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Limb ischaemia

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https://www.readbyqxmd.com/read/28712882/perfusion-of-muscle-flaps-independent-of-the-anatomical-vascular-pedicle-pedicle-autonomy
#1
K Bradshaw, M Wagels
INTRODUCTION: Free muscle flaps are being used more commonly for complex lower limb reconstruction. Up to 33% of flaps used to reconstruct lower limb trauma will require an orthopaedic procedure after reconstruction. To date there have been only case reports detailing the variable survival of muscle flaps after actual or simulated pedicle injury and the process and timeframe of neovascularisation remains undefined. We aim to show that perfusion of a muscle flap is possible after injury to its anatomical vascular pedicle...
June 7, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28711979/acute-kidney-injury-and-critical-limb-ischaemia-associated-with-the-use-of-the-so-called-legal-high-3-fluorophenmetrazine
#2
Michael Fawzy, Wei San Wong-Morrow, Anthony Beaumont, Chris K T Farmer
Until the law in the United Kingdom (UK) changed in May 2016 so called "legal highs" or "new psychoactive substances" were freely available in high street shops across the UK. Following prohibition these drugs are still easily purchased illegally via the internet. We report a case of a patient who self-administered 3-fluorophenmetrazine intravenously with catastrophic consequences. Adverse effects were almost immediate with symptoms of malaise and tachycardia. Two days post administration he was transferred to the intensive therapy unit with acute kidney injury and irreversible four limb ischaemia...
July 15, 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28701057/treatment-of-serious-complications-following-endovascular-aortic-repair-for-type-b-thoracic-aortic-dissection
#3
Zhao Liu, Yepeng Zhang, Chen Liu, Dian Huang, Ming Zhang, Feng Ran, Wei Wang, Tao Shang, Tong Qiao, Min Zhou, Changjian Liu
Objective This study aimed to describe treatment of serious complications after primary thoracic endovascular aortic repair (TEVAR) in type B aortic dissection. Methods From June 2008 to March 2016, serious complications occurred in 58 patients without Marfan syndrome who received TEVAR for type B aortic dissection. Results Complications included endoleak, distal true lumen collapse, retrograde dissection, stroke, stent-graft (SG) migration and mistaken deployment, lower limb ischaemia, and SG fracture. Treatment included endovascular repair, surgical procedures, or conservative medication...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28688873/extra-corporeal-shockwave-therapy-for-peripheral-arterial-disease-a-review-of-the-potential-mechanisms-of-action
#4
REVIEW
Ali Raza, Amy Harwood, Joshua Totty, George Smith, Ian Chetter
INTRODUCTION: Lower limb peripheral arterial disease (PAD) affects 20% of population over 65 years. Extracorporeal Shockwave Therapy (ESWT) has recently emerged as a novel, safe and effective treatment option. This review aims to assess the mechanism of action by which ESWT improves symptoms in patients with PAD. METHODS: Medline and Embase databases were searched in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
July 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28684310/selective-inhibition-of-plasma-membrane-calcium-atpase-4-improves-angiogenesis-and-vascular-reperfusion
#5
Sathishkumar Kurusamy, Dolores López-Maderuelo, Robert Little, David Cadagan, Aaron M Savage, Jude C Ihugba, Rhiannon R Baggott, Farjana B Rowther, Sara Martínez-Martínez, Pablo Gómez-Del Arco, Clare Murcott, Weiguang Wang, J Francisco Nistal, Delvac Oceandy, Ludwig Neyses, Robert N Wilkinson, Elizabeth J Cartwright, Juan Miguel Redondo, Angel Luis Armesilla
AIMS: Ischaemic cardiovascular disease is a major cause of morbidity and mortality worldwide. Despite promising results from pre-clinical animal models, VEGF-based strategies for therapeutic angiogenesis have yet to achieve successful reperfusion of ischaemic tissues in patients. Failure to restore efficient VEGF activity in the ischaemic organ remains a major problem in current pro-angiogenic therapeutic approaches. Plasma membrane calcium ATPase 4 (PMCA4) negatively regulates VEGF-activated angiogenesis via inhibition of the calcineurin/NFAT signalling pathway...
July 3, 2017: Journal of Molecular and Cellular Cardiology
https://www.readbyqxmd.com/read/28670345/the-comparative-efficacy-of-angiosome-directed-and-indirect-revascularisation-strategies-to-aid-healing-of-chronic-foot-wounds-in-patients-with-co-morbid-diabetes-mellitus-and-critical-limb-ischaemia-a-literature-review
#6
Benedictine Y C Khor, Pamela Price
BACKGROUND: Ischaemic ulcerations have been reported to persist and/or deteriorate despite technically successful revascularisations; a higher incidence of which affects patients with diabetes and critical limb ischaemia. In the context of wound healing, it is unclear if applications of the angiosome concept in 'direct revascularisation' (DR) would be able to aid the healing of chronic foot ulcerations better than the current 'best vessel' or 'indirect revascularisation' (IR) strategy in patients with co-morbid diabetes and critical limb ischaemia...
2017: Journal of Foot and Ankle Research
https://www.readbyqxmd.com/read/28665187/is-contrast-enhanced-ultrasonography-a-useful-tool-for-the-evaluation-of-muscular-microcirculation-in-patients-with-critical-limb-ischaemia
#7
Christophe Seinturier, Sophie Blaise, Olivier Pichot, Sebastien Guigard, Céline Genty, Jean Luc Magne, Jean Luc Bosson, Gilles Pernod, Patrick Henry Carpentier
No abstract text is available yet for this article.
June 30, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28622743/endovascular-treatment-for-chronic-lower-extremity-ischaemia-with-sub-acute-deterioration
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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