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Tibial arteries

Etienne Cavaignac, Gregoire Laumond, Nicolas Reina, Karine Wytrykowski, Jérôme Murgier, Marie Faruch, Philippe Chiron
Ultrasonography (US) is a nonirradiating, low-cost, real-time imaging modality that has very good spatial resolution. US can be used to view the anterolateral ligament (ALL) and injuries to the ALL. Several authors have sought to analyze the anterolateral aspect of the knee using US with varying luck. All of them analyzed the ALL statically only. The goal of this Technical Note is to describe in detail the technique that we use to analyze the anterolateral aspect of the knee in patients with an anterior cruciate ligament tear...
January 2018: Arthroscopy Techniques
Ichiro Tonogai, Fumio Hayashi, Yoshihiro Tsuruo, Koichi Sairyo
Arthroscopy is an important and minimally invasive diagnostic and therapeutic tool. However, the risk of injury to the neurovascular structures around the portals exists during arthroscopy of the ankle. In the present study, we measured the distance between each portal and the adjacent neurovascular structures with the foot in plantarflexion and dorsiflexion in the Japanese population. Standard anterolateral (AL), anteromedial, posterolateral (PL), and posteromedial portal positions were identified in 6 fresh adult cadaveric feet...
March 13, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Dale G Wilson, Sheena K Harris, Chandler Barton, Jeffrey D Crawford, Amir F Azarbal, Enjae Jung, Erica L Mitchell, Gregory J Landry, Gregory L Moneta
OBJECTIVE: The ankle-brachial index (ABI) is a well-established measure of distal perfusion in lower extremity ischemia; however, the ABI is of limited value in patients with noncompressible lower extremity arteries. We sought to demonstrate whether duplex ultrasound-determined tibial artery velocities can be used as an alternative to ABI as an objective performance measure after endovascular treatment of above-knee arterial stenosis. METHODS: Thirty-six patients undergoing above-knee endovascular intervention had preprocedure and postprocedure duplex ultrasound examination within 6 months of intervention...
March 6, 2018: Journal of Vascular Surgery
Hong Kuan Kok, Shirish G Prabhudesai, Irfan Ahmed, Narayan Karunanithy, Said Abisi, Konstantinos Katsanos, Athanasios Diamantopoulos
PURPOSE: Endovascular treatment of infrapopliteal peripheral arterial disease (PAD) is an established and effective treatment strategy for patients with symptomatic PAD. Increasingly, complex infrapopliteal lesions are treated with an endovascular first approach, especially in the setting of critical limb ischemia for limb salvage, avoiding major amputations which impact on mobility and quality of life. However, many complex infrapopliteal lesions involving the bifurcation of the tibial arteries remain challenging to treat due to recoil or acute dissection following angioplasty and may require stenting using specialized techniques...
March 5, 2018: Annals of Vascular Surgery
Frank M Davis, Jeremy Albright, Katherine A Gallagher, Hitinder S Gurm, Gerald C Koenig, Theodore Schreiber, P Michael Grossman, Peter K Henke
OBJECTIVES: Acute limb ischemia (ALI) of the lower extremity is a potentially devastating condition that requires urgent and definitive management. This challenging scenario is often treated with endovascular, open surgical, or hybrid revascularization in an urgent basis, but the comparative effects of such therapies remain poorly defined. The purpose of this study was to compare outcomes of endovascular, open surgical, and hybrid revascularization for ALI in the contemporary era. METHODS: A large statewide cardiovascular consortium of 45 hospitals was queried for patients between January 2012 and June 2015 who underwent an endovascular, open surgical, or hybrid revascularization for ALI deemed at high risk of limb loss if not treated within 24 hours (Rutherford class IIA or IIB)...
March 5, 2018: Annals of Vascular Surgery
Abhisekh Mohapatra, Jon C Henry, Efthimios D Avgerinos, Rabih A Chaer, Steven A Leers, Aureline Boitet, Michael J Singh, Eric S Hager
OBJECTIVE: Ischemic heel ulcerations are generally thought to carry a poor prognosis for limb salvage. We hypothesized that patients undergoing infrapopliteal revascularization for heel wounds, either bypass or endovascular intervention, would have lower wound healing rates and amputation-free survival than patients with forefoot wounds. METHODS: A retrospective chart review was performed of patients who presented between 2006 and 2013 to our institution with ischemic foot wounds and infrapopliteal arterial disease and underwent either pedal bypass or endovascular tibial artery intervention...
February 28, 2018: Annals of Vascular Surgery
Chih-Chien Yen, Chih-Hong Kao, Chien-Sung Tsai, Shin-Han Tsai
OBJECTIVE: Application of extracorporeal membrane oxygenation (ECMO) for life support has been widely used in various fields of resuscitation. When the common femoral artery (CFA) is used during cannulation for ECMO support in adults, it is often complicated by limb ischemia. Placement of distal perfusion catheter (DPC) can reduce the incidence of limb ischemia and increases the likelihood of limb preservation, but selection criteria is uncertain. METHODS: This is a retrospective study...
January 16, 2018: Heart Surgery Forum
Yoshito Kadoya, Kan Zen, Yohei Oda, Satoaki Matoba
Tip separation of a Crosser catheter is a serious complication; however, there is limited information on bailout methods. Here, we describe a case of successful retrieval of the separated tip of a Crosser catheter using a 2-wire technique with a gooseneck snare. A 76-year-old woman with a history of hemodialysis and diabetes mellitus who developed ulcers on her right toes was diagnosed as having critical limb ischemia and underwent transfemoral antegrade endovascular treatment of the anterior tibial artery (ATA)...
January 1, 2018: Vascular and Endovascular Surgery
Abhisekh Mohapatra, Mikayla N Lowenkamp, Jon C Henry, Aureline Boitet, Efthimios D Avgerinos, Rabih A Chaer, Michel S Makaroun, Steven A Leers, Eric S Hager
INTRODUCTION: Endovascular strategies are often preferred for revascularization of ischemic foot wounds secondary to infrapopliteal disease due to the less invasive technique and faster recovery. Bypass is typically reserved for failures or lesions not amenable to balloon angioplasty. However, the effects of an endovascular-first approach on subsequent bypass grafts is largely unknown. This study evaluates the effects of prior tibial interventions on successive bypasses to pedal targets...
February 23, 2018: Annals of Vascular Surgery
Jin-Song Liu, Zhi-Yao Li
OBJECTIVE: To compare blood supply changes around the knee joint between normal and osteoarthritis knee. METHODS: From June 2014 to June 2015, 30 patients with knee osteoarthritis and 30 healthy adults were recruited. In osteoarthritis group, there were 9 males and 21 females, with a mean age of (65.967±7.132) years old(ranged, 53 to 82 years old), and the mean arterial pressure was(93.462±7.633) mmHg. In control group, there were 9 males and 21 females, with a mean age of (62...
August 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Athanasios Diamantopoulos, Serafino Santonocito, Narayanan Thulasidasan, Panos Gkoutzios, Irfan Ahmed, Hany Zayed, Konstantinos Katsanos
PURPOSE: To report use of the Outback reentry device for targeted distal reentry during subintimal recanalization of chronic total occlusions (CTOs) in the infragenicular arteries. METHODS: During an 18-month period, the Outback device was applied in 10 patients (mean age 71.8±18.8 years; 8 men) to achieve reentry at the infragenicular segment following either unsuccessful spontaneous reentry after subintimal crossing of a CTO or when a targeted reentry was desired...
February 1, 2018: Journal of Endovascular Therapy
Erkan Orhan, Ömer Özçağlayan
Objectives The main factor in the healing of foot ulcers in diabetic patients is adequate perfusion. There is no consensus on whether direct or indirect revascularization is more effective in leg revascularization. At the centre of that debate, there is a disagreement about whether collateral circulation is sufficient or not. Our aim is to evaluate collateral circulation activity between angiosomes in the feet of diabetic patients by evaluating the level of occlusion in leg arteries and comparing the angiosome regions that have necrosis...
January 1, 2018: Vascular
Axel Haine, Alan G Haynes, Andreas Limacher, Tim Sebastian, Wuttichai Saengprakai, Torsten Fuss, Iris Baumgartner
BACKGROUND: Patency of the pedal-plantar arch limits risk of amputation in peripheral artery disease (PAD). We examined patients without chronic kidney disease (CKD)/diabetes mellits (DM) [PAD-control], those with DM without CKD, and those with CKD without DM. METHOD: Uni- and multivariate logistic regression was used to assess association of CKD with loss of patency of the pedal-plantar arch and presence of tibial or peroneal vessel occlusion. Multivariate models adjusted for age, sex, hypertension, hyperlipidemia and smoking...
February 1, 2018: Therapeutic Advances in Cardiovascular Disease
Brian M Leoce, Jack T Bernik, Anjuli M Gupta, Herbert Dardik, Thomas R Bernik
Most anterior tibial aneurysm cases described in the literature are pseudoaneurysms resulting from trauma. Since 1967, only 8 cases published on true anterior tibial artery aneurysms were atraumatic. Recent experience with an atraumatic aneurysm of the anterior tibial artery prompted a literature review regarding their incidence, and accordingly, we feel the need exists for greater recognition and understanding of this entity.
February 5, 2018: Annals of Vascular Surgery
Marco Pappalardo, Vincent G Laurence, Yu-Te Lin
For painful, dysfunctional, posttraumatic metacarpophalangeal (MCP) joints, the free vascularized toe joint transfer may represent a good solution. Successful reconstruction is potentially limited, however, by 2 features of the traditional vascularized metatarsophalangeal (MTP) transfer: inadequate arc of flexion and insufficient soft tissue coverage. The solution to both of these dilemmas lies in the manner of utilizing the donor site. Because of its innate hyperextensibility, rotating the MTP 180° volar to dorsal provides the greatest arc of flexion in the reconstructed MCP...
February 2018: Journal of Hand Surgery
Chu-Zhao Lin, Xue Xia, Hu Wang, Dong-Xin Liu
Children with simultaneous injury to the Achilles tendon and heel skin remain a challenge for clinicians. The purpose of this study is to evaluate a combined surgical procedure involving use of the fascia lata to reconstruct the Achilles tendon, and the posterior tibial artery perforator flap to cover the accompanying heel skin injury.Between February 2010 and February 2013, 8 children (3 females and 5 males) between 3 and 12 years of age, with a median age of 7.5 years, were hospitalized in the First Affiliated Hospital of Shantou University Medical College...
February 2018: Medicine (Baltimore)
Rodrigo B Biagioni, Luisa C Biagioni, Felipe Nasser, Marcelo C Burihan, José C Ingrund, Adnan Neser, Fausto Miranda
OBJECTIVE: The aim was to analyse the effect of the treatment of more than one infrapopliteal artery with respect to wound healing and limb salvage. METHODS: Seventy-eight patients were enrolled prospectively for 80 procedures (80 limbs) that were randomly divided into two groups: 40 in the single vessel (SV) group and 40 in the multiple vessel group (MV). All patients had tissue loss. The choice of the first artery to treat was based on an analysis of two factors: the ease of the required endovascular technique and the presence of adequate distal outflow...
February 2, 2018: European Journal of Vascular and Endovascular Surgery
Rokayaa Abd El Aziz, Mary Wadie Fawzy, Noha Khalil, Sahar Abdel Atty, Zainab Sabra
Introduction: Obesity has become an important issue affecting both males and females. Obesity is now regarded as an independent risk factor for atherosclerosis-related diseases. Metabolic syndrome is associated with increased risk for development of cardiovascular disease. Urinary 8-oxo-7,8-dihydro-2'-deoxyguanosine concentration has been used to express oxidation status. Methods: Twenty-seven obese patients with metabolic syndrome, 25 obese patients without metabolic syndrome and 31 healthy subjects were included in our study...
February 2018: Therapeutic Advances in Endocrinology and Metabolism
Birnur Yilmaz
OBJECTIVE: To investigate the value of Acoustic Radiation Force Impulse elastography and its application in Achilles tendon elasticity of intermittent claudication due to lower extremity arterial ischaemia. METHODS: This prospective case-control study was conducted at the Department of Radiology, Faculty of Medicine, Baskent University, Istanbul, Turkey, from October 2015 to January 2016, and comprised bilateral Achilles tendons of patients with intermittent claudication and healthy individuals...
January 2018: JPMA. the Journal of the Pakistan Medical Association
Luis M Palena, Larry J Diaz-Sandoval, Laiq M Raja, Luis Morelli, Marco Manzi
PURPOSE: To describe a novel technique designed to safely and precisely deploy the Supera stent accurately at the ostium of the proximal superficial femoral artery (SFA) without compromising the profunda and common femoral arteries. TECHNIQUE: After antegrade crossing of the chronic total occlusion (CTO) at the SFA ostium and accurate predilation of the entire SFA lesion, a retrograde arterial access is obtained. The Supera stent is navigated in retrograde fashion to position the first crown to be released just at the SFA ostium...
January 1, 2018: Journal of Endovascular Therapy
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