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Femoral-popliteal disease

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https://www.readbyqxmd.com/read/28073668/drug-eluting-stenting-for-femoropopliteal-lesions-followed-by-cilostazol-treatment-reduces-stent-restenosis-in-patients-with-symptomatic-peripheral-artery-disease
#1
Kan Zen, Mitsuyoshi Takahara, Osamu Iida, Yoshimitsu Soga, Daizo Kawasaki, Shinsuke Nanto, Hiroyoshi Yokoi, Satoaki Matoba
BACKGROUND: Cilostazol improves clinical endovascular therapy outcomes for femoropopliteal (FP) lesions in patients with symptomatic peripheral arterial disease, but whether it also has clinical benefits for patients after drug-eluting stent implantation remains unclear. METHODS: This study is a subanalysis of the ZilvEr PTX for tHe Femoral ArterY and Proximal Popliteal ArteRy (ZEPHYR) study, a prospective multicenter study investigating FP lesions treated with the Zilver (Cook Medical, Bloomington, Ind) paclitaxel-eluting stent...
January 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27986482/high-dose-rate-brachytherapy-for-the-treatment-of-lower-extremity-in-stent-restenosis
#2
Karen J Ho, Phillip M Devlin, Arin L Madenci, Marcus E Semel, Edwin C Gravereaux, Louis L Nguyen, Michael Belkin, Matthew T Menard
OBJECTIVE: Historically, edge stenosis and late thrombosis limited the effectiveness of adjunctive endovascular brachytherapy (EVBT) for in-stent restenosis (ISR) after percutaneous transluminal angioplasty (PTA) and stenting. We evaluated an updated protocol of PTA and EVBT for ISR among patients with lower extremity occlusive disease. METHODS: This is a retrospective, single-center review of patients treated with PTA and EVBT for ISR in the iliac and femoropopliteal segments between 2004 and 2012...
December 13, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27976693/patient-specific-structural-effects-on-hemodynamics-in-the-ischemic-lower-limb-artery
#3
Pengcheng Xu, Xin Liu, Qi Song, Guishan Chen, Defeng Wang, Heye Zhang, Li Yan, Dan Liu, Wenhua Huang
Lower limb peripheral artery disease is a prevalent chronic non-communicable disease without obvious symptoms. However, the effect of ischemic lower limb peripheral arteries on hemodynamics remains unclear. In this study, we investigated the variation of the hemodynamics caused by patient-specific structural artery characteristics. Computational fluid dynamic simulations were performed on seven lower limb (including superficial femoral, deep femoral and popliteal) artery models that were reconstructed from magnetic resonance imaging...
December 15, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27940376/prevalence-and-severity-of-arterial-calcifications-in-pseudoxanthoma-elasticum-pxe-compared-to-hospital-controls-novel-insights-in-to-the-vascular-phenotype-of-pxe
#4
Guido Kranenburg, Pim A de Jong, Willem P Mali, Mohamed Attrach, Frank L J Visseren, Wilko Spiering
BACKGROUND AND AIMS: Pseudoxanthoma elasticum (PXE) is a monogenetic disorder with progressive calcifications of the skin, the Bruch's membrane in the eyes and the arterial wall. Vascular disease is considered to be very prevalent, but the whole-body distribution of arterial calcifications in PXE is unknown. We aimed to systematically investigate arterial calcifications in PXE. METHODS: We included 104 PXE patients from the Dutch PXE cohort and 93 hospital controls...
November 13, 2016: Atherosclerosis
https://www.readbyqxmd.com/read/27908824/arteriographic-patterns-of-atherosclerosis-and-the-association-between-diabetes-mellitus-and-ethnicity-in-chronic-critical-limb-ischemia
#5
Jayer Chung, J Gregory Modrall, Martyn Knowles, Qun Xiang, Lawrence A Lavery, Carlos H Timaran, R James Valentine
BACKGROUND: Disparate outcomes in critical limb ischemia (CLI) persist between ethnicities. The contribution of modifiable factors versus intrinsic biologic differences remains unclear. Hence, we aimed to quantify the associations between ethnicity and anatomic patterns of arterial occlusive disease in CLI, adjusting for known atherosclerotic risk factors. METHODS: We performed a retrospective, single-center review of consecutive patients presenting to the vascular surgery service with CLI...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27901322/risk-factors-analysis-of-thromboembolectomy-for-acute-thromboembolic-lower-extremity-ischemia-in-native-arteries
#6
Gabriele Piffaretti, Alessandro Angrisano, Marco Franchin, Massimo Ferrario, Nicola Rivolta, Alessandro Bacuzzi, Patrizio Castelli, Matteo Tozzi
BACKGROUND: Aim of this study is to report the results of thromboembolectomy (ThEmb) for acute thromboembolic lower limb ischemia (ATLI) in native arteries and to create a predictive score for amputation-free survival (AFS) at 30 days. METHODS: It is a single center, retrospective analysis of a four years period. All patients had ThEmb: adjunctive procedures included femoral and/or popliteal endarterectomy in 30 (18.3%) cases, PTA- stent in 24 (14.6%), and femoral endarterectomy plus PTA-stent in 12 (7...
November 30, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27884360/cost-effectiveness-of-endovascular-femoropopliteal-intervention-using-drug-coated-balloons%C3%A2-versus-standard-percutaneous-transluminal-angioplasty-results-from-the-in-pact%C3%A2-sfa-ii-trial
#7
Adam C Salisbury, Haiyan Li, Katherine R Vilain, Michael R Jaff, Peter A Schneider, John R Laird, David J Cohen
OBJECTIVES: The aim of this study was to evaluate the cost-effectiveness of drug-coated balloon (DCB) angioplasty versus standard percutaneous transluminal angioplasty (PTA). BACKGROUND: Recent trials have reported lower rates of target lesion revascularization with DCB angioplasty versus standard PTA. However, the cost-effectiveness of DCB angioplasty is unknown. METHODS: A prospective economic study was performed alongside the IN.PACT SFA II (IN...
November 28, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27818999/percutaneous-transluminal-angioplasty-in-patients-with-peripheral-arterial-disease-does-not-affect-circulating-monocyte-subpopulations
#8
Pawel Maga, Tomasz P Mikolajczyk, Lukasz Partyka, Marek Krzanowski, Krzysztof P Malinowski, Rafal Nizankowski
Monocytes are mononuclear cells characterized by distinct morphology and expression of CD14 and CD16 surface receptors. Classical, quiescent monocytes are positive for CD14 (lipopolysaccharide receptor) but do not express Fc gamma receptor III (CD16). Intermediate monocytes coexpress CD16 and CD14. Nonclassical monocytes with low expression of CD14 represent mature macrophage-like monocytes. Monocyte behavior in peripheral arterial disease (PAD) and during vessel wall directed treatment is not well defined...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27793622/tibioperoneal-occlusive-disease-a-review-of-below-the-knee-endovascular-therapy-in-patients-with-critical-limb-ischemia
#9
Kathryn B Muir, Patrick R Cook, Maxwell R Sirkin, Gilbert Aidinian
BACKGROUND: Tibioperoneal occlusive disease is one of the most difficult disease processes to successfully treat. Previous studies have attempted to address the outcomes of tibial interventions in this patient population; however, the majority of these study cohorts are composed of patients who have undergone concomitant aortoiliac or femoral procedures. Our objective was to present the outcomes of patients treated with endovascular intervention for isolated below-the-knee atherosclerotic disease causing critical limb ischemia (CLI)...
January 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27765310/local-ultrasound-to-enhance-paclitaxel-delivery-after-femoral-popliteal-treatment%C3%A2-in-critical-limb-ischemia-the-pacus-trial
#10
Roberto Gandini, Costantino Del Giudice
OBJECTIVES: The aim of this study was to evaluate the safety and efficacy of percutaneous catheter-delivered ultrasound energy to improve local paclitaxel delivery effects in patients with critical limb ischemia (CLI) treated for femoral-popliteal arterial disease. BACKGROUND: Treatment of patients with CLI continues to be the greatest challenge in peripheral artery disease; in particular, treatment of femoral-popliteal chronic total occlusion is characterized by poor primary patency...
October 24, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27762107/sensitivity-and-specificity-of-pulse-oximetry-and-ankle-brachial-index-for-screening-asymptomatic-peripheral-vascular-diseases-in-type-2-diabetes-mellitus
#11
M Satheesh Kumar, Ayush Lohiya, Viviktha Ramesh, Priyamadhaba Behera, Sarika Palepu, S A Rizwan
OBJECTIVES: To compare pulse oximetry and Ankle-Brachial Index (ABI) with duplex ultrasonography as reference standard to determine the diagnostic accuracy for screening asymptomatic PVD in type 2 diabetes mellitus. METHODS: This cross-sectional study was conducted in 2012 at tertiary hospital in Madurai among diabetic patients attending the medicine outpatient department (OPD). Type 2 Diabetes Mellitus patients, asymptomatic with regards to symptoms and signs of PVD, aged above 40 years were included...
August 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27751735/a-multi-institutional-experience-in-adventitial-cystic-disease
#12
Raghu L Motaganahalli, Matthew R Smeds, Michael P Harlander-Locke, Peter F Lawrence, Naoki Fujimura, Randall R DeMartino, Giovanni De Caridi, Alberto Munoz, Sherene Shalhub, Susanna H Shin, Kwame S Amankwah, Hugh A Gelabert, David A Rigberg, Jeffrey J Siracuse, Alik Farber, E Sebastian Debus, Christian Behrendt, Jin H Joh, Naveed U Saqib, Kristofer M Charlton-Ouw, Catherine M Wittgen
BACKGROUND: Adventitial cystic disease (ACD) is an unusual arteriopathy; case reports and small series constitute the available literature regarding treatment. We sought to examine the presentation, contemporary management, and long-term outcomes using a multi-institutional database. METHODS: Using a standardized database, 14 institutions retrospectively collected demographics, comorbidities, presentation/symptoms, imaging, treatment, and follow-up data on consecutive patients treated for ACD during a 10-year period, using Society for Vascular Surgery reporting standards for limb ischemia...
January 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27659155/puncturing-plaques
#13
Trisha Roy, Garry Liu, Noor Shaikh, Andrew D Dueck, Graham A Wright
PURPOSE: To test and validate magnetic resonance imaging (MRI) sequences for peripheral artery lesion characterization and relate the MRI characteristics to the amount of force required for a guidewire to puncture peripheral chronic total occlusions (CTOs) as a surrogate for immediate failure of endovascular therapy. METHODS: Diseased superficial femoral, popliteal, and tibial artery segments containing 55 atherosclerotic lesions were excised from the amputated limbs of 7 patients with critical limb ischemia...
February 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27647689/deformation-of-the-femoropopliteal-segment-effect-of-stent-length-location-flexibility-and-curvature
#14
Ríona Ní Ghriallais, Kevin Heraty, Bob Smouse, Martin Burke, Paul Gilson, Mark Bruzzi
PURPOSE: To quantify the deformation behavior of the diseased femoropopliteal segment and assess the change to deformation behavior due to various stent placements. METHODS: The length and curvature changes of 6 femoropopliteal segments (the right and left superficial femoral and popliteal arteries) from 3 cadavers were measured in 3-dimensional space based on rotational angiography image data in straight leg and flexed hip/knee (50°/90°) positions before and after placement of nitinol stents of varying type (EverFlex, Misago, and BioMimics 3D) and length (60, 100, and 200 mm) in different locations along the arteries...
September 19, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27638628/non-invasive-management-of-peripheral-arterial-disease
#15
K J Williams, A Babber, R Ravikumar, A H Davies
BACKGROUND: Peripheral arterial disease (PAD) is common and symptoms can be debilitating and lethal. Risk management, exercise, radiological and surgical intervention are all valuable therapies, but morbidity and mortality rates from this disease are increasing. Circulatory enhancement can be achieved using simple medical electronic devices, with claims of minimal adverse side effects. The evidence for these is variable, prompting a review of the available literature. METHODS: Embase and Medline were interrogated for full text articles in humans and written in English...
September 17, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27626262/-assessment-of-surgical-risk-in-patients-with-lower-limb-chronic-critical-ischaemia
#16
Iu I Kazakov, I B Lukin, N Iu Sokolova, M A Strakhov
Analysed herein are both immediate and remote results of surgical treatment of 93 patients presenting with chronic atherosclerotic occlusion of the femoral-popliteal-tibial segment in the stage of critical ischaemia. The patients were subjected to autovenous femoropopliteal bypass grafting to the isolated arterial segment or balloon angioplasty with stenting of the superficial femoral artery. While choosing the method of arterial reconstruction we assessed concomitant diseases, primarily lesions of the coronary and cerebral circulation...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/27621646/critical-appraisal-of-paclitaxel-balloon-angioplasty-for-femoral-popliteal-arterial-disease
#17
REVIEW
Monika Herten, Giovanni B Torsello, Eva Schönefeld, Stefan Stahlhoff
Peripheral arterial disease, particularly critical limb ischemia, is an area with urgent need for optimized therapies because, to date, vascular interventions often have limited life spans. In spite of initial encouraging technical success after femoropopliteal percutaneous transluminal angioplasty or stenting, postprocedural restenosis remains the major problem. The challenging idea behind the drug-coated balloon (DCB) concept is the biological modification of the injury response after balloon dilatation. Antiproliferative drugs administered via DCBs or drug-eluting stents are able to suppress neointimal hyperplasia, the main cause of restenosis...
2016: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/27614555/monitoring-of-foot-oxygenation-with-near-infrared-spectroscopy-in-patients-with-critical-limb-ischemia-undergoing-percutaneous-transluminal-angioplasty-a-pilot-study
#18
R P E Boezeman, B P Becx, D A F van den Heuvel, Ç Ünlü, J A Vos, J P P M de Vries
OBJECTIVE: Near-infrared spectroscopy (NIRS) non-invasively determines tissue oxygen saturation (Sto2) in muscle tissue. Its application to monitor real time hemodynamic changes during percutaneous transluminal angioplasty (PTA) and Sto2 changes in feet 4 weeks after PTA was evaluated. METHODS: This study included 14 patients with critical limb ischemia (CLI, six patients Rutherford classification Stage IV, two patients Stage V, and six patients Stage VI). In patients with arterial ulcers, NIRS optodes were placed near the ulcer of the diseased foot (Optode 1), and at the same spot at the contralateral foot (Optode 2)...
November 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27546850/outcomes-of-critical-limb-ischemia-in-an-urban-safety-net-hospital-population-with-high-wifi-amputation-scores
#19
Robert Ward, Joie Dunn, Leonardo Clavijo, David Shavelle, Vincent Rowe, Karen Woo
BACKGROUND: Patients presenting to a public hospital with critical limb ischemia (CLI) typically have advanced disease with significant comorbidities. The purpose of this study was to assess the influence of revascularization on 1-year amputation rate of CLI patients presenting to Los Angeles County USC Medical Center, classified according to the Society for Vascular Surgery Wound, Ischemia and foot Infection (WIfI). METHODS: A retrospective review of patients who presented to a public hospital with CLI from February 2010 to July 2014 was performed...
January 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27511998/11-dehydro-thromboxane-b2-levels-after-percutaneous-transluminal-angioplasty-in-patients-with-peripheral-arterial-occlusive-disease-during-a-one-year-follow-up-period
#20
P Maga, M Sanak, J Jawien, B Rewerska, M Maga, A Wachsmann, M Koziej, I Gregorczyk-Maga, R Nizankowski
The aim of our study was to determine if the generation of thromboxane is altered in patients with peripheral arterial occlusive disease following percutaneous transluminal angioplasty (PTA) during a one year follow-up period. In this study, 175 patients diagnosed with peripheral arterial occlusive disease (PAOD) and demonstrating short-distance claudication or ischemic rest pain, requiring PTA in either the iliac, femoral, or popliteal arteries, were enrolled. The excretion of 11-dehydro thromboxane B2 (TXB2) was measured in urine samples by high-performance liquid chromatography-mass spectrometry and recalculated based on the creatinine concentration...
June 2016: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
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