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https://www.readbyqxmd.com/read/29233197/takayasu-arteritis-in-paediatrics
#1
Marisa Di Santo, Erica V Stelmaszewski, Alejandra Villa
Takayasu arteritis is an idiopathic chronic granulomatous panarteritis predominantly affecting the aorta and its main branches. Although idiopathic, genetic contribution to disease susceptibility is being increasingly recognised. Rare in children, Takayasu arteritis is a worldwide disease with significant morbidity and mortality. Its diagnosis is a challenge and requires awareness of the condition as clinical features at presentation are non-specific and assessing disease activity is difficult. In the inflammatory stage, treatment is essential to prevent the insidious course and vascular damage: stenotic, occlusive lesions, aneurysms, and aortic regurgitation...
December 13, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29227173/changes-in-platelet-function-with-inflammation-in-patients-undergoing-vascular-surgery
#2
Bartosz Olechowski, Vikram Khanna, Mark Mariathas, Alexander Ashby, Richard T Dalton, Ian Nordon, Nicola Englyst, Scott Harris, Zoe Nicholas, Kala Thayalasamy, Michael Mahmoudi, Nick Curzen
The role of platelets in ischaemic events is well established. Aspirin represents the default antiplatelet and blocks the metabolism of arachidonic acid (AA) at the cyclo-oxygenase enzyme (COX). AA is commonly used as a test of response to aspirin, but recent data raise uncertainty about the validity of this approach. Specifically, in some patients AA-induced clotting is not suppressed, but the level of COX-dependent AA metabolite, thromboxane B2 (TXB2) is negligible. Furthermore, AA-induced whole blood clotting varies dynamically in individuals, who are aspirin responsive according to TXB2 levels...
December 11, 2017: Platelets
https://www.readbyqxmd.com/read/29225030/a-rare-cause-of-critical-limb-ischaemia-an-aneurysmal-persistent-sciatic-artery
#3
Gabriele Pagliariccio, Luciano Carbonari
No abstract text is available yet for this article.
December 7, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29221684/ex-vivo-flush-of-the-limb-allograft-reduces-inflammatory-burden-prior-to-transplantation
#4
Kavit R Amin, Alexandra L Ball, Chandanpreet Chhina, Rebecca J Edge, John P Stone, William R Critchley, Jason K Wong, James E Fildes
BACKGROUND: Passenger leucocytes and inflammatory debris transferred from the donor limb to the recipient can induce allorecognition, which activates the host immune response. This is the first study to evaluate whether the transfer of this inflammatory burden can be reduced via post-preservation flush prior to revascularisation, and whether this is influenced by ischaemia. METHODS: Bilateral forelimbs from the same pig were procured and infused with preservation flush and stored on ice...
November 24, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29220060/upper-limb-ischaemia-a-south-african-single-centre-experience
#5
Tinus du Toit, Kathryn Manning, Nadraj G Naidoo
OBJECTIVE: The aims of this study were to report on our experience with upper limb ischaemia (ULI), to define the pattern and distribution of disease, describe key demographic features and report on conventional clinical outcomes. METHODS: This was a single-centre, retrospective, descriptive study. All patients (n = 64) who underwent a surgical intervention for ULI over a 12-year study period were included. Findings were analysed and compared with the current literature...
December 8, 2017: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/29217434/upper-limb-ischemia-by-subclavian-artery-dissection-after-osteopathic-manipulation
#6
Carine Boulon, Alexandre Maillet, Pierre Salaun, Sophie Skopinski, Joël Constans
We report the case of a young woman who experienced ischemia of upper limb after osteopathic manipulation. Duplex and CT scan showed wall hematoma of the ostium of subclavian artery. The patient spontaneously recovered so that no surgery was necessary. Dissection of vertebral and carotid arteries has been reported after osteopathic manipulations. We report ischaemia of upper limb secondary to dissection of subclavian artery. Arterial dissections associated with manipulation should be recorded in a register in order to assess more carefully the vascular risk that this method carries...
December 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29201044/ischaemic-preconditioning-suppresses-necrosis-of-adipocutaneous-flaps-in-a-diabetic-rat-model-regardless-of-the-manner-of-preischaemia-induction
#7
Christian Ottomann, Markus Küntscher, Bernd Hartmann, Vlado Antonic
Ischaemic insult in the skin flaps is a major problem in reconstructive surgery particularly in patients with diabetes mellitus. Here, we sought to investigate the effectiveness of ischaemic preconditioning (IP) on diabetic skin flaps in rat animal model. Hundred Wistar rats (90 streptozotocin treated animals and 10 nondiabetic controls) were used. Diabetes mellitus was confirmed by measuring glucose level in blood, HbA1c, and ketonuria. We used blood vessel clamping, hind limb tourniquet, and NO donors (Spermine/NO complex) to induce short-term ischaemia of tissues that will be excised for skin flaps...
2017: Dermatology Research and Practice
https://www.readbyqxmd.com/read/29192344/pulseless-supracondylar-humeral-fractures-in-children-vascular-complications-in-a-ten%C3%A2-year-series
#8
Adeline Cambon-Binder, Pascal Jehanno, Laurent Tribout, Philippe Valenti, Anne-Laure Simon, Brice Ilharreborde, Keyvan Mazda
PURPOSE: The management of pulseless supracondylar fractures remains controversial. The aims of this study were to: (1) analyse functional and vascular outcomes of conservative treatment for cases with absent pulse before reduction, whether patients showed limb ischaemia or not; and (2) identify factors associated with vascular complications. METHODS: Twenty-seven children with absent pulses on presentation were treated consecutively between 1999 and 2009. The brachial artery was surgically explored in cases of persistent signs of ischaemia after reduction...
November 30, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29166938/a-case-of-blunt-thoracic-aortic-injury-requiring-ecmo-for-acute-malperfusion-before-tevar
#9
Daiki Wada, Koichi Hayakawa, Shuji Kanayama, Shuhei Maruyama, Hiromu Iwamura, Noriyuki Miyama, Fukuki Saito, Yasushi Nakamori, Yasuyuki Kuwagata
BACKGROUND: Blunt thoracic aortic injury (BTAI) is associated with a high mortality rate and the paradigm of treating patients with BTAI currently favours thoracic endovascular aneurysm repair (TEVAR) if possible. In BTAI, lethal malperfusion caused by a pseudoaneurysm has rarely been reported. We present the first report of a successful case in which a pseudoaneurysm causing the infrequent occurrence of lethal malperfusion and subsequent acute severe ischaemia in the distal portion of the thoracic descending aorta was overcome by veno-arterial extracorporeal membrane oxygenation (VA ECMO) as a bridging therapy until the initiation of TEVAR...
November 22, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/29165599/direct-axillary-cannulation-with-open-seldinger-guided-technique-is-it-safe
#10
Davide Carino, Makoto Mori, Philip Y K Pang, Mrinal Singh, Sherif Elkinany, Maryann Tranquilli, Bulat A Ziganshin, John A Elefteriades
OBJECTIVES: Axillary artery cannulation is commonly used in thoracic aortic surgery, often utilizing a sidearm graft. Although our institutional preference is femoral cannulation, we use axillary cannulation in select cases with a 'dirty' aorta on computed tomography scan or intraoperative transoesophageal echocardiography. Since 2011, we have routinely used an open Seldinger-guided approach for axillary cannulation. Here, we report our experience with open Seldinger-guided technique, evaluating its safety and efficacy...
November 20, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29160765/antithrombotic-treatment-in-peripheral-artery-disease
#11
Dan-Mircea Olinic, Dan Alexandru Tataru, Calin Homorodean, Mihail Spinu, Maria Olinic
This review treats antithrombotic use for peripheral arterial disease (PAD). In asymptomatic patients, there are no scientific data to support single antiplatelet therapy (SAPT) for primary prophylaxis. In symptomatic PAD, SAPT with aspirin or clopidogrel is indicated. The efficacy of aspirin is controversial. Clopidogrel may be preferred over aspirin. Ticagrelor is not superior to clopidogrel in reducing major adverse cardiovascular events and major adverse limb events, but lowers the risk of ischaemic stroke...
November 21, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29116654/cardiovascular-and-all-cause-mortality-in-patients-with-intermittent-claudication-and-critical-limb-ischaemia
#12
S T W van Haelst, C Koopman, H M den Ruijter, F L Moll, F L Visseren, I Vaartjes, G J de Borst
BACKGROUND: The aim of this study was to evaluate absolute mortality risks and to determine whether changes in mortality risk occurred in patients with intermittent claudication (IC) or critical limb ischaemia (CLI) in the Netherlands between 1998 and 2010. METHODS: Data for patients treated between 1998 and 2010 were obtained from Dutch nationwide registers: the Hospital Discharge Register, Population Register and Cause of Death Register. The registers were used to obtain information regarding IC and CLI hospitalizations, co-morbidities, demographic factors, and date and cause of death...
November 8, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/29109739/a-case-of-polyarteritis-nodosa-presenting-as-rapidly-progressing-intermittent-claudication-of-right-leg
#13
Chathuranga Lakmal Fonseka, Sampath Rukshani Galappaththi, Dayakshi Abeyaratne, Nirmali Tissera, Lalith Wijayaratne
Background: Polyarteritis nodosa (PAN) is a medium vessel vasculitis which causes significant morbidity and mortality. Usually, it presents with constitutional symptoms with angiographic evidence of aneurysms or segmental stenosis of arteries of mesenteric or renal vasculature. It is exceedingly uncommon for PAN to present with symptomatic progressive intermittent claudication. Case Presentation: We describe a 60-year-old male who presented with rapidly progressive intermittent claudication of his right leg...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/29105269/the-impact-of-coronary-artery-disease-and-left-ventricular-ejection-fraction-on-the-prognosis-of-patients-with-peripheral-artery-disease
#14
Takuya Tsujimura, Osamu Iida, Takayuki Ishihara, Masashi Fujita, Masaharu Masuda, Shin Okamoto, Kiyonori Nanto, Takashi Kanda, Akihiro Sunaga, Mitsuyoshi Takahara, Masaaki Uematsu
The impact of the severity of coronary artery disease (CAD) and left ventricular ejection fraction (LVEF) on the prognosis of patients with peripheral artery disease (PAD) has not been systematically studied. We retrospectively analysed 622 patients with PAD (intermittent claudication (IC): n = 446; critical limb ischaemia (CLI): n = 176). The association of SYNTAX score and LVEF with mortality was analysed using the Cox proportional hazard model. In patients with IC, a high SYNTAX score was significantly associated with mortality, whereas reduced LVEF was significantly associated with mortality in patients with CLI...
November 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29083500/prognosis-of-the-infected-diabetic-foot-ulcer-a-12-month-prospective-observational-study
#15
Mwidimi Ndosi, Alexandra Wright-Hughes, Sarah Brown, Michael Backhouse, Benjamin A Lipsky, Moninder Bhogal, Catherine Reynolds, Peter Vowden, Edward Jude, Jane Nixon, E Andrea Nelson
AIMS: To determine clinical outcomes and explore prognostic factors related to ulcer healing in people with a clinically infected diabetic foot ulcer. METHODS: This multicentre, prospective, observational study reviewed participants' data at 12 months after culture of a diabetic foot ulcer requiring antibiotic therapy. From participants' notes, we obtained information on the incidence of wound healing, ulcer recurrence, lower extremity amputation, lower extremity revascularization and death...
October 30, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29065790/surgical-and-endovascular-venous-arterialization-for-treatment-of-critical-limb-ischaemia
#16
Michael Lichtenberg, Michiel A Schreve, Roberto Ferraresi, Daniel A F van den Heuvel, Çagdas Ünlü, Vincent Cabane, Steven Kum
Patients with critical limb ischaemia have a poor life expectancy. Aggressive revascularization is accepted in order to preserve their independence in the final phase of their lives. Bypass surgery and more recently endovascular interventions with angioplasty and stenting have become the treatment of choice to prevent amputation and to resolve pain. However, as many as 20 % of patients with critical limb ischaemia are unsuitable candidates for a vascular intervention because of extensive occlusions of outflow in the crural and pedal vessels...
October 25, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29063607/spinal-or-general-anaesthesia-for-lower-limb-amputation-in-peripheral-artery-disease-a-retrospective-cohort-study
#17
M Niskakangas, S Dahlbacka, J Liisanantti, M Vakkala, T Kaakinen
BACKGROUND: The present study aimed to determine which method of anaesthesia (spinal anaesthesia or general anaesthesia) is better in reducing post-operative analgesic requirements in patients undergoing major limb amputation for lower-limb ischaemia. Another aim was to find out if anaesthesiologists use neuraxial anaesthesia in high-risk patients despite abnormal coagulation profile or use of anticoagulation. METHODS: The study was a retrospective cohort study...
October 24, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29057728/-a-multidisciplinary-approach-in-diabetic-foot-disease-is-mandatory
#18
J G van Baal, W B Aan de Stegge, N C Schaper
The history of two patients (66- and 53-year-old males) with diabetes and peripheral neuropathy illustrates the variety of clinical presentations and pitfalls in treatment of diabetic foot ulcers. Peripheral arterial disease and mechanical stress as a consequence of peripheral neuropathy are important risk factors for developing an ulcer and eventually loss of a limb. Revascularisation of the limb should be considered in the presence of critical limb ischaemia or in the presence of mild to severe ischaemia in combination with a deep infection...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29026631/salmonella-typhimurium-gastroenteritis-leading-to-chronic-prosthetic-vascular-graft-infection
#19
Milo Cullinan, Michael Clarke, Tim Dallman, Steven Peart, Deborah Wilson, Daniel Weiand
Introduction. It is estimated up to 6 % of prosthetic vascular grafts become infected. Staphylococcus aureus is predominant in early infection and coagulase-negative staphylococci are predominant in late infections. Enterobacteriaceae cause 14-40 % of prosthetic vascular graft infections. This is, to our knowledge the first reported case of Salmonella gastroenteritis causing chronic prosthetic vascular graft infection (PVGI). Case presentation. A 57 years old lady presented with signs and symptoms of prosthetic vascular graft infection...
August 2017: JMM Case Reports
https://www.readbyqxmd.com/read/29017734/anatomy-of-the-vasculature-of-the-lower-leg-and-harvest-of-a-fibular-flap-a-systematic-review
#20
REVIEW
A K Abou-Foul, A Fasanmade, S Prabhu, F Borumandi
The fibular free flap (FFF) is based on the peroneal artery, which has a consistent anatomy and makes a minimal contribution to the pedal circulation. However, certain anatomical variations in the vasculature of the leg might leave the peroneal artery with a major role in the perfusion of the foot, and to raise a FFF could lead to ischaemic complications. Our aim was to review the implications of anatomical variants on planning and harvest of a FFF. We systematically reviewed all relevant publications, and included 28 cases that described a dominant peroneal artery and FFF...
November 2017: British Journal of Oral & Maxillofacial Surgery
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