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Limb ischemia risk score

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https://www.readbyqxmd.com/read/28259571/preoperative-inflammatory-status-as-a-predictor-of-primary-patency-after-femoropopliteal-stent-implantation
#1
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...
March 1, 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
#2
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)...
February 17, 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
#3
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
#4
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
#5
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
#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/27890841/development-of-a-scoring-system-for-the-prediction-of-early-graft-failure-after-peripheral-arterial-bypass-surgery
#7
Andreas M Lazaris, Sotiria Mastoraki, Evangelos Kontopantelis, Konstantinos Seretis, Maria Karouki, Konstantinos Moulakakis, Miltiadis Matsagkas, Spyros N Vasdekis
OBJECTIVES: 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. DESIGN AND 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...
November 24, 2016: 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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/27347220/aortic-wall-extracellular-matrix-proteins-correlate-with-syntax-score-in-patients-undergoing-coronary-artery-bypass-surgery
#13
Terri Chiong, Esther S H Cheow, Chin C Woo, Xiao Y Lin, Lay W Khin, Chuen N Lee, Mikael Hartman, Siu K Sze, Vitaly A Sorokin
AIMS: The SYNTAX score correlate with major cardiovascular events post-revascularization, although the histopathological basis is unclear. We aim to evaluate the association between syntax score and extracellular matrix histological characteristics of aortic punch tissue obtained during coronary artery bypass surgery (CABG). This analysis compares coronary artery bypass surgery patients with High and Low syntax score which were followed up for one year period. METHODS AND RESULTS: Patients with High (score ≥ 33, (n=77)) and Low Syntax Scores (score ≤ 22, (n=71)) undergoing elective CABG were recruited prospectively...
2016: Open Cardiovascular Medicine Journal
https://www.readbyqxmd.com/read/27321888/impact-of-chronic-kidney-disease-on-clinical-outcomes-of-endovascular-treatment-for-femoropopliteal-arterial-disease
#14
Paul P Heideman, Mohammad Reza Rajebi, Michael A McKusick, Haraldur Bjarnason, Gustavo S Oderich, Jeremy L Friese, Mark D Fleming, Andrew H Stockland, William S Harmsen, Jay Mandrekar, Sanjay Misra
PURPOSE: To evaluate effect of chronic kidney disease (CKD) on all-cause mortality, major adverse limb event (MALE), MALE and postoperative death (MALE + POD), and amputation after endovascular treatment of femoropopliteal disease. MATERIALS AND METHODS: A retrospective review from January 2002 to October 2011 was performed of 440 patients who underwent endovascular treatment of symptomatic femoropopliteal disease for claudication (n = 251) or critical limb ischemia (CLI) (n = 267)...
August 2016: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/27303938/revisiting-microsurgical-distal-bypass-for-critical-limb-ischemia
#15
Yoshio Tanaka, Tetsuji Uemura, Shinobu Ayabe, Tomohiro Hirao, Tomohisa Nagasao
Background The purpose of this study was to investigate the efficacy of introducing microsurgical techniques to distal bypass surgery for critical limb ischemia. Methods Datasets of 83 consecutive microsurgical distal bypasses in a multicenter (SKY) study were compared with the results of the PREVENT III (PIII) study regarding the following: (1) patients' characteristics, (2) clinical severity according to the PIII risk score, (3) conduits and procedures for revascularization, (4) proximal and distal anastomosis sites, and (5) primary patency and amputation-free survival (AFS) rates at 1 year...
June 15, 2016: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/27237403/comparative-effectiveness-of-peripheral-vascular-intervention-versus-surgical-bypass-for-critical-limb-ischemia-in-the-vascular-study-group-of-greater-new-york
#16
Andrew J Meltzer, Art Sedrakyan, Abby Isaacs, Peter H Connolly, Darren B Schneider
OBJECTIVE: In this study, the effectiveness of peripheral vascular intervention (PVI) was compared with surgical bypass grafting (BPG) for critical limb ischemia (CLI) in the Vascular Study Group of Greater New York (VSGGNY). METHODS: Patients undergoing BPG or PVI for CLI at VSGGNY centers (2011-2013) were included. The Society for Vascular Surgery objective performance goals for CLI were used to directly compare the safety and effectiveness of PVI and BPG. Propensity score matching was used for risk-adjusted comparisons of PVI with BPG...
November 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27231794/comparative-assessment-of-medical-resource-use-and-costs-associated-with-patients-with-symptomatic-peripheral-artery-disease-in-the-united-states
#17
Monica Reed Chase, Howard S Friedman, Prakash Navaratnam, Kim Heithoff, Ross J Simpson
BACKGROUND: There is growing concern about appropriate disease management for peripheral artery disease (PAD) because of the rapidly expanding population at risk for PAD and the high burden of illness associated with symptomatic PAD. A better understanding of the potential economic impact of symptomatic PAD relative to a matched control population may help improve care management for these patients. OBJECTIVE: To compare the medical resource utilization, costs, and medication use for patients with symptomatic PAD relative to a matched control population...
June 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27060019/single-centre-experience-of-combat-related-vascular-injury-in-victims-of-syrian-conflict-retrospective-evaluation-of-risk-factors-associated-with-amputation
#18
Emrah Şişli, Ali Aycan Kavala, Mustafa Mavi, Osman Nejat Sarıosmanoğlu, Öztekin Oto
OBJECTIVE: To elucidate the risk factors associated with amputation in cases with combat-related vascular injury (CRVI). MATERIAL AND METHODS: This retrospective study included 90 cases with CRVI treated between May 2011 and July 2013. The patients were divided into group I (n=69), in which the limb was salvaged and group II (n=21), in which the patients received amputation. RESULTS: The overall and the secondary amputation rates were 23% and 18%, respectively...
September 2016: Injury
https://www.readbyqxmd.com/read/27036309/society-for-vascular-surgery-limb-stage-and-patient-risk-correlate-with-outcomes-in-an-amputation-prevention-program
#19
Marlin W Causey, Ayman Ahmed, Bian Wu, Warren J Gasper, Alex Reyzelman, Shant M Vartanian, Jade S Hiramoto, Michael S Conte
OBJECTIVE: Clinical decision making and accurate outcomes comparisons in advanced limb ischemia require improved staging systems. The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System (Wound extent, Ischemia, and foot Infection [WIfI]) was designed to stratify limb outcomes based on three major factors-wound extent, ischemia, and foot infection. The Project or Ex-Vivo vein graft Engineering via Transfection III (PREVENT) III (PIII) risk score was developed to stratify patients by expected amputation-free survival (AFS) after surgical revascularization...
June 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/26995365/the-liberty-study-design-of-a-prospective-observational-multicenter-trial-to-evaluate-the-acute-and-long-term-clinical-and-economic-outcomes-of-real-world-endovascular-device-interventions-in-treating-peripheral-artery-disease
#20
RANDOMIZED CONTROLLED TRIAL
George L Adams, Jihad Mustapha, William Gray, Nick J Hargus, Brad J Martinsen, Gary Ansel, Michael R Jaff
BACKGROUND: Most peripheral artery disease (PAD) clinical device trials are supported by commercial manufacturers and designed for regulatory device approval, with extensive inclusion/exclusion criteria to support homogeneous patient populations. High-risk patients with advanced disease, including critical limb ischemia (CLI), are often excluded leading to difficulty in translating trial results into real-world clinical practice. As a result, physicians have no direct guidance regarding the use of endovascular devices...
April 2016: American Heart Journal
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