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Limb ischaemia

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https://www.readbyqxmd.com/read/28622743/endovascular-treatment-for-chronic-lower-extremity-ischaemia-with-sub-acute-deterioration
#1
Liangxi Yuan, Songlin Guo, Jian Dong, Jian Zhou, Qingsheng Lu, Junmin Bao, Zaiping Jing
OBJECTIVES: The purpose of this study is to report the efficacy of endovascular treatment for patients with sub-acute (14-day to 2-month) deterioration of chronic lower extremity ischaemia. MATERIALS AND METHODS: Between June 2013 and May 2015, 26 consecutive patients (22 men, 4 women; mean age, 68.6 years; range, 50-86 years) were treated for sub-acute deterioration of chronic lower extremity ischaemia in our hospital. All patients were treated with catheter-directed thrombolysis initially and then adjunctive percutaneous transluminal angioplasty and/or stenting was performed to correct underlying lesions...
July 2017: Diabetes & Vascular Disease Research
https://www.readbyqxmd.com/read/28605479/collapsed-stent-graft-and-severe-malperfusion-2%C3%A2-years-after-endovascular-aortic-repair
#2
Yoshihiro Goto, Soh Hosoba, Shinji Ogawa, Yoshihisa Kinoshita
Late collapsing of a stent graft is an extremely rare event, with one existing report describing this phenomenon. A 65-year-old man with a history of endovascular aortic repair for an abdominal aortic aneurysm presented with paraplegia and bilateral lower limb ischaemia. Contrast-enhanced computed tomography showed a dissection of the descending thoracic aorta and a collapsed stent graft, resulting in bilateral lower limb ischaemia. Subsequent axillo-bifemoral bypass resolved his lower extremity functions. The patient required haemodialysis due to acute kidney failure...
June 10, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28602903/major-lower-limb-amputation-outcomes-are-improving
#3
David A Kelly, Stephanie Pedersen, Patrik Tosenovsky, Kishore Sieunarine
INTRODUCTION: Outcomes following major lower limb amputation (MLLA) between 2000 and 2002 from the department of vascular surgery at Royal Perth Hospital (RPH) have been published; mean postoperative length of stay 20 days, inpatient complication rate 54% and 30-day mortality 10%. The last decade has seen increasing endovascular revascularization techniques, increased focus on MLLA patients and general improvements in the model of care. The aim of this study is to compare outcomes between 2000-2002 and 2010-2012...
June 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28602580/a-comparison-of-outcomes-in-patients-with-infrapopliteal-disease-randomised-to-vein-bypass-or-plain-balloon-angioplasty-in-the-bypass-vs-angioplasty-in-severe-ischaemia-of-the-leg-basil-trial
#4
M A Popplewell, H O B Davies, J Narayanswami, M Renton, A Sharp, G Bate, S Patel, J Deeks, A W Bradbury
OBJECTIVE: The aim was to compare outcomes in a subgroup of patients with infrapopliteal (IP) disease randomised to infrapopliteal vein bypass (VB) or plain balloon angioplasty (PBA) in the original BASIL trial. METHODS: A comparison of outcomes from patients randomised to VB or PBA undergoing revascularisation for severe limb ischaemia (SLI) because of IP disease with or without femoropopliteal disease. Data were extracted from case report forms from the BASIL trial...
June 8, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28594805/-survival-of-patients-with-primary-and-secondary-amputations-for-critical-lower-limb-ischaemia
#5
M N Kudykin, R A Deriabin, A N Vasiagin, V V Beschastnov, M G Riabkov, G E Sheĭko, I V Maklakhov
The authors analysed therapeutic outcomes in a total of 171 patients presenting with critical lower limb ischaemia and subjected to amputation at various levels. In so doing, eighty-eight (Group One) patients sustained primary amputation and the remaining eighty-three (Group Two) patients endured secondary amputation after an initially undertaken attempt at revascularization. It was determined that performing primary amputation statistically significantly shortened the lifespan in the postoperative period as compared with secondary amputation performed...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28594796/hybrid-surgery-in-chronic-thoracoabdominal-aortic-dissection
#6
A M Cherniavskiĭ, D A Sirota, T Caus, D S Khvan, S A Al'sov, M M Liashenko
The authors describe and analyse their experience gained in performing prosthetic repair of the thoracoabdominal portion of the aorta, combined with open aortic stenting using the Djumbodis uncovered metal stent. Over the period from 2013 to 2015 we performed a total of 16 hybrid interventions. All patients were found to have type B aortic dissection, with their false and true lumens patent. All patients underwent reconstruction of the thoracoabdominal aorta combined with open implantation of the Djumbodis uncovered metal stent into the area of lower thoracic and visceral arteries...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28594792/-assessment-of-functional-state-of-microcirculatory-bed-of-the-foot-in-patients-with-lower-limb-critical-ischaemia
#7
S A Platonov, V V Zavatskiĭ, M A Kiselev, A I Avramenko, A S Novitskiĭ, I A Alimkhadzhiev, D V Kandyba, V E Savello, I P Dudanov
The authors assessed perfusion of the foot in patients presenting with lower limb critical ischaemia before and after endovascular revascularization, as well as analysed the interrelationship between the change of perfusion and the clinical result of treatment. The study includes a total of 15 patients presenting with ulcerative-necrotic defects of the foot. All patients underwent study of 2D-perfusion of the foot before and after the endovascular intervention. The '2D-perfusion' package was used within the framework of an angiographic examination, and required neither increase in the volume of the contrast medium nor radiation load...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28594443/growth-factors-for-angiogenesis-in-peripheral-arterial-disease
#8
REVIEW
Vitali Gorenoi, Michael U Brehm, Armin Koch, Anja Hagen
BACKGROUND: Peripheral artery disease (PAD) is associated with a high clinical and socioeconomic burden. Treatments to alleviate the symptoms of PAD and decrease the risks of amputation and death are a high societal priority. A number of growth factors have shown a potential to stimulate angiogenesis. Growth factors delivered directly (as recombinant proteins), or indirectly (e.g. by viral vectors or DNA plasmids encoding these factors), have emerged as a promising strategy to treat patients with PAD...
June 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28587798/is-vein-bypass-truly-superior-to-endovascular-intervention-for-tibial-disease-with-severe-limb-ischaemia
#9
L Harris
No abstract text is available yet for this article.
June 3, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28587797/comparison-of-long-term-outcomes-of-heparin-bonded-polytetrafluoroethylene-and-autologous-vein-below-knee-femoropopliteal-bypasses-in-patients-with-critical-limb-ischaemia
#10
C Uhl, C Grosch, C Hock, I Töpel, M Steinbauer
OBJECTIVE/BACKGROUND: Endovascular first is the preferred therapy approach to critical limb ischaemia (CLI). However, in spite of new endovascular techniques, bypass surgery still plays an important role, especially in patients with complex anatomy in whom endovascular therapy is not considered feasible, or has failed. The goal of this study was to analyse the outcomes of prosthetic or autologous vein for femoropopliteal (P3) bypasses performed under the abovementioned conditions. METHODS: A retrospective analysis of patients who underwent a femoropopliteal (P3) bypass for CLI (March 2007-December 2015) was conducted...
June 3, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28583719/weak-links-in-the-early-chain-of-care-of-acute-lower-limb-ischaemia-in-terms-of-recognition-and-emergency-management
#11
M Langenskiöld, K Smidfelt, A Karlsson, C Bohm, J Herlitz, J Nordanstig
OBJECTIVES: Acute lower limb ischaemia (ALLI) is a potentially fatal, limb threatening medical emergency. Early treatment is essential for a good outcome. The aim was to describe the early chain of care in ALLI focusing on lead times and emergency management in order to identify weak links for improvement. METHODS: This was a retrospective, descriptive case study. This study analysed the medical records of all patients with a main discharge diagnosis of ALLI between January 2009 and December 2014...
June 2, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28575392/should-limb-revascularization-take-priority-over-dissection-repair-in-type-a-aortic-dissection-presenting-as-isolated-acute-limb-ischaemia
#12
Ryan Preece, Vivek Srivastava, Enoch Akowuah, Simon Kendall
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was should limb revascularization take priority over dissection repair in acute type A aortic dissection (ATAAD) presenting as isolated acute limb ischaemia? Altogether 133 papers were found using the reported search, of which 7 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated...
June 1, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28574037/-diagnostic-significance-of-the-color-duplex-scanning-in-estimation-of-the-arteries-state-at-different-stages-of-infrainguinal-reconstructions
#13
I E Timina, I I Piatkova, A E Zotikov, Z A Adyrkhaev
AIM: The study was aimed at assessing diagnostic possibilities of duplex scanning (DS) of lower limb arteries, used as 'ultrasonographic angiography' in patients presenting with critical ischaemia for appropriately planning complicated infrainguinal reconstructions at stages of surgical management, including dynamic follow up in the postoperative period. PATIENTS AND METHODS: We examined a total of 30 patients. Of these, 14 patients composed the control group and 16 patients with critical ischaemia of lower limb arteries who underwent 8 external iliac-tibial and 8 femorotibial bypass graftings with a relieving arteriovenous fistula and application of a venous cuff according to the type of 'St...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28574036/-stimulation-of-angiogenesis-by-bone-marrow-cells-in-experimental-ischaemia-of-lower-limb
#14
B S Sukovatykh, A Iu Orlova
The objective of the study was to experimentally substantiate a possibility of treating lower limb chronic ischaemia by means of administration of bone marrow cells. The study was performed on 100 laboratory 'Wistar' rats subdivided into four groups: intact, control, first and second study groups. The intact group consisted of 10 animals, with the remaining three containing 30 rats each. All animals, except the intact ones, were subjected to modelled critical ischaemia of a hind limb by means of excision of major vessels of the extremity...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28574034/-effect-of-actovegin-and-solcoseryl-on-microcirculation-in-experimental-critical-lower-limb-ischaemia
#15
A Iu Orlova, B S Sukovatykh, E B Artiushkova, M Iu Gordov
The authors examined the effect of actovegin and solcoseryl on microcirculation parameters in treatment of experimental critical lower limb ischaemia. The study included a total of 130 male Wistar albino rats divided into four groups: intact, control, first and second study groups. The intact group consisted of 10 animals used for assessment of the normal indices of microcirculation, with the remaining three groups comprising 40 rats each. All animals, except the intact ones, were subjected to modelled critical ischaemia of a hind limb...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28567433/maggot-debridement-therapy-for-a-patient-with-critical-limb-ischaemia-and-severe-cardiac-dysfunction-possibility-of-limb-salvage
#16
Akio Nishijima, Naoto Yamamoto, Ryuichi Yoshida, Koji Hozawa, Satoshi Yanagibayashi, Megumi Takikawa, Rie Hayasaka, Junko Nishijima, Tadasu Okada, Mitsuru Sekido
Ischaemic skin ulcer occurred on the foot of a 73-year-old man who had a history of fulminant myocarditis with severe cardiac dysfunction. We attempted wound bed preparation by maggot debridement therapy and salvaged his limb. It can be one of the adjuvant treatment strategies for critical limb ischaemia.
2017: Case Reports in Plastic Surgery & Hand Surgery
https://www.readbyqxmd.com/read/28528282/management-options-in-the-treatment-of-femoral-pseudoaneurysms-secondary-to-intravenous-drug-abuse-a-case-series
#17
James Rammell, Nisheeth Kansal, Vish Bhattacharya
INTRODUCTION: Infected femoral pseudoaneurysms are a common presentation in intravenous drug users with little consensus as to the optimum management of these patients. Whilst emergency revascularisation options are available, excision and ligation of the femoral artery remains the most common operative intervention but risks leaving the patient with critical ischaemia or intermittent claudication. This case series reviewed the outcomes of 4 patients who underwent excision-ligation without revascularisation of an infected femoral pseudoaneurysm at a district general hospital...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28526046/balloon-versus-stenting-in-severe-ischaemia-of-the-leg-3-basil-3-study-protocol-for-a-randomised-controlled-trial
#18
Benjamin D Hunt, Matthew A Popplewell, Huw Davies, Lewis Meecham, Hugh Jarrett, Gareth Bate, Margaret Grant, Smitaa Patel, Catherine Hewitt, Lazaros Andronis, Jonathan J Deeks, Andrew Bradbury
BACKGROUND: Severe limb ischaemia (SLI) is defined as the presence of rest pain and/or tissue loss secondary to lower extremity atherosclerotic peripheral arterial disease. The superficial femoral and popliteal arteries are the most commonly diseased vessels in such patients and are being increasingly treated using endovascular revascularisation techniques. However, it is currently unknown whether drug-eluting stents and drug-coated balloons confer additional clinical benefits over more established techniques using plain balloons and bare metal stents, or whether they represent a cost-effective use of NHS resources...
May 19, 2017: Trials
https://www.readbyqxmd.com/read/28503301/is-there-a-role-for-ischaemic-conditioning-in-cardiac-surgery
#19
REVIEW
Luciano Candilio, Derek Hausenloy
Coronary artery disease (CAD) is a major cause of morbidity and mortality worldwide. Coronary artery bypass graft (CABG) surgery is the revascularisation strategy of choice in patients with diabetes mellitus and complex CAD. Owing to a number of factors, including the ageing population, the increased complexity of CAD being treated, concomitant valve and aortic surgery, and multiple comorbidities, higher-risk patients are being operated on, the result of which is an increased risk of sustaining perioperative myocardial injury (PMI) and poorer clinical outcomes...
2017: F1000Research
https://www.readbyqxmd.com/read/28475445/outcomes-after-foot-surgery-in-people-with-a-diabetic-foot-ulcer-and-a-12-month-follow-up
#20
E Lenselink, S Holloway, D Eefting
OBJECTIVE: The aim of this study was to retrospectively measure the outcomes of foot-sparing surgery at one year follow-up for patients with diabetic foot ulcers (DFUs). We assessed wound healing and the need for further surgery in relation to the variables that influence healing. METHOD: Data were retrospectively collected by reviewing the electronic files of patients attending the Wound Expert Clinic (WEC). Outcomes of surgical debridement, toe, ray and transmetatarsal amputations were assessed...
May 2, 2017: Journal of Wound Care
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