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Femoral-popliteal disease

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https://www.readbyqxmd.com/read/28526560/limb-flexion-induced-axial-compression-and-bending-in-human-femoropopliteal-artery-segments
#1
William Poulson, Alexey Kamenskiy, Andreas Seas, Paul Deegan, Carol Lomneth, Jason MacTaggart
BACKGROUND: High failure rates of femoropopliteal artery (FPA) interventions are often attributed in part to severe mechanical deformations that occur with limb movement. Axial compression and bending of the FPA likely play significant roles in FPA disease development and reconstruction failure, but these deformations are poorly characterized. The goal of this study was to quantify axial compression and bending of human FPAs that are placed in positions commonly assumed during the normal course of daily activities...
May 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28526046/balloon-versus-stenting-in-severe-ischaemia-of-the-leg-3-basil-3-study-protocol-for-a-randomised-controlled-trial
#2
Benjamin D Hunt, Matthew A Popplewell, Huw Davies, Lewis Meecham, Hugh Jarrett, Gareth Bate, Margaret Grant, Smitaa Patel, Catherine Hewitt, Lazaros Andronis, Jonathan J Deeks, Andrew Bradbury
BACKGROUND: Severe limb ischaemia (SLI) is defined as the presence of rest pain and/or tissue loss secondary to lower extremity atherosclerotic peripheral arterial disease. The superficial femoral and popliteal arteries are the most commonly diseased vessels in such patients and are being increasingly treated using endovascular revascularisation techniques. However, it is currently unknown whether drug-eluting stents and drug-coated balloons confer additional clinical benefits over more established techniques using plain balloons and bare metal stents, or whether they represent a cost-effective use of NHS resources...
May 19, 2017: Trials
https://www.readbyqxmd.com/read/28502550/lower-extremity-computed-tomography-angiography-can-help-predict-technical-success-of-endovascular-revascularization-in-the-superficial-femoral-and-popliteal-artery
#3
Nathan K Itoga, Tanner Kim, Anna M Sailer, Dominik Fleischmann, Matthew W Mell
OBJECTIVE: Preprocedural computed tomography angiography (CTA) assists in evaluating vascular morphology and disease distribution and in treatment planning for patients with lower extremity peripheral artery disease (PAD). The aim of the study was to determine the predictive value of radiographic findings on CTA and technical success of endovascular revascularization of occlusions in the superficial femoral artery-popliteal (SFA-pop) region. METHODS: Medical records and available imaging studies were reviewed for patients undergoing endovascular intervention for PAD between January 2013 and December 2015 at a single academic institution...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28502546/cryopreserved-saphenous-vein-as-a-last-ditch-conduit-for-limb-salvage
#4
Leigh Ann O'Banion, Bian Wu, Charles M Eichler, Linda M Reilly, Michael S Conte, Jade S Hiramoto
OBJECTIVE: In patients lacking autogenous vein suitable for infrainguinal bypass, cryopreserved saphenous vein (CSV) allograft (CryoLife, Inc, Kennesaw, Ga) may be an acceptable alternative. The purpose of this study was to examine outcomes of CSV conduit for infrainguinal revascularization. METHODS: Between February 2008 and August 2015, 70 patients underwent infrainguinal bypass grafts in 73 limbs using CSV. All patients lacked suitable arm or leg vein. Demographic data and patient outcomes were retrospectively collected using electronic medical records...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28501130/collateral-artery-pathways-of-the-femoral-and-popliteal-artery
#5
Rombout R Kruse, Denise E Doomernik, Kasper V Maltha, Jan G M Kooloos, Tamas L Kozicz, Michel M P J Reijnen
BACKGROUND: The role of collateral artery circulation in the lower limb is under debate but clinically relevant, particularly when using covered stents for occlusive disease. Covered stents seem to outperform nitinol stents in extensive disease, but collaterals could be essential in case of acute thrombosis. In the present study, we describe the collateral pathways of the deep and superficial femoral artery (DFA, SFA) and the popliteal artery (PA), observed in human cadavers. METHODS: Ten fresh frozen cadaver legs were selected...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28488106/treatment-evaluation-of-flow-limiting-stenoses-of-the-superficial-femoral-and-popliteal-artery-by-parametric-color-coding-analysis-of-digital-subtraction-angiography-series
#6
Michael Kostrzewa, Kerim Kara, Lothar Pilz, Hannelore Mueller-Muertz, Nils Rathmann, Stefan O Schoenberg, Steffen J Diehl
PURPOSE: To evaluate the hemodynamic effect of percutaneous transluminal intervention (PTI) on stenosis of the superficial femoral (SFA) and popliteal arteries (PA) using time-density curves (TDCs) derived from digital subtraction angiography (DSA) series in correlation with ultrasound peak systolic velocity ratio (PSVR) and ankle brachial index (ABI). MATERIALS AND METHODS: DSA series of SFA or PA of patients with symptomatic peripheral arterial occlusive disease was obtained with a flat-panel angiography system with intention-to-treat...
May 9, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28479462/iliac-artery-stenting-combined-with-ipsilateral-open-femoro-popliteal-revascularization-and-its-effect-on-bypass-patency
#7
Michele Piazza, Francesco Squizzato, Sandro Lepidi, Mirko Menegolo, Franco Grego, Michele Antonello
OBJECTIVES: In cases of multilevel obstructive atherosclerotic disease, hybrid procedures of concomitant iliac artery stenting and femoro-popliteal bypass (IS-FPB) may represent a valid approach, but results are still unclear. The aim was to evaluate early and long-term outcomes of concurrent IS-FPB. METHODS: This retrospective study included 75 patients (76 limbs) treated with concomitant IS-FPB between January 2010 and June 2016. All patients were prospectively enrolled in a dedicated database...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28472949/distinct-gene-expression-profiles-associated-with-notch-ligands-delta-like-4-and-jagged1-in-plaque-material-from-peripheral-artery-disease-patients-a-pilot-study
#8
Giorgio Aquila, Cinzia Fortini, Antonio Pannuti, Serena Delbue, Micaela Pannella, Marco Bruno Morelli, Cristiana Caliceti, Fausto Castriota, Monica de Mattei, Alessia Ongaro, Agnese Pellati, Pasquale Ferrante, Lucio Miele, Luigi Tavazzi, Roberto Ferrari, Paola Rizzo, Alberto Cremonesi
BACKGROUND: The lack of early diagnosis, progression markers and effective pharmacological treatment has dramatic unfavourable effects on clinical outcomes in patients with peripheral artery disease (PAD). Addressing these issues will require dissecting the molecular mechanisms underlying this disease. We sought to characterize the Notch signaling and atherosclerosis relevant markers in lesions from femoral arteries of symptomatic PAD patients. METHODS: Plaque material from the common femoral, superficial femoral or popliteal arteries of 20 patients was removed by directional atherectomy...
May 4, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28471381/galectin-3-in-peripheral-artery-disease-relationships-with-markers-of-oxidative-stress-and-inflammation
#9
Isabel Fort-Gallifa, Anna Hernández-Aguilera, Anabel García-Heredia, Noemí Cabré, Fedra Luciano-Mateo, Josep M Simó, Vicente Martín-Paredero, Jordi Camps, Jorge Joven
Galectin-3 is a modulator of oxidative stress, inflammation, and fibrogenesis involved in the pathogenesis of vascular diseases. The present study sought to characterize, in patients with peripheral artery disease (PAD), the localization of galectin-3 in arterial tissue, and to analyze the relationships between the circulating levels of galectin-3 and oxidative stress and inflammation. It also sought to compare the diagnostic accuracy of galectin-3 with that of other biochemical markers of this disease. We analyzed femoral or popliteal arteries from 50 PAD patients, and four control arteries...
May 4, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28471154/stent-based-revascularization-for-complex-lesions-in-pad
#10
Jason D'Souza, Jay Giri, Taisei Kobayashi
Peripheral artery disease (PAD) burdens a significant number of adult Americans and is associated with significant morbidity and mortality. The Transatlantic Inter-Society Consensus II (TASC II) guidelines standardize the degree of disease burden in individual vessel segments by assigning grades correlating to the complexity of lesion intervention. We sought data regarding endovascular approaches to lower extremity PAD in TASC C/D lesions in patients with claudication. Published data in these patients have demonstrated success in terms of procedural success, quality of life metrics, and intermediate to long-term primary patency rates...
May 3, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28440041/ultrasound-assisted-versus-conventional-catheter-directed-thrombolysis-for-acute-ilio-femoral-deep-vein-thrombosis-one-year-follow-up-data-of-a-randomized-controlled-trial
#11
Rolf P Engelberger, Anna Stuck, David Spirk, Torsten Willenberg, Axel Haine, Daniel Périard, Iris Baumgartner, Nils Kucher
BACKGROUND: In patients with acute ilio-femoral deep vein thrombosis (IFDVT), catheter-directed thrombolysis (CDT) aims to prevent the post-thrombotic syndrome (PTS). Adding intravascular high-frequency, low-power ultrasound energy to CDT does not seem to improve the immediate thrombolysis results but its impact on clinical outcomes at 12 months is not known. PATIENTS/METHODS: In this randomized-controlled trial, 48 patients (mean age 50±21 years, 52% women) with acute IFDVT were randomized to conventional CDT (n=24) or ultrasound-assisted CDT (USAT; n=24)...
April 25, 2017: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/28424223/low-dose-paclitaxel-coated-versus-uncoated-percutaneous-transluminal-balloon-angioplasty-for-femoropopliteal-peripheral-artery-disease-1-year-results-of-the-illumenate-european-randomized-clinical-trial
#12
Henrik Schroeder, Martin Werner, Dirk-Roelfs Meyer, Peter Reimer, Karsten Krüger, Michael R Jaff, Marianne Brodmann
Background -Numerous studies have reported favorable outcomes using drug-coated balloons (DCBs) for treatment of symptomatic peripheral artery disease (PAD) of the superficial femoral and popliteal arteries. However, the treatment effect compared to an uncoated balloon has differed greatly amongst the randomized trials with better outcomes observed with higher-dose DCBs. This European trial was designed to assess the safety and effectiveness of a next-generation low dose (2 µg/mm(2) surface dose of paclitaxel) DCB...
April 19, 2017: Circulation
https://www.readbyqxmd.com/read/28411701/lack-of-symmetry-in-the-major-lower-limb-veins
#13
Anirudh Chandrashekar, Antonios Gasparis, Nicos Labropoulos
BACKGROUND: Contemporary texts frequently present the venous system of the lower limb as a prime example of bilateral symmetry. However, overt bilateral asymmetry may be noted. This study was designed to examine and to quantify the level of symmetry in the lower extremity veins. METHODS: This prospective cohort study evaluated major anatomic differences between right and left lower extremity veins in adult patients. Two hundred patients presenting with signs and symptoms of chronic venous disease (CVD; class 2-6) and venous reflux on duplex ultrasound were examined...
May 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28382804/optical-coherence-tomography-guided-therapy-of-instent-restenosis-for-peripheral-arterial-disease
#14
Michael K Lichtenberg, Jeffrey G Carr, Jaafer A Golzar
Approximately 27 million people in Europe and North America currently have peripheral arterial disease (PAD)1. The endovascular treatment of stenosis or blocked peripheral arteries in PAD include percutaneous transluminal angioplasty (PTA) with or without a drug coated balloon, atherectomy (rotational, directional, orbital or laser), and stenting. The development of next generation peripheral stents and drug coated stents have led to the improved treatment of complex SFA lesions, and consequently increased their usage23...
April 4, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28377342/-efficacy-of-drug-coated-balloon-and-common-balloon-for-treatment-of-superficial-femoral-artery-and-popliteal-artery-arteriosclerosis-obliterans-prospective-randomized-controlled-triac
#15
Jing-Yuan Lu, Jian-Ping Gu, Wen-Jian Xu, Wen-Sheng Lou, Tao Wang
OBJECTIVE: To compared the efficacy of drug-coated balloon and common balloon for treatment of superficial femoral artery and popliteal artery occlusive disease. METHODS: Forty-six patients were admitted for ipsilateral single or multiple superficial femoral artery and/or popliteal artery lesions (between 3 and 15 cm stenosis or occlusion), Rutherford grades 2 to 5, with or without other accompanying diseases in the Department of Interventional Vascular Therapy of the First Hospital of Nanjing between September, 2015 and December, 2016...
March 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28358184/the-role-of-drug-coated-balloons-in-in-stent-restenosis
#16
Martin Andrassy, Sultan Celik, Joachim Andrassy, Michael K Lichtenberg, Marianne Brodmann
INTRODUCTION: Despite a constantly expanding spectrum of therapeutic options for lower limb artery disease, there is not yet a well-defined consensus on the specific type of endovascular treatment that is best suited. Clinical data on patients with femoropopliteal disease treated with drug-coated balloons have not been elaborated sufficiently, especially in the case of in-stent restenosis (ISR). EVIDENCE ACQUISITION: For this review a systematic research of the medical databases (http://www...
March 28, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28330991/limb-flexion-induced-twist-and-associated-intramural-stresses-in-the-human-femoropopliteal-artery
#17
Anastasia Desyatova, William Poulson, Paul Deegan, Carol Lomneth, Andreas Seas, Kaspars Maleckis, Jason MacTaggart, Alexey Kamenskiy
High failure rates of femoropopliteal artery (FPA) interventions are often attributed to severe mechanical deformations that occur with limb movement. Torsion of the FPA likely plays a significant role, but is poorly characterized and the associated intramural stresses are currently unknown. FPA torsion in the walking, sitting and gardening postures was characterized in n = 28 in situ FPAs using intra-arterial markers. Principal mechanical stresses and strains were quantified in the superficial femoral artery (SFA), adductor hiatus segment (AH) and the popliteal artery (PA) using analytical modelling...
March 2017: Journal of the Royal Society, Interface
https://www.readbyqxmd.com/read/28296239/stent-placement-in-the-superficial-femoral-and-proximal-popliteal-arteries-with-the-innova-self-expanding-bare-metal-stent-system
#18
Richard J Powell, Michael R Jaff, Herman Schroë, Andrew Benko, Juan Diaz-Cartelle, Stefan Müller-Hülsbeck
OBJECTIVES: The SuperNOVA trial was designed to evaluate performance of the Innova Vascular Self-Expanding Stent System (Boston Scientific, Marlborough, MA) for treating lesions in the femoropopliteal arteries. METHODS: Patients with chronic lower limb peripheral artery disease (Rutherford category 2, 3, or 4) and atherosclerotic lesions in the native superficial femoral and/or proximal popliteal artery (lengths 30-190 mm) were enrolled in this single-arm, multinational study...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28251562/how-should-recent-endovascular-trials-for-femoropopliteal-artery-disease-be-interpreted
#19
REVIEW
Yoshiaki Yokoi
Most cases of femoral-popliteal disease require aggressive medical treatment, but patients with severe lifestyle-limiting symptoms and limb-threatening disease are increasingly receiving endovascular treatment. The femoropopliteal artery is the longest vessel in the thigh and the unique physical forces involved in this vessel are considered to cause high rates of restenosis and stent fracture. Endovascular therapy for superficial artery (SFA) disease is still a challenge in terms of long-term patency and clinical effectiveness...
March 1, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28236917/outcomes-of-native-superficial-femoral-artery-chronic-total-occlusion-recanalization-after-failed-femoropopliteal-bypass
#20
COMPARATIVE STUDY
Mark G Davies, Hosam F El-Sayed
OBJECTIVE: When a bypass fails, the options are lysis, redo bypass, or endovascular intervention. If lysis of the original bypass is not considered an option, which is better-redo bypass or attempts at endovascular recanalization of the native system? This retrospective study examined the outcomes of native superficial femoral artery (SFA) chronic total occlusion (CTO) recanalization compared with redo bypass after failed femoropopliteal bypass. METHODS: Patients presenting with a symptomatic failed femoropopliteal bypass that underwent attempted CTO endovascular (EV) recanalization of the native SFA or a redo femoropopliteal bypass (BP) from 2000 to 2015 were analyzed...
March 2017: Journal of Vascular Surgery
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