tetralogy-of-fallot-repair-surgery-a-randomized-controlled-trial
#3
Qingping Wu, Tingting Wang, Shiqiang Chen, Quanjun Zhou, Haobo Li, Na Hu, Yinglu Feng, Nianguo Dong, Shanglong Yao, Zhengyuan Xia
Aims: Remote ischaemic preconditioning (RIPC) by inducing brief ischaemia in distant tissues protects the heart against myocardial ischaemia-reperfusion injury (IRI) in children undergoing open-heart surgery, although its effectiveness in adults with comorbidities is controversial. The effectiveness and mechanism of RIPC with respect to myocardial IRI in children with tetralogy of Fallot (ToF), a severe cyanotic congenital cardiac disease, undergoing open heart surgery are unclear. We hypothesized that RIPC can confer cardioprotection in children undergoing ToF repair surgery...
February 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28291676/long-term-outcome-after-thrombolysis-for-acute-lower-limb-ischaemia
#4
O Grip, A Wanhainen, S Acosta, M Björck
OBJECTIVES: The purpose was to study long-term outcome after thrombolysis for acute arterial lower limb ischaemia, and to evaluate the results depending on the underlying aetiology of arterial occlusion. METHODS: This was a retrospective study of patients entered into a prospective database. Patients were identified in prospective databases from two vascular centres, including a large number of variables. Case records were analysed retrospectively. Through cross linkage with the Population Registry 100% accurate survival data were obtained...
March 10, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28275827/intraprocedural-distal-embolization-after-femoropopliteal-angioplasty-is-there-a-role-for-below-the-knee-stents
#5
Miltiadis Krokidis, Tariq Ali, Nicholas Hilliard, Nadeem Shaida, Andrew Winterbottom, Brendan Koo, Teik Choon See
PURPOSE: Intraprocedural distal embolization is an accepted complication of femoropopliteal angioplasty. The purpose of this study is to assess the use of below-the-knee stents in the "bail-out" of conventional methods. MATERIALS AND METHODS: We retrospectively reviewed 1485 of femoropopliteal angioplasties that were performed in our centre in a 4-year period and analysed 12 cases (<1%) where distal embolization that required further intervention occurred. In all cases lesions were chronic and 75% suffered from critical limb ischaemia...
March 8, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28271745/very-distal-vein-bypass-in-patients-with-thromboangiitis-obliterans
#6
Achim Neufang, Carolina Vargas-Gomez, Patrick Ewald, Nicolaos Vitolianos, Tolga Coskun, Nael Abu-Salim, Rainer Schmiedel, Peter von Flotow, Savvas Savvidis
BACKGROUND: Surgical revascularization for chronic critical limb ischaemia in patients with thromboangiitis obliterans (TAO) still remains controversial. Generally, besides cessation of smoking, conservative treatment supported by intravenous administration of vasoactive agents is regarded as the treatment of choice, in combination with local wound therapy or minor amputation. PATIENTS AND METHODS: In four male patients (42-47 years) surgical revascularization was chosen as therapy for established gangrene or non-healing ulceration after unsuccessful conservative treatment and cessation of smoking...
March 8, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28245882/development-of-a-surrogate-potency-assay-to-determine-the-angiogenic-activity-of-stempeucel%C3%A2-a-pooled-ex-vivo-expanded-allogeneic-human-bone-marrow-mesenchymal-stromal-cell-product
#7
Charan Thej, Balamurugan Ramadasse, Ankita Walvekar, Anish S Majumdar, Sudha Balasubramanian
BACKGROUND: Mesenchymal stromal cells (MSCs) have emerged as a more beneficial alternative to conventional therapy and may offer a potential cure for unmet medical needs. MSCs are known to possess strong immunomodulatory and anti-inflammatory properties. Moreover, they promote angiogenesis and tissue regeneration through the secretion of trophic factors. For these reasons, the past decade witnessed a sharp increase in the number of clinical trials conducted with stem cells for various vascular diseases requiring angiogenesis...
February 28, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28245772/structure-of-atherosclerotic-plaques-in-different-vascular-territories-clinical-relevance
#8
Pavel Poredos, Peter Poredos, Mateja Kaja Jezovnik
Atherosclerosis is a systemic disease with different faces. Despite similar, or even identical, risk factors and pathogenesis, atherosclerotic lesions and their clinical manifestations vary in different parts of the vasculature. Peripheral arterial disease (PAD) in the superficial femoral artery (SFA) represents a frequent clinical manifestations of atherosclerotic disease. The pathohistological characteristics of plaques in PAD differ from lesions in the coronary arteries. Plaques in the SFA have more fibrotic elements with less lipid and degenerative tissue elements; this makes them more stable and less prone to rupture...
February 26, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28216714/acute-life-threatening-limb-ischaemia-from-common-femoral-artery-thrombosis-following-total-hip-arthroplasty-surgery-a-rare-complication
#9
Shiva Kumar Narayan, A K Ajith Kumar, Rajesh Mohan Shetty, Sunil Karanth
No abstract text is available yet for this article.
January 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28215512/angiosome-targeted-pta-is-more-important-in-endovascular-revascularisation-than-in-surgical-revascularisation-analysis-of-545-patients-with-ischaemic-tissue-lesions
#10
K Špillerová, N Settembre, F Biancari, A Albäck, M Venermo
INTRODUCTION: This study aimed to evaluate the impact of angiosome targeted (direct) revascularisation according to revascularisation method in patients with diabetes. MATERIALS AND METHODS: This retrospective study cohort comprised 545 diabetic patients with critical limb ischaemia and tissue loss (Rutherford 5, 6). All patients underwent infrapopliteal endovascular (PTA) or open surgical revascularisation between January 2008 and December 2013. Differences in the outcome after direct revascularisation, bypass surgery, and PTA were investigated by means of Cox proportional hazards analysis...
February 16, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28215511/popliteal-artery-entrapment-syndrome-in-children-experience-with-four-cases-of-acute-ischaemia-and-review-of-the-literature
#11
REVIEW
N Settembre, Z Bouziane, M A Bartoli, V Nabokov, M Venermo, P Feugier, S Malikov
OBJECTIVE: Popliteal artery entrapment syndrome (PAES) is an uncommon anatomical anomaly, frequently described in adults. The most common symptom is claudication. Acute limb ischaemia (ALI) in children is rare, but it may evolve and lead to limb loss or lifelong complications. Clinical and surgical experience of PAES in children is reported. Data from the literature are analysed in order to assess the severity of this disease and to identify the factors characterising the diagnosis and the outcome of treatment in paediatric patients...
February 16, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28140457/assessment-and-validation-of-a-novel-angiographic-scoring-system-for-peripheral-artery-disease
#12
D R Morris, T P Singh, J V Moxon, A Smith, F Stewart, R E Jones, J Golledge
BACKGROUND: Angiography is used routinely in the assessment of lower-limb arteries, but there are few well validated angiographic scoring systems. The aim of this study was to develop and validate a novel angiographic scoring system for peripheral artery disease. METHODS: An angiographic scoring system (the ANGIO score) was developed and applied to a sample of patients from a single vascular surgical department who underwent CT angiography of the lower limbs. The reproducibility of the ANGIO score was compared with those of the Bollinger and Trans-Atlantic inter-Society Consensus (TASC) IIb systems in a series of randomly selected patients...
January 31, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28131538/dual-antiplatelet-therapy-safe-but-still-unsettled-for-endovascular-femoropopliteal-stenting-commentary-on-dual-antiplatelet-therapy-improves-outcome-in-diabetic-patients-undergoing-endovascular-femoropopliteal-stenting-for-critical-limb-ischaemia
#13
https://www.readbyqxmd.com/read/28131536/dual-antiplatelet-therapy-improves-outcome-in-diabetic-patients-undergoing-endovascular-femoropopliteal-stenting-for-critical-limb-ischaemia
#14
O Thott, F Granath, J Malmstedt, C-M Wahlgren
OBJECTIVE: The purpose of this study was to analyse the effect of dual antiplatelet therapy (DAPT) compared to aspirin on outcome after endovascular interventions in patients with CLI. METHODS: This was a population based retrospective nationwide cohort analysis. Several linked national databases in Sweden: Swedish National Vascular Registry, Prescribed Drug Registry and National Discharge Registry. A total of 1941 patients (median age 79; range 43-103 years; women 58%) were identified with CLI who had undergone primary femoropopliteal endovascular intervention between 2006 and 2012...
January 25, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28128018/german-guideline-on-the-diagnosis-and-treatment-of-peripheral-artery-disease-a-comprehensive-update-2016
#15
Holger Lawall, Peter Huppert, Christine Espinola-Klein, Claudia Silke Zemmrich, Gerhard Ruemenapf
The prevalence of peripheral artery disease (PAD) is increasing worldwide and is strongly age-related, affecting about 20 % of Germans over 70 years of age. Recent advances in endovascular and surgical techniques as well as clinical study results on comparative treatment methods strengthened the need for a comprehensive review of the published evidence for diagnosis, management, and prevention of PAD. The interdisciplinary guideline exclusively covers distal aorta and atherosclerotic lower extremity artery disease...
January 27, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28089406/intervention-should-not-be-the-thermopylae-to-avoid-amputation-commentary-on-not-all-patients-with-critical-limb-ischaemia-require-revascularisation
#16
EDITORIAL
M A Cairols
No abstract text is available yet for this article.
January 12, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28069703/loss-of-osteoglycin-promotes-angiogenesis-in-limb-ischaemia-mouse-models-via-modulation-of-vascular-endothelial-growth-factor-and-vascular-endothelial-growth-factor-receptor-2-signalling-pathway
#17
Qi-Hong Wu, Yu Ma, Cheng-Chao Ruan, Yan Yang, Xin-He Liu, Qian Ge, Ling-Ran Kong, Ji-Wei Zhang, Chen Yan, Ping-Jin Gao
OBJECTIVE: Osteoglycin (OGN) has been noted for its implication in cardiovascular disease in recent studies. However, the relationship between OGN and angiogenesis remains unknown. Therefore, we aimed to investigate the effect of OGN on ischaemia-induced angiogenesis and to address the underlying mechanisms. METHODS AND RESULTS: The expression of OGN was decreased in a limb ischaemia mouse model. OGN knockout (KO) mice were used to further understand the role of OGN after ischaemia...
January 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28065441/clinimetric-evaluation-of-the-vascular-quality-of-life-questionnaire-in-patients-with-lower-limb-ischaemia
#18
A P Conijn, T B K Santema, S Bipat, M J W Koelemay, R J de Haan
OBJECTIVES: Although commonly used to measure health related quality of life in patients with lower limb ischaemia, the measurement properties of the VascuQol and its assumed underlying health dimensions have not been studied in depth. The objective of this study was therefore to evaluate aspects of reliability and validity of the Dutch version of the VascuQol in patients with intermittent claudication (IC) and critical limb ischaemia (CLI). METHODS: Two datasets containing 195 patients with IC and 150 patients with CLI were used...
January 4, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28031849/a-classical-case-of-non-bacterial-thrombotic-endocarditis-from-pancreatic-adenocarcinoma-presenting-as-multiple-strokes-myocardial-infarction-and-acute-limb-ischaemia
#19
Ching-Hui Sia, Joline Si Jing Lim, Kian Keong Poh, Tan Min Chin
Non-bacterial thrombotic endocarditis (NBTE) classically presents in the context of pancreatic adenocarcinomas. Echocardiography is useful to investigate for valvular vegetations, and institution of early treatment is crucial as this can be complicated by multiple systemic emboli, leading to significant morbidity or mortality in serious cases. Treatment options involve anticoagulation with unfractionated heparin, and the role of surgical intervention is unclear. In this report, we describe a classical case of a middle-aged lady with unresectable pancreatic adenocarcinoma who developed NBTE complicated by multiple systemic emboli...
November 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/28027892/venous-arterialisation-for-salvage-of-critically-ischaemic-limbs-a-systematic-review-and-meta-analysis
#20
REVIEW
M A Schreve, C G Vos, A C Vahl, J P P M de Vries, S Kum, G J de Borst, Ç Ünlü
BACKGROUND: Critical limb ischaemia (CLI) is the end stage of peripheral artery disease (PAD) and is associated with high amputation and mortality rates and poor quality of life. For CLI patients with no revascularisation options, venous arterialisation could be a last resort for limb salvage. OBJECTIVE: To review the literature on the clinical effectiveness of venous arterialisation for lower limb salvage in CLI patients with no revascularisation options. METHOD: Different databases were searched for papers published between January 1966 and January 2016...
December 24, 2016: European Journal of Vascular and Endovascular Surgery
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