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Limb ischaemia

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https://www.readbyqxmd.com/read/27935893/-results-of-using-various-methods-of-autovenous-femoropopliteal-bypass-grafting-below-the-knee-joint-fissure
#1
B S Sukovatykh, L N Belikov, M B Sukovatykh, D V Sidorov, M A Inarkhov, E B Inokhodova
The objective of the study was to improve therapeutic outcomes in patients presenting with lower limb critical ischaemia by means of optimizing the technique of femoropopliteal bypass grafting. The authors analysed the results of comprehensive examination and treatment of a total of 90 patients presenting with critical lower limb ischaemia on the background of atherosclerotic lesions of arteries of the femoropopliteal and crural segments. Depending on the technology of performing femoropopliteal bypass grafting, the patients were subdivided into three groups each consisting of 30 subjects...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/27935892/-two-year-results-of-infrainguinal-reconstructions-using-autovenous-shunts-and-xenografts
#2
I S Tishchenko, V N Zolkin, N V Maksimov, I N Korotkov, I Yu Demidov, M A Barzaeva
The authors analysed two-year results of inftrainguinal distal arterial reconstructions using xenograft ("kemAngioprosthesis") as compared with an autovein. Ours was a retrospective study including a total of 110 patients who endured 57 femoropopliteal (distal) and 54 femorotibial bypasses by means of both an autovein and a xenograft used as a shunt. The indications for reconstructive operation in the majority of cases was critical ischaemia induced by an atherosclerotic lesion of the femoropoplitealtibial segment corresponding to type D according to the TASC II classification...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/27935880/-efficacy-of-intramuscular-administration-of-stem-progenitor-cells-in-experiment-on-the-model-of-lower-limb-ischaemia
#3
O V Poveshchenko, A P Lykov, N A Bondarenko, I I Kim, E V Yankaite, O V Kazakov, M A Surovtseva, N P Bgatova, A A Karpenko, E A Pokushalov, V I Konenkov
An experimental model of lower limb ischaemia induced by ligation of the femoral artery in CBA-line mail rats was used to study efficacy and effect of intramuscular administration of autologous bone-marrow stem/progenitor cells on the process of angiogenesis. Based on the findings of laser Doppler flowmetry it was shown that administration of autologous stem/progenitor cells promotes acceleration of the processes of neoangiogenesis, which was confirmed by the results of histological study.
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/27935878/-five-year-results-of-treating-patients-with-chronic-lower-limb-ischaemia-by-means-of-gene-engineering
#4
Yu V Chervyakov, I N Staroverov, O N Vlasenko, I Ya Bozo, A A Isaev, R V Deev
The authors share their experience in comprehensive conservative treatment of patients presenting with chronic lower limb ischaemia (CLLI) associated with atherosclerosis of peripheral arteries by means of the first Russian registered gene therapeutic agent "Neovasculgen" (plasmid with the vegf165 gene), analysing the long-term outcomes of treating a total of 45 patients with stage II and III CLLI according to the classification of Pokrovsky-Fontain. The patients were followed up for 5 years. Efficacy of treatment was assessed by registering the dynamics of the pain-free walking distance (PFWD), linear blood velocity (LBV), ankle-brachial index (ABI), as well as the limb salvage rate and survival of patients...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/27919610/renal-artery-stenosis-in-patients-with-peripheral-artery-disease-prevalence-risk-factors-and-long-term-prognosis
#5
V Aboyans, I Desormais, J Magne, G Morange, D Mohty, P Lacroix
OBJECTIVE/BACKGROUND: The objective was to determine the prevalence and clinical determinants of renal artery stenosis (RAS) in patients undergoing digital subtraction angiography (DSA) for the assessment of peripheral artery disease (PAD), and to evaluate its prognostic significance. METHODS: All DSAs performed from January 2000 to January 2006 were retrospectively reviewed for assessment of PAD in patients naive for any prior revascularisation of lower-limb arteries...
December 2, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27919605/not-all-patients-with-critical-limb-ischaemia-require-revascularisation
#6
T B Santema, R M Stoekenbroek, J van Loon, M J W Koelemay, D T Ubbink
OBJECTIVES: International guidelines recommend revascularisation as the preferred treatment for patients with critical limb ischaemia (CLI). Most contemporary research focuses on the outcome of invasive procedures for CLI, but little is known about the outcome of conservative management. Amputation free survival (AFS) and overall survival (OS) was investigated in patients with CLI who did or did not receive revascularisation, and characteristics associated with clinical outcomes were explored...
December 2, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27894392/-advances-in-the-research-on-effect-of-detecting-skin-perfusion-pressure-in-clinic
#7
X L Pan, C M Han
Skin perfusion pressure (SPP) is the perfusion pressure at the skin level, and it can serve as an index of microcirculation in skin and subcutaneous tissue. SPP can be measured simply, with less injury and high reproducibility in a short time, without interfering vascular calcification. It has been widely used in various fields, including evaluation of critical limb ischaemia and effect of vascular surgery, selection of proper level of amputation, and prediction of wound healing. So far, there is no relevant reports about the application of SPP in China...
November 20, 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/27890526/femoropopliteal-in-stent-restenosis-repair-midterm-outcomes-after-paclitaxel-eluting-balloon-use-plaisir-trial
#8
N Bague, P Julia, A Sauguet, J M Pernès, P Chatelard, J F Garbé, S Penillon, J M Cardon, P Commeau, O Planché, B Guyomarch, Y Gouëffic
OBJECTIVE: The aim was to assess 18 month outcomes of the paclitaxel eluting balloon (PEB) in patients with femoropopliteal (FP) in-stent restenosis (ISR). METHODS: In a national prospective and multicentre cohort study, symptomatic patients with femoropopliteal in-stent restenosis were included from January 2012 to June 2013. Patients were treated by paclitaxel eluting balloon angioplasty (In Pact Admiral, Medtronic, Santa Rosa, CA, USA). Clinical and duplex scan follow-up evaluations were performed at 1, 3, 6, 9, 12, and 18 months...
November 24, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27889202/analysis-of-the-elective-treatment-process-for-critical-limb-ischaemia-with-tissue-loss-diabetic-patients-require-rapid-revascularisation
#9
K Noronen, E Saarinen, A Albäck, M Venermo
OBJECTIVES: The number of elderly people is increasing; inevitably, the result will be more patients with critical limb ischaemia (CLI) in the future. Tissue loss in CLI is related to a high risk of major amputation. The aim of this study was to analyze the treatment process from referral to revascularisation, to discover possible delays and reasons behind them, and to distinguish patients benefitting the most from early revascularisation. METHODS: A retrospective analysis was performed of 394 consecutive patients with a combined 447 affected limbs, referred to the outpatient clinic during 2010-2011 for tissue loss of suspected ischaemic origin...
November 24, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27888791/influence-of-genetic-variations-in-platelet-glycoproteins-and-enos-in-the-development-of-arterial-ischaemia-of-lower-limbs-in-type-2-diabetes-mellitus-patients
#10
Virginia Carvalhais, Ema Ruivães, Luis Bernardo Pina-Cabral, Bárbara Mesquita, Flávio Oliveira, Maria Céu Monteiro, Maria Begoña Criado
Endothelial and platelet dysfunction increase the atherothrombotic risk in diabetes mellitus patients. Therefore, arterial ischaemia of lower limbs is an important complication in diabetes mellitus. In the present work, type 2 diabetic patients were classified by a podiatrist into presence or absence of arterial ischaemia of lower limbs. Several polymorphisms in platelet glycoproteins and eNOS genes were evaluated. Our results suggest that the -5CC genotype in Kozak sequence of GPIbα may be associated with a higher risk of developing arterial ischaemia of lower limbs in type 2 diabetes mellitus patients...
October 26, 2016: Foot
https://www.readbyqxmd.com/read/27869551/critical-limb-ischaemia-and-the-response-to-bone-marrow-derived-cell-therapy-according-to-tcpo2-measurement
#11
Mario Maufus, Marie Antoinette Sevestre-Pietri, Carmine Sessa, Bernard Pignon, Harald Egelhofer, Stephane Dupas, Philippe Nguyen, Celine Genty, Gilles Pernod
BACKGROUND: Cell therapy is an emerging potential biotherapy for critical limb ischaemia (CLI) patients who are not eligible for revascularization. However, the findings on this technique's efficacy are inconsistent. Trials investigating this topic focused on the more severe CLI patients who were often beyond any therapy. Therefore, identifying those who may truly benefit from cell transplantation is now warranted. To this end, we studied the prognostic value of tcPO2 for major amputation after 1 year in patients treated with bone marrow-derived cells...
November 21, 2016: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/27843672/management-strategy-in-non-limb-threatening-acute-ischaemia-of-limbs-should-we-rethink
#12
Syed M Asim Hussain, Thomas Joseph
The Society of Vascular Surgery and the International Society of Cardiovascular Surgery identify three types of acute limb ischaemia to inform prognosis and management. Type 1 limb ischaemia is non-limb-threatening and is currently managed conservatively. We describe three cases of Type 1 limb ischaemia with femoropopliteal occlusion that were managed differently. The first case was initially managed conservatively but resulted in an adverse outcome following worsening of ischaemia. Overall, the cases managed with earlier intervention had good outcomes suggesting that conservative management alone may not be sufficient despite resolution of symptoms...
2016: Case Reports in Vascular Medicine
https://www.readbyqxmd.com/read/27833919/the-impact-of-walking-exercises-and-resistance-training-upon-the-walking-distance-in-patients-with-chronic-lower-limb-ischaemia
#13
Maria Szymczak, Grzegorz Oszkinis, Marian Majchrzycki
Objective. The objective of this paper is to compare the impact of supervised walking and resistance training upon the walking distance in PAD patients. Materials and Methods. The examination involved 50 PAD patients at the 2nd stage of the disease according to Fontaine's scale. The participants were randomly allocated to two groups: one exercising on the treadmill (n = 24) and one performing resistance exercises of lower limbs (n = 26). Results. The 12-week program of supervised rehabilitation led to a significant increase in the intermittent claudication distance measured both on the treadmill and during the 6-minute walking test...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27826785/recanalisation-of-chronically-occluded-remote-superficial-femoral-artery-endarterectomy-through-angioplasty-for-limb-salvage
#14
Mohammad Ali Husainy, Hani Slim, Hisham Rashid, Dean Y Huang
We report a novel application of balloon angioplasty to recanalise a chronically occluded remote endarterectomy superficial femoral artery. This patient previously had two occluded surgical bypass grafts in an attempt to revascularise the limb and presented with critical limb ischaemia and necrotic foot ulcerations. Following the angioplasty, the patient showed significant improvement in rest pain and healing of the ulcerations. This technique may be useful for limb salvage in patients where surgical options have been exhausted...
November 8, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27808440/an-integrative-review-of-health-related-quality-of-life-in-patients-with-critical-limb-ischaemia
#15
REVIEW
Susan Monaro, Sandra West, Janice Gullick
AIMS & OBJECTIVES: The aim of this review is to examine the domains and the domain-specific characteristics within a Peripheral Arterial Disease health-related quality of life framework for their usefulness in defining critical limb ischaemia health-related quality of life. BACKGROUND: Critical Limb Ischaemia presents a highly individualised set of personal and health circumstances. Treatment options include conservative management, revascularisation or amputation...
November 3, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27793863/true-brachial-artery-aneurysm-in-a-child-aged-2%C3%A2-years
#16
Aamir Ghazanfar, Afifa Asghar, Naqeeb Ullah Khan, Sidra Abdullah
Congenital brachial artery true aneurysms are exceedingly rare. Most are pseudoaneurysms secondary to trauma or infection. We report a boy aged 2 years who presented with painless, pulsatile swelling on the medial aspect of the right arm, 4 cm above the elbow joint that had been present since birth. Spiral CT angiography showed a fusiform aneurysm of the distal right brachial artery with a peripheral crescent-shaped thrombus. Distal arteries were normally opacified. There was no evidence of abnormal dilation or stenosis in any other artery...
October 28, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27763685/long-term-outcomes-of-a-randomized-clinical-trial-of-supervised-exercise-percutaneous-transluminal-angioplasty-or-combined-treatment-for-patients-with-intermittent-claudication-due-to-femoropopliteal-disease
#17
F A K Mazari, J A Khan, N Samuel, G Smith, D Carradice, P C McCollum, I C Chetter
BACKGROUND: The aim was to compare the long-term outcomes of percutaneous transluminal angioplasty (PTA), a supervised exercise programme (SEP) and combined treatment (PTA + SEP) in patients with intermittent claudication owing to femoropopliteal disease. METHODS: Patients recruited to an RCT comparing these treatments were invited for long-term follow-up from 2010 to 2011. Indicators of limb ischaemia were recorded (ankle : brachial pressure index (ABPI) and treadmill walking distances)...
October 20, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27733016/the-emerging-role-of-microdialysis-in-diabetic-patients-undergoing-amputation-for-limb-ischaemia
#18
Lampros Liasis, George Malietzis, George Galyfos, Thanos Athanasiou, Harry T Papaconstantinou, Fragiska Sigala, Georgios Zografos, Konstantinos Filis
INTRODUCTION: Lower limb ischaemia in diabetic patients is a result of macro- and microcirculation dysfunction. Diabetic patients undergoing limb amputation carry high mortality and morbidity rates, and decision making concerning the level of amputation is critical. Aim of this study is to evaluate a novel microdialysis technique in order to monitor tissue microcirculation preoperatively and predict the success of limb amputation in such patients. MATERIALS AND METHODS: Overall, 165 patients with type II diabetes mellitus undergoing lower limb amputation were enrolled...
October 12, 2016: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/27730333/characterization-of-patients-with-diabetic-foot-disease-presenting-to-an-irish-podiatry-centre-profiling-suitability-for-entry-to-a-clinical-trial-of-advanced-wound-therapeutics
#19
A M Mahon, C MacGilchrist, C McIntosh, T O'Brien
BACKGROUND: Diabetes mellitus, coined the 'Black Death of the Twenty-First Century', is associated with complications, including foot ulceration with potential loss of limb. There is a need for development of new wound therapies through completion of robust clinical trials. AIMS: To profile demographics and wound characteristics of an Irish cohort with diabetes, forecast eligibility for entry to a clinical trial of advanced wound therapeutics, and adjust criteria to optimize eligibility for enrolment...
October 11, 2016: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/27723450/fully-automated-clinical-grade-bone-marrow-processing-a-single-centre-experience
#20
Benedetta Mazzanti, Serena Urbani, Simone Dal Pozzo, Paola Bufano, Lara Ballerini, Alessia Gelli, Irene Sodi, Irene Donnini, Massimo Di Gioia, Stefano Guidi, Julien Camisani, Riccardo Saccardi
BACKGROUND: Clinical grade processing of harvested bone marrow is required in various clinical situations, particularly in the management of ABO mismatching in allogeneic haematopoietic stem cell transplantation (HSCT) and in regenerative medicine. MATERIAL AND METHODS: We report a single-centre experience using a fully automated, clinical grade, closed system (Sepax, Biosafe, Switzerland). From 2003 to 2015, 125 procedures were performed in our laboratory, including buffy-coat production for HSCT (n=58), regenerative medicine in an orthopaedic setting (n=54) and density-gradient separation in a trial for treatment of critical limb ischaemia (n=13)...
September 27, 2016: Blood Transfusion, Trasfusione del Sangue
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