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Limb ischemia risk score

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https://www.readbyqxmd.com/read/28665192/adipose-tissue-derived-stem-cell-sheet-application-for-tissue-healing-in-vivo-a-systematic-review
#1
Panithi Sukho, Abigael Cohen, Jan Willem Hesselink, Jolle Kirpensteijn, Femke Verseijden, Yvonne M Bastiaansen-Jenniskens
Adipose tissue-derived stem cells (ASCs) are known to be tissue-healing promoters due to their cellular plasticity and secretion of paracrine factors. Cultured ASC sheets provide a novel method of ASC application and can retain ASCs at the targeted tissue. The purpose of this systematic review is to evaluate preclinical studies using ASC sheet transplantation therapy for promoting tissue healing. First, we searched databases to identify studies of ASC sheet therapy in different experimental animal models, and then determined the quality score of studies using SYRCLE's risk bias tool...
August 4, 2017: Tissue Engineering. Part B, Reviews
https://www.readbyqxmd.com/read/28655549/lower-extremity-bypass-for-critical-limb-ischemia-decreases-major-adverse-limb-events-with-equivalent-cardiac-risk-compared-with-endovascular-intervention
#2
J Hunter Mehaffey, Robert B Hawkins, Anna Fashandi, Kenneth J Cherry, John A Kern, Irving L Kron, Gilbert R Upchurch, William P Robinson
OBJECTIVE: Lower extremity bypass (LEB) has traditionally been the "gold standard" in the treatment of critical limb ischemia (CLI). Infrainguinal endovascular intervention (IEI) has become more commonly performed than LEB, but comparative outcomes are limited. We sought to compare rates of major adverse limb events (MALEs) and major adverse cardiovascular events (MACEs) after LEB and IEI in a propensity score-matched, national cohort of patients with CLI. METHODS: The National Surgical Quality Improvement Program (NSQIP) vascular targeted files (2011-2014) for LEB and IEI were merged...
June 24, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28595883/prognostic-impact-of-revascularization-in%C3%A2-poor-risk-patients-with-critical%C3%A2-limb%C3%A2-ischemia-the-priority-registry-poor-risk-patients-with-and-without-revascularization-therapy-for-critical-limb-ischemia
#3
Osamu Iida, Mitsuyoshi Takahara, Yoshimitsu Soga, Nobuyoshi Azuma, Shinsuke Nanto, Masaaki Uematsu
OBJECTIVES: The authors sought to investigate the prognostic impact of revascularization for poor-risk CLI patients in real-world settings. BACKGROUND: Critical limb ischemia (CLI) is often accompanied with various comorbidities, and frailty is not rare in the population. Although previous studies suggested favorable outcomes of revascularization for CLI patients, those studies commonly included the healthier, that is, less frail patients. METHODS: This was a multicenter prospective observational study, registering patients who presented with CLI and who required assistance for their daily lives because of their disability in activities of daily living (ADL) and/or impairment of cognitive function...
June 12, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28562573/predictors-of-secondary-amputation-in-patients-with-grade-iiic-lower-limb-injuries-a-retrospective-analysis-of-35-patients
#4
Wenhao Song, DongSheng Zhou, Jinlei Dong
The aim of this study was to identify risk factors for failure of limb salvage surgery in grade IIIC lower extremity injuries.A single-institution, retrospective review was performed of all patients with grade IIIC lower limb injuries presenting from January 2009 to April 2014. We gathered the data on each patient who underwent limb salvage and analyzed the final outcome for these patients (limb salvage vs secondary amputation).Grade IIIC lower limb injuries were identified in 41 patients. Primary amputation was performed in 6 patients (15%) as the initial procedure...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28434264/exploring-effects-of-remote-ischemic-preconditioning-in-a-pig-model-of-hypothermic-circulatory-arrest
#5
Johanna Herajärvi, Tuomas Anttila, Elitsa Y Dimova, Tuomas Laukka, Mikko Myllymäki, Henri Haapanen, Benjamin A Olenchock, Hannu Tuominen, Ulla Puistola, Peeter Karihtala, Kai Kiviluoma, Peppi Koivunen, Vesa Anttila, Tatu Juvonen
OBJECTIVES: During aortic and cardiac surgery, risks for mortality and morbidity are inevitable. Surgical setups involving deep hypothermic circulatory arrest (DHCA) are effective to achieve organ protection against ischemic injury. The aim of this study was to identify humoural factors mediating additive protective effects of remote ischemic preconditioning (RIPC) in a porcine model of DHCA. DESIGN: Twenty-two pigs were randomized into the RIPC group (n = 11) and the control group (n = 11)...
April 24, 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/28410924/society-for-vascular-surgery-wound-ischemia-foot-infection-wifi-score-correlates-with-the-intensity-of-multimodal-limb-treatment-and-patient-centered-outcomes-in-patients-with-threatened-limbs-managed-in-a-limb-preservation-center
#6
William P Robinson, Lorraine Loretz, Colleen Hanesian, Julie Flahive, John Bostrom, Nicholas Lunig, Andres Schanzer, Louis Messina
OBJECTIVE: The Society for Vascular Surgery Wound, Ischemia, foot Infection (WIfI) system aims to stratify threatened limbs according to their anticipated natural history and estimate the likelihood of benefit from revascularization, but whether it accurately stratifies outcomes in limbs undergoing aggressive treatment for limb salvage is unknown. We investigated whether the WIfI stage correlated with the intensity of limb treatment required and patient-centered outcomes. METHODS: We stratified limbs from a prospectively maintained database of consecutive patients referred to a limb preservation center according to WIfI stage (October 2013-May 2015)...
August 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28344615/usefulness-of-the-platelet-to-lymphocyte-ratio-in-predicting-long-term-cardiovascular-mortality-in-patients-with-peripheral-arterial-occlusive-disease
#7
Fatih Uzun, Mehmet Erturk, Huseyin Altug Cakmak, Ali Kemal Kalkan, Ibrahim Faruk Akturk, Ahmet Arif Yalcin, Begum Uygur, Umit Bulut, Kursat Oz
INTRODUCTION: Inflammation and increased platelet activation play a crucial role in the initiation and progression of atherosclerosis. Platelet-to-lymphocyte ratio (PLR) has recently been reported as a new independent predictor for major adverse cardiovascular events in cardiovascular diseases. AIM: To investigate the relation between PLR and cardiovascular mortality in patients with intermittent claudication or critical limb ischemia (CLI) or both. MATERIAL AND METHODS: In our retrospective study, 602 consecutive patients who were admitted to a large tertiary hospital with the diagnosis of symptomatic peripheral arterial occlusive disease (PAOD) were included...
2017: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/28342514/angiosome-directed-revascularization-in-patients-with-critical-limb-ischemia
#8
REVIEW
Hidde Jongsma, Joost A Bekken, George P Akkersdijk, Sanne E Hoeks, Hence J Verhagen, Bram Fioole
OBJECTIVE: Direct revascularization (DR), according to the angiosome concept, provides direct blood flow to the site of tissue loss in patients with critical limb ischemia (CLI). DR may lead to improved outcomes; however, evidence for this is controversial. This systematic review and meta-analysis investigated the outcomes of surgical and endovascular DR compared with indirect revascularization (IR) in patients with CLI. METHODS: A systematic review was undertaken using the Cochrane Collaboration specified tool, and a meta-analysis was done according to the MOOSE (Meta-analysis of Observational Studies in Epidemiology) criteria...
April 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28259571/preoperative-inflammatory-status-as-a-predictor-of-primary-patency-after-femoropopliteal-stent-implantation
#9
Kenneth R Nakazawa, Sean P Wengerter, John R Power, Robert A Lookstein, Rami O Tadros, Windsor Ting, Peter L Faries, Ageliki G Vouyouka
OBJECTIVE: The purpose of this study was to evaluate the impact of preoperative inflammatory status, as determined by complete blood count test parameters, on 12- and 24-month patency of femoropopliteal stenting for peripheral arterial disease. METHODS: We retrospectively analyzed baseline clinical and angiographic data among 138 patients (median age, 73 years; 46% female) from 2005 to 2014 at our institution with preoperative complete blood count test values and information of patency for at least 12 months after first-time femoropopliteal stenting...
July 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28222984/index-complications-predict-secondary-complications-after-infrainguinal-lower-extremity-bypass-for-critical-limb-ischemia
#10
Matthew R Peacock, Nishant K Shah, Alik Farber, Su Yeon Lee, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Jeffrey J Siracuse
OBJECTIVE: Patients undergoing lower extremity bypass (LEB) are at high risk of perioperative complications that can lead to a cascade of secondary complications. Our goal was to understand the association of index complications with secondary complications after LEB. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database from 2005 to 2012 was used to analyze secondary complications after five index complications after LEB: deep/organ space surgical site infection, urinary tract infection (UTI), myocardial infarction (MI), pneumonia, and acute renal failure (ARF)...
May 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28194186/safety-and-effectiveness-of-bone-marrow-cell-concentrate-in-the-treatment-of-chronic-critical-limb-ischemia-utilizing-a-rapid-point-of-care-system
#11
Venkatesh Ponemone, Saniya Gupta, Dalip Sethi, Manish Suthar, Monika Sharma, Richard J Powell, Kenneth Lee Harris, Nungshi Jungla, Priyadarshini Arambam, Upendra Kaul, Ashok Seth, Suhail Bukhari
Critical limb ischemia (CLI) is the end stage of lower extremity peripheral vascular disease (PVD) in which severe obstruction of blood flow results in ischemic rest pain, ulcers and/or gangrene, and a significant risk of limb loss. This open-label, single-arm feasibility study evaluated the safety and therapeutic effectiveness of autologous bone marrow cell (aBMC) concentrate in revascularization of CLI patients utilizing a rapid point-of-care device. Seventeen (17) no-option CLI patients with ischemic rest pain were enrolled in the study...
2017: Stem Cells International
https://www.readbyqxmd.com/read/28073665/predictive-ability-of-the-society-for-vascular-surgery-wound-ischemia-and-foot-infection-wifi-classification-system-after-first-time-lower-extremity-revascularizations
#12
Jeremy D Darling, John C McCallum, Peter A Soden, Raul J Guzman, Mark C Wyers, Allen D Hamdan, Hence J Verhagen, Marc L Schermerhorn
OBJECTIVE: The Society for Vascular Surgery (SVS) Wound, Ischemia and foot Infection (WIfI) classification system was proposed to predict 1-year amputation risk and potential benefit from revascularization. Our goal was to evaluate the predictive ability of this scale in a real-world selection of patients undergoing a first-time lower extremity revascularization for chronic limb-threatening ischemia (CLTI). METHODS: From 2005 to 2014, 1336 limbs underwent a first-time lower extremity revascularization for CLTI, of which 992 had sufficient data to classify all three WIfI components (wound, ischemia, and foot infection)...
March 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28057289/clinical-outcomes-of-pedal-artery-angioplasty%C3%A2-for%C3%A2-patients-with-ischemic-wounds-results-from-the-multicenter-rendezvous-registry
#13
Tatsuya Nakama, Nozomi Watanabe, Takuya Haraguchi, Hiroshi Sakamoto, Daisuke Kamoi, Yoshinori Tsubakimoto, Kenji Ogata, Katsuhiko Satoh, Kazushi Urasawa, Hiroshi Andoh, Hiroshi Fujita, Yoshisato Shibata
OBJECTIVES: The aim of this study was to investigate the clinical outcomes of pedal artery angioplasty (PAA) for patients with critical limb ischemia. BACKGROUND: Pedal artery disease is considered a predictor of delayed wound healing (DH) after endovascular therapy. Adjunctive PAA might improve the speed and extent of wound healing. METHODS: Consecutive patients with critical limb ischemia (n = 257) presenting with de novo infrapopliteal and pedal artery disease were retrospectively reviewed from a multicenter registry...
January 9, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27901322/risk-factors-analysis-of-thromboembolectomy-for-acute-thromboembolic-lower-extremity-ischemia-in-native-arteries
#14
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/27890841/development-of-a-scoring-system-for-the-prediction-of-early-graft-failure-after-peripheral-arterial-bypass-surgery
#15
Andreas M Lazaris, Sotiria Mastoraki, Evangelos Kontopantelis, Konstantinos Seretis, Maria Karouki, Konstantinos Moulakakis, Miltiadis Matsagkas, Spyros N Vasdekis
BACKGROUND: An occluded lower limb arterial bypass is associated with poor prognosis for the limb. Currently, no risk assessment method to estimate the risk of early graft failure exists. Aim of this study was to investigate the effect of various potential factors on early graft failure of infrainguinal bypass surgery and to develop a risk-scoring model to predict it. METHODS: A prospective observational clinical study was performed. One hundred infrainguinal bypass procedures (60 autologous and 40 synthetic grafts), throughout a 3-year period were included...
April 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27516032/limb-ischemia-an-alarm-signal-to-a-thromboembolic-cascade-renal-infarction-and-nephrectomy-followed-by-surgical-suppression-of-the-left-atrial-appendage
#16
Cosmin Caraşca, Angela Borda, Alexandru Incze, Emilian Caraşca, Attila Frigy, HoraŢiu Suciu
We present the case of a 55-year-old male with mild hypertension and brief episodes of paroxysmal self-limiting atrial fibrillation (AF) since 2010. Despite a small cardioembolic risk score, CHA2DS2-Vasc=1 (Congestive heart failure, Hypertension, Age=75, Diabetes melitus, prior Stroke), the patient is effectively anticoagulated using acenocumarol. In December 2014, he showed signs of plantar transitory ischemia, for which he did not address the doctor. In early January 2015, he urgently presented at the hospital with left renal pain, caused by a renal infarction, diagnosed by computed tomography (CT) angiography...
2016: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/27481496/day-case-treatment-of-peripheral-arterial-disease-results-from-a-multi-center-european-study
#17
MULTICENTER STUDY
Stavros Spiliopoulos, Dimitrios Karnabatidis, Konstantinos Katsanos, Athanasios Diamantopoulos, Tariq Ali, Panagiotis Kitrou, Alessandro Cannavale, Miltiadis Krokidis
PURPOSE: The purpose of the study was to investigate safety and feasibility of day-case endovascular procedures for the management of peripheral arterial disease. MATERIALS AND METHODS: This was a multi-center, retrospective study including all patients treated over a 30-month period with endovascular angioplasty or stenting for intermittent claudication (IC) or critical limb ischemia (CLI) on a day-case basis, in Interventional Radiology (IR) departments of three European tertiary hospitals...
December 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27473129/a-multicenter-predictive-score-for-amputation-free-survival-for-patients-operated-on-with-an-heparin-bonded-eptfe-graft-for-critical-limb-ischemia
#18
Walter Dorigo, Gabriele Piffaretti, Raffaele Pulli, Patrizio Castelli, Carlo Pratesi
AIM OF THE STUDY: To retrospectively create a predictive score for estimating amputation-free survival (AFS) in patients with critical limb ischemia (CLI) operated on with the use of a heparin-bonded expanded polytetrafluoroethylene (ePTFE) bypass graft (Hb-ePTFE). METHODS: Over a 13-year period, ending in March 2015, a Hb-ePTFE graft was implanted in 683 patients undergoing below-knee revascularization for CLI in seven Italian vascular hospitals. Data concerning these interventions were retrospectively collected in a multicenter registry with a dedicated database...
January 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/27457110/junctional-bradycardia-is-a-potential-risk-factor-of-stroke
#19
COMPARATIVE STUDY
Gwang Sil Kim, Jae-Sun Uhm, Tae-Hoon Kim, Hancheol Lee, Junbeom Park, Jin-Kyu Park, Boyoung Joung, Hui-Nam Pak, Moon-Hyoung Lee
BACKGROUND: This study aimed to determine the risk of thromboembolic events in patients with junctional bradycardia(JB). METHODS: We retrospectively reviewed electrocardiograms(ECGs) for 380,682 patients. Those with JB on an ECG at least twice over a ≥3-month interval were included for analysis. We additionally included 138 CHADS2 score-matched patients(age, 68.4 ± 15.7 years; male, 52.2%) in sinus rhythm as a control group. Between the JB patients(with or without retrograde P wave) and controls, we compared incidences of ischemic stroke and a composite of ischemic stroke, renal infarction, ischemic colitis, acute limb ischemia, and pulmonary embolism...
July 25, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27432201/semiquantitative-assessment-of-tibial-artery-calcification-by-computed-tomography-angiography-and-its-ability-to-predict-infrapopliteal-angioplasty-outcomes
#20
In Sook Kang, Wonkyung Lee, Byoung Wook Choi, Donghoon Choi, Myeong-Ki Hong, Yangsoo Jang, Young-Guk Ko
OBJECTIVE: Tibial artery calcification (TAC) is associated with increased risk of amputation and mortality in peripheral artery disease. We sought to investigate whether the severity of TAC based on semiquantitative analysis of computed tomography angiography (CTA) can predict outcomes of endovascular therapy in patients with critical limb ischemia. METHODS: We reviewed medical records of 124 patients who underwent lower extremity CTA before intervention. Based on CTA, TAC severity was categorized into three groups: minimal calcification (MC; n = 43), intermediate calcification (IC; n = 36), or extensive calcification (EC; n = 45)...
November 2016: Journal of Vascular Surgery
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