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Limb ischaemia

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https://www.readbyqxmd.com/read/29665013/planhab-hypoxia-does-not-worsen-the-impairment-of-skeletal-muscle-oxidative-function-induced-by-bed-rest-alone
#1
Desy Salvadego, Michail E Keramidas, Roger Kölegård, Lorenza Brocca, Stefano Lazzer, Irene Mavelli, Jörn Rittweger, Ola Eiken, Igor B Mekjavic, Bruno Grassi
KEY POINTS: Superposition of hypoxia on 21 day bed rest did not worsen the impairment of skeletal muscle oxidative function induced by bed rest alone. A significant impairment of maximal oxidative performance was identified downstream of cardiovascular O2 delivery, involving both the intramuscular matching between O2 supply and utilization and mitochondrial respiration. These chronic adaptations appear to be relevant in terms of exposure to spaceflights and reduced gravity habitats (Moon or Mars), as characterized by low gravity and hypoxia, in patients with chronic diseases characterized by hypomobility/immobility and hypoxia, as well as in ageing...
April 17, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29658630/lumbar-sympathectomy-versus-prostanoids-for-critical-limb-ischaemia-due-to-non-reconstructable-peripheral-arterial-disease
#2
REVIEW
Indrani Sen, Sunil Agarwal, Prathap Tharyan, Rachel Forster
BACKGROUND: Peripheral arterial disease (PAD) is a common circulatory problem that can lead to reduced blood flow to the limbs, which may result in critical limb ischaemia (CLI), a painful manifestation that occurs when a person is at rest. The mainstay of treatment for CLI is surgical or endovascular repair. However, when these means of treatment are not suitable, due to anatomical reasons or comorbidities, treatment for pain is limited. Lumbar sympathectomy and prostanoids have both been shown to reduce pain from CLI in people who suffer from non-reconstructable PAD, but there is currently insufficient evidence to determine if one treatment is superior...
April 16, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29656359/myocardial-infarct-size-reduction-provided-by-local-and-remote-ischaemic-preconditioning-references-values-from-the-hatter-cardiovascular-institute
#3
Xavier Rossello, Zhenhe He, Derek M Yellon
PURPOSE: To accurately estimate the effect size of both local or classic ischaemic preconditioning (IPC) and remote ischaemic preconditioning (RIPC) using a pooling data set of 91 animals. METHODS: We combined all the available mouse data collected from our Institute over the last 3 years regarding (i) local IPC (4 cycles of 5 min of global ischaemia/reperfusion injury, IRI, followed by 35-min ischaemia and 2-h reperfusion) in the Langendorff-isolated perfused mouse heart model and (ii) RIPC (3 cycles of 5 min of limb occlusion followed by 40-min ischaemia and 2-h reperfusion) in the in vivo mouse model...
April 14, 2018: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/29627774/acute-lower-limb-ischaemia-secondary-to-intestinal-occlusion
#4
Francois-Charles Malo, Philippe Acar, Véronique Lapie, Valérie Bédard
In general, acute lower limb ischaemia is caused by embolic, thrombotic or traumatic phenomena. Here, we describe the case of a 67-year-old woman in an emergency room setting who was initially assessed for paralysis and numbness of her lower left limb. On physical examination, the abdomen was distended and non-compressible. An abdominal AngioScan showed complete occlusion of the left iliac artery by extrinsic compression of the dilated small intestine. After a review of the literature, no case was found describing a lower limb ischaemia by extrinsic vascular compression secondary to a compartment syndrome caused by small bowel obstruction...
April 7, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29619536/penetrating-femoral-artery-injuries-an-urban-trauma-centre-experience
#5
Shreya Rayamajhi, Nivashini Murugan, Andrew Nicol, Sorin Edu, Juan Klopper, Nadraj Naidoo, Pradeep Navsaria
AIM: This study reviews a single centre experience with penetrating femoral artery injuries. PATIENTS AND METHODS: The records of all patients with femoral artery injuries admitted to the Trauma Centre at Groote Schuur Hospital from January 2002 to December 2012 were reviewed. These were analysed for demographics, injury mechanism, perioperative, and surgical management. Outcome was categorised by limb salvage. RESULTS: One-hundred and fifty-eight (158) patients with femoral artery injuries were identified...
April 4, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29599067/a-comparison-of-clinical-outcomes-between-primary-bypass-and-secondary-bypass-after-failed-plain-balloon-angioplasty-in-the-bypass-versus-angioplasty-for-severe-ischaemia-of-the-limb-basil-trial
#6
Lewis Meecham, Smitaa Patel, Gareth R Bate, Andrew W Bradbury
OBJECTIVE: Chronic limb threatening ischaemia (CLTI) is a growing global health problem. The UK NIHR HTA funded BASIL trial is still the only randomised controlled trial to have compared a "bypass surgery first" with a "plain balloon angioplasty (PBA) first" strategy for the management of CLTI. In patients who were likely to survive for 2 years and had a suitable vein, primary bypass (PB) was associated with better clinical outcomes. Furthermore, PBA was associated with a high technical and clinical failure rate and many went on to have secondary bypass (SB)...
March 27, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29579246/high-sensitivity-cardiac-troponin-and-natriuretic-peptide-with-risk-of-lower-extremity-peripheral-artery-disease-the-atherosclerosis-risk-in-communities-aric-study
#7
Kunihiro Matsushita, Lucia Kwak, Chao Yang, Yuanjie Pang, Shoshana H Ballew, Yingying Sang, Ron C Hoogeveen, Bernard G Jaar, Elizabeth Selvin, Christie M Ballantyne, A Richey Sharrett, Aaron R Folsom, Gerardo Heiss, Josef Coresh, Alan T Hirsch
Aims: Cardiac troponin T (cTnT) is suggested as a predictor of amputation in patients with peripheral artery disease (PAD). However, cTnT-PAD association has not been systematically studied in a large study. This study evaluated the association of high-sensitivity cTnT (hs-cTnT) with PAD incidence and also explored whether natriuretic peptide (NT-proBNP), another representative cardiac marker, predicts PAD risk. Methods and results: Among 12 288 middle-aged adults, the associations of hs-cTnT and NT-proBNP with incident PAD (hospitalizations with PAD diagnosis or leg revascularization [cases with rest pain or tissue loss considered as critical limb ischaemia (CLI)]) were quantified with multivariable Cox regression models...
March 22, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29578106/two-team-management-of-vascular-injuries-concomitant-with-osteo-articular-injuries-in-36-patients-over-six-years
#8
B Leclerc, E Boyer, G Menu, G Leclerc, P Sergent, E Ducroux, L Salomon Du Mont, P Garbuio, S Rinckenbach, L Obert
BACKGROUND: Patients with both vascular and osteoarticular injuries require multidisciplinary management. Vascular injuries may be function- and/or life-threatening. The lower limbs are predominantly affected. Traffic, domestic, and work-related accidents contribute most of the cases. The primary objective of this study was to describe the management of patients with concomitant vascular and osteo-articular injuries, with special attention to the rates of amputation and fasciotomy. The secondary objective was to suggest a management sequence to optimise our surgical practice...
March 22, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29566413/rivaroxaban-a-new-treatment-paradigm-in-the-setting-of-vascular-protection
#9
Rupert Bauersachs, Faiez Zannad
The pathophysiology of atherosclerosis involves a diseased endothelium, lipid accumulation and low-grade inflammation. In later stages of coronary artery disease (CAD) and peripheral arterial disease (PAD), plaque rupture may induce atherothrombosis caused by fibrin formation and platelet activation, leading to vessel occlusion with subsequent organ damage such as myocardial infarction, stroke or limb ischaemia. Because of the high disease burden associated with CAD and PAD, there is a need for continuous vascular protection beyond currently available treatments including antiplatelet agents...
March 22, 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29557735/microarray-analysis-for-delineating-the-gene-expression-in-biopsies-of-gastrocnemius-muscle-of-patients-with-chronic-critical-limb-ischaemia-compared-with-non-ischaemic-controls
#10
Daniel Freund, Silke Brilloff, Tamer Ghazy, Stephan Kirschner, Gabor Gäbel, Irene Hinterseher, Norbert Weiss, Adrian Mahlmann
BACKGROUND: Microarray analysis has been carried out in this pilot study to compare delineated gene expression profiles in the biopsies of skeletal muscle taken from patients with chronic critical limb ischaemia (CLI) and non-ischaemic control subjects. PATIENTS AND METHODS: Biopsy of gastrocnemius muscle was obtained from six patients with unreconstructed CLI referred for surgical major amputation. As control, biopsies of six patients undergoing elective knee arthroplasty without evidence of peripheral arterial occlusive disease were taken...
March 20, 2018: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29544385/decrease-of-muscle-strength-in-vascular-access-hand-due-to-silent-ischaemia
#11
Tereza Kmentova, Anna Valerianova, Lucie Kovarova, Jana Lachmanova, Zuzana Hladinova, Jan Malik
BACKGROUND: Creation of vascular access leads to considerable local haemodynamic changes with decreased hand perfusion. Distal limb tissues then represent a model of hand ischaemia effect on muscles. The aim of our study was to investigate how the presence of vascular access influences the hand muscle strength in end-stage renal disease patients. METHODS: We included 52 chronically haemodialysed patients with upper limb access without clinical signs of hand ischaemia...
March 1, 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29532760/efficacy-and-safety-of-autologous-cell-based-therapy-in-patients-with-no-option-critical-limb-ischaemia-a-meta-analysis
#12
Fadilah S Abdul Wahid, Nor Azimah Ismail, Wan Fariza Wan Jamaluddin, Nor Asiah Muhamad, Mohamad Mohamad Azim Mohamad Idris, Nai Ming Lai
BACKGROUND: Revascularisation therapy is the curent gold standard of care for critical limb ischaemia (CLI), although a significant proportion of patients with CLI either are not fit for or do not respond well to this procedure. Recently, novel angiogeneic therapies such as the use of autologous cell-based therapy (CBT) have been examined, but the results of individual trials were inconsistent. OBJECTIVE: To pool all published studies that compared the safety and efficacy of autologous CBT derived from different sources and phenotypes with non cell-based therapy (NCT) in CLI patients...
March 13, 2018: Current Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/29528384/central-versus-peripheral-cannulation-of-extracorporeal-membrane-oxygenation-support-during-double-lung-transplant-for-pulmonary-hypertension
#13
Matthieu Glorion, Olaf Mercier, Delphine Mitilian, Alexandra De Lemos, Lilia Lamrani, Séverine Feuillet, Pauline Pradere, Jérôme Lepavec, Daniel Lehouerou, François Stephan, Laurent Savale, Dominique Fabre, Sacha Mussot, Elie Fadel
OBJECTIVES: Extracorporeal membrane oxygenation (ECMO) has become the standard of cardiopulmonary support during a sequential double lung transplant for pulmonary hypertension. Whether central or peripheral cannulation is the best strategy for these patients remains unknown. Our goal was to determine which is the best strategy by comparing 2 populations of patients. METHODS: We performed a single-centre retrospective study based on an institutional prospective lung transplant database...
March 8, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29516399/lumbar-sympathectomy-can-improve-symptoms-associated-with-ischaemia-vasculitis-diabetic-neuropathy-and-hyperhidrosis-affecting-the-lower-extremities-a-single-centre-experience
#14
Sean C Maguire, Christina A Fleming, Gavin O'Brien, Gerald McGreal
BACKGROUND: Lumbar sympthectomy (LS) was traditionally performed for intermittent claudication but is now eclipsed by revascularisation for that indication. However, it retains a role in the management of critical limb ischaemia and other conditions causing lower limb pain with or without ischaemia. We report the role of LS in modern surgical practice when revascularisation and pain management options have been exhausted. METHODS: A medical chart review was performed on all patients who underwent LS in our unit from 2005 to 2016 (inclusive)...
March 7, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29516192/randomized-controlled-trial-of-remote-ischaemic-conditioning-in-st-elevation-myocardial-infarction-as-adjuvant-to-primary-angioplasty-ric-stemi
#15
António Gaspar, André P Lourenço, Miguel Álvares Pereira, Pedro Azevedo, Roberto Roncon-Albuquerque, Jorge Marques, Adelino F Leite-Moreira
To test whether remote ischaemic conditioning (RIC) as adjuvant to standard of care (SOC) would prevent progression towards heart failure (HF) after ST-elevation myocardial infarction (STEMI). Single-centre parallel 1:1 randomized trial (computerized block-randomization, concealed allocation) to assess superiority of RIC (3 cycles of intermittent 5 min lower limb ischaemia) over SOC in consecutive STEMI patients (NCT02313961, clinical trials.gov). From 258 patients randomized to RIC or SOC, 9 and 4% were excluded because of unconfirmed diagnosis and previously unrecognized exclusion criteria, respectively...
March 7, 2018: Basic Research in Cardiology
https://www.readbyqxmd.com/read/29490953/budget-impact-analysis-of-heparin-bonded-polytetrafluoroethylene-grafts-propaten-against-standard-polytetrafluoroethylene-grafts-for-below-the-knee-bypass-in-patients-with-critical-limb-ischaemia-in-france
#16
Simon Vergnaud, Valéry-Pierre Riche, Philippe Tessier, Nicolas Mauduit, Adrien Kaladji, Yann Gouëffic
OBJECTIVES: To evaluate the budget impact of progressive replacement of standard polytetrafluoroethylene (PTFE) grafts by heparin-bound PTFE (Propaten) for below-the-knee (BTK) bypass in patients with critical limb ischaemia (CLI). DESIGN: From a review of the scientific literature, we calculated a theoretical BTK primary patency for Propaten grafts. Using the French hospital expenditure database (PMSI), we retrospectively estimated a rehospitalisation rate for standard PTFE grafts...
February 28, 2018: BMJ Open
https://www.readbyqxmd.com/read/29484958/hybrid-treatment-of-multilevel-revascularization-in-patients-with-peripheral-arterial-disease-a-multi-centre-study-in-korea
#17
Soon Cheon Lee, Jin Hyun Joh, Jeong-Hwan Chang, Hyung-Kee Kim, Jang Yong Kim, KiHyuk Park, Ki Chun Hong, Seung Jae Byun, Tae Seung Lee, Hyuk Jae Jung, Sang Su Lee
BACKGROUND: Endovascular treatment is an alternative first-line management for peripheral artery disease (PAD). Hybrid treatment (HT) is defined as a combined treatment for patients with PAD using endovascular and open surgery, simultaneously performed in an operating room. The results of HT are reportedly good for multilevel revascularization (MR) in patients with chronic limb ischaemia, and even in older high-risk patients. The goal of this study was to examine the clinical and haemodynamic outcomes of HT in patients who need MR...
February 27, 2018: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29478910/ten-year-mortality-in-different-peripheral-arterial-disease-stages-a-population-based-observational-study-on-outcome
#18
Fredrik Sartipy, Birgitta Sigvant, Fredrik Lundin, Eric Wahlberg
OBJECTIVE: The aim was to determine long-term mortality rates and the underlying cause of death for subjects with different peripheral arterial disease (PAD) stages in a population based setting. METHODS: A randomly selected population sample of 5080 subjects was enrolled in the study in 2004-2005. Participants completed health state questionnaires and underwent ankle brachial index (ABI) measurements for classification into PAD severity stages and reference subjects...
February 22, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29473538/-a-woman-with-swelling-and-blue-red-discolouration-of-the-leg
#19
E Benthem, V Brown
A 61-year-old woman presented with a sudden marked swelling and blue-red discolouration of her entire left leg. The diagnosis phlegmasia cerulea dolens was made. This is an extreme case of lower-extremity deep venous thrombosis that can cause critical limb ischaemia and possible limb loss.
2018: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29436250/effects-of-preconditioned-plasma-collected-during-the-late-phase-of-remote-ischaemic-preconditioning-on-ventricular-arrhythmias-caused-by-myocardial-ischaemia-reperfusion-in-rats
#20
Yang Zhao, Zhi-Nan Zheng, Xiang Liu, Gang Dai, San-Qing Jin
Objective The administration of preconditioned plasma collected during the late phase of preconditioning has been shown to reduce myocardial infarct size. This study aimed to investigate if preconditioned plasma could attenuate ventricular arrhythmias in a rat model in vivo. Methods Eighty rats were randomized to eight groups (10 rats/group). Two groups provided preconditioned or non-preconditioned plasma 48 h after transient limb ischaemia or the control protocol. Six groups of ischaemia-reperfusion (IR) rats received normal saline, non-preconditioned plasma, or preconditioned plasma, respectively, 1 h (groups A1, A2, A3) or 24 h (groups B1, B2, B3) before undergoing myocardial IR...
January 1, 2018: Journal of International Medical Research
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