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https://www.readbyqxmd.com/read/28603176/autologous-bone-marrow-mononuclear-cell-implantation-and-its-impact-on-the-outcome-of-patients-with-critical-limb-ischemia%C3%A3-results-of-a-randomized-double-blind-placebo-controlled-trial
#1
Bernard Pignon, Marie-Antoinette Sevestre, Lukshe Kanagaratnam, Gilles Pernod, Dominique Stephan, Joseph Emmerich, Claude Clement, Gabrielle Sarlon, Carine Boulon, Claire Tournois, Philippe Nguyen
BACKGROUND: Cell therapy is a therapeutic option for patients presenting with nonrevascularizable critical limb ischemia (CLI). However there is a lack of firm evidence on its efficacy because of the paucity of randomized controlled trials.Methods and Results:The BALI trial was a multicenter, randomized, controlled, double-blind clinical trial that included 38 patients. For all of them, 500 mL of bone marrow were collected for preparation of a BM-MNC product that was implanted in patients assigned to active treatment...
June 10, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28602246/pressure-signatures-can-influence-tissue-response-for-individuals-supported-on-an-alternating-pressure-mattress
#2
C Y Chai, O Sadou, P R Worsley, D L Bader
Prolonged mechanical loading can lead to the breakdown of skin and underlying tissues which can, in turn, develop into a pressure ulcer. The benefits of pressure relief and/or redistribution to minimise risk have been well documented. Manufacturers have developed alternating air pressure mattresses (APAMs) to provide periodic relief for individuals on prolonged bed-rest. The present study describes the development of a control system, termed Pneumatic Manager which can vary the signature of an APAM, namely its pressure amplitude, cell profile and cycle period...
May 10, 2017: Journal of Tissue Viability
https://www.readbyqxmd.com/read/28574039/-peripheral-perfusion-in-cad-patients-with-various-stage-chronic-heart-failure-undergoing-coronary-artery-bypass-grafting
#3
O V Kamenskaia, A S Klinkova, D V Khabarov
Using the orthostatic test, we examined peripheral perfusion by means of laser Doppler flowmetry (LDF) and transcutaneous oximetry in a total of 104 patients presenting with coronary artery disease and functional class II-IV chronic heart failure (CHF) prior to coronary artery bypass grafting (CABG) and in the remote terms thereafter. Volumetric velocity of the microcirculatory blood flow (MCB) of the lower limbs was measured by means of LDF in perfusion units; partial oxygen pressure (TcPO2, mmHg) was registered by means of transcutaneous oximetry...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28545710/evaluation-of-hyperspectral-imaging-technology-in-patients-with-peripheral-vascular-disease
#4
Nathaniel Chiang, Jitendra K Jain, Jamie Sleigh, Thodur Vasudevan
BACKGROUND: Hyperspectral imaging technology is a novel method of using transcutaneous measurement of oxyhemoglobin (HT-Oxy) and deoxyhemoglobin (HT-Deoxy) concentrations to create a two-dimensional, color-coded "oxygen map." The aims of this study were to compare the use of a hyperspectral imaging device with the transcutaneous oxygen measurement (TCOM), ankle-brachial index (ABI), and severity of peripheral vascular disease (PVD) and to assess their correlations. METHODS: This prospective study recruited 294 participants divided into three distinct groups composed of healthy volunteers and patients with PVD...
May 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28527350/bi-dimensional-variational-mode-decomposition-of-laser-speckle-contrast-imaging-data-a-clinical-approach-to-critical-limb-ischemia
#5
Anne Humeau-Heurtier, Pierre Abraham, Samir Henni
The number of patients suffering from peripheral arterial occlusive disease (PAOD) is growing worldwide. PAOD corresponds to an impairment of perfusion in the distal portion of some arteries that can generate critical limb ischemia. For some patients, the pathology leads to the necessity of amputation. PAOD may be diagnosed and studied with transcutaneous oxygen (tcpO2) measurements. However, the tcpO2 technique is a contact technique: probes have to be positioned on the limb, which may be impossible in case of ulcers and can lead to infection risks...
July 1, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/28520446/-diabetic-foot-syndrome-importance-of-calf-muscles-mr-spectroscopy-in-the-assessment-of-limb-ischemia-and-effect-of-revascularization
#6
Andrea Němcová, Michal Dubský, Alexandra Jirkovská, Petr Šedivý, Miloslav Drobný, Milan Hájek, Monika Dezortová, Robert Bém, Vladimíra Fejfarová, Anna Pyšná
AIM: The standard method for assessment of effect of revascularization in patients with diabetic foot (DF) and critical limb ischemia (CLI) is transcutaneous oxygen pressure (TcPO2). Phosphorus magnetic resonance spectroscopy (31P MRS) enables to evaluate oxidative muscle metabolism that could be impaired in patients with diabetes and its complications. The aim of our study was to compare MRS of calf muscle between patients with DF and CLI and healthy controls and to evaluate the contribution of MRS in the assessment of the effect of revascularization...
2017: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/28446371/beware-of-the-toilet-the-risk-for-a-deep-tissue-injury-during-toilet-sitting
#7
Maayan Lustig, Ayelet Levy, Kara Kopplin, Zehava Ovadia-Blechman, Amit Gefen
A pressure injury (PrI) compromises quality of life and can be life-threatening. The fundamental cause of PrIs is sustained deformations in weight-bearing soft tissues, e.g., during prolonged sitting on inadequate surfaces such as a toilet seat. In nursing homes and geriatric facilities, patients need assistance using the restroom, and patients being left on the toilet for tens-of-minutes is a real-world scenario, unfortunately. Nevertheless, there are no published studies regarding sustained tissue loads during toilet sitting and their effects on tissue physiology...
April 23, 2017: Journal of Tissue Viability
https://www.readbyqxmd.com/read/28413177/exercise-transcutaneous-oximetry-of-the-buttocks%C3%A3-external-validation-with-computed-tomography-angiography
#8
Martin Audonnet, Isabelle Signolet, Christophe Colas-Ribas, Myriam Ammi, Pierre Abraham, Samir Henni
BACKGROUND: Exercise transcutaneous oximetry (Ex-tcPO2) is a non-invasive test for exercise-induced buttock ischemia. Prior study defined Ex-tcPO2 normal/abnormal cut-offs against arteriography but no external validation was available. The aims of this study were therefore to (1) determine the diagnostic performance of Ex-tcPO2 against CTA; (2) determine the cut-off point for detection of stenosis >75% in arteries toward the hypogastric circulation; and (3) determine the effect of chest profile classification on the diagnostic performance of Ex-tcPO2...
April 13, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28265729/quality-control-of-the-foot-revascularization-using-indocyanine-green-fluorescence-imaging
#9
Nicla Settembre, Petteri Kauhanen, Anders Albäck, Kristyna Spillerova, Maarit Venermo
OBJECTIVES: Critical limb ischemia (CLI) is a clinical diagnosis, confirmed by objective tests, usually ankle-brachial index (ABI), toe pressure (TP) and TcPO2. Furthermore, the anatomical lesions in patients affected by CLI were visualized by ultrasound, angiography, CTA, or MRA. Indocyanine green fluorescence imaging (ICG-FI) is a diagnostic modality for assessing foot perfusion. We aimed to study the usefulness of ICG-FI in the quality control of revascularization. MATERIALS AND METHODS: One hundred and four CLI limbs in 101 patients were studied with ICG-FI using SPY Elite before and after open or endovascular revascularization...
July 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28242269/the-correlation-between-transcutaneous-oxygen-tension-and-microvascular-complications-in-type-2-diabetic-patients
#10
Ke Huang, Yujin Ma, Jie Wang, Shousen Shi, Liujun Fu, Jie Liu, Liping Li, Haibo Lu, Xiaoli Liang, Yanyun Liu, Hongwei Jiang
AIMS: This study aimed to assess whether transcutaneous oxygen tension (TcPO2) was associated with the presence of microvascular complications in type 2 diabetic (T2D) patients and whether TcPO2 could act as an independent risk factor for predicting the occurrence of microvascular events in these patients. METHODS: We recruited 436 patients with T2D. Based on the presence of diabetic kidney disease, diabetic retinopathy, and/or diabetic peripheral neuropathy, the patients were divided into groups with and without microvascular complications...
May 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28225505/nonrevascularizable-buttock-claudication-improved-with-sildenafil-a-case-report
#11
Loukman Omarjee, Audrey Camarzana, Samir Henni, Pierre Abraham
RATIONALE: Sildenafil, a phosphodiesterase-5-inhibitor (PDE5i), could represent a new treatment in addition to the medical treatment and advice to walk in peripheral arterial disease (PAD). PATIENT CONCERNS AND DIAGNOSES: We report a case of a 62-year-old heavy smoker man who developed a buttock claudication and a severe walking limitation following an aorto-bi-femoral bypass in 1992. Since 2003, each year, he has been referred for investigation of bilateral buttock claudication on treadmill using transcutaneous oxygen pressure (tcpO2) measurement during exercise to argue for the vascular origin of the walking impairment...
February 2017: Medicine (Baltimore)
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
#12
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/28187214/what-s-the-remedy-for-the-distal-necrosis-of-diep-flap-better-venous-drain-or-more-arterial-supply
#13
Yi Zhang, Tingliang Wang, Jiao Wei, Jinguang He, Tao Wang, Ying Liu, Hua Xu, Jiasheng Dong
BACKGROUND: We developed a novel pedicled DIEP flap model in rat to explore the possible remedy for the distal necrosis of the flap. METHODS: A deep inferior epigastric perforator (DIEP) flap, based on the second right cranial perforator (P2) as the main pedicle, was elevated in 48 Sprague-Dawley rats. The rats were randomized into 4 groups: group I, the left P2 remaining intact as supercharging; group II, the left P2 artery alone kept as supercharging; group III, the left P2 vein alone kept as supercharging; group IV, no supercharging...
2017: PloS One
https://www.readbyqxmd.com/read/28051243/long-term-survival-of-patients-with-critical-limb-ischemia-treated-with-iloprost-response-rate-and-predictive-criteria-a-retrospective-analysis-of-102-patients
#14
E Melillo, E Lucaccini, R Berchiolli, D Adami, M Nuti, G Dell'Omo, A Farina, G Panigada, A T Roberts, S Meini
OBJECTIVE: Critical limb ischemia (CLI) patients have poor long-term prognosis. We showed that iloprost improves outcomes (major amputation and survival) up a 5-year follow-up, but it is not known if in this length of time the survival curves, of clinical responders and non-responders, differ. PATIENTS AND METHODS: A retrospective study enrolling 102 consecutive patients between 2004-2008, with clinical and instrumental (ultrasound, angiography, transcutaneous tensiometry of oxygen TcpO2 and carbon dioxide TcpCO2 in the affected and contralateral limbs) diagnosis of critical ischemia...
December 2016: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28049004/microcirculatory-assessment-of-arterial-below-knee-stumps-near-infrared-spectroscopy-versus-transcutaneous-oxygen-tension-a-preliminary-study-in-prosthesis-users
#15
Davy Laroche, José-Luis Barnay, Bastien Tourlonias, Cyril Orta, Christine Obert, Jean-Marie Casillas
OBJECTIVE: To examine metrologic properties of near-infrared spectroscopy (NIRS) versus transcutaneous oxygen tension (TcPO2) for microcirculatory assessment of vascular transtibial stumps at the stabilized period of prosthesis fitting, as a preliminary step before exploring its ability to predict stump healing, considering the previously identified limits of TcPO2 (borderline area between 15 and 35mmHg). DESIGN: Prospective single-center observational study. SETTING: University-based rehabilitation center...
December 31, 2016: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/27958690/granulocyte-colony-stimulating-factor-improves-the-efficacy-of-autologous-bone-marrow-derived-mononuclear-cell-transplantation-treatment-for-lower-limb-ischemia
#16
Yongquan Gu, Lianrui Guo, Jianming Guo, Alan Dardik, Shuwen Zhang, Zhu Tong, Jian Zhang, Zhonghao Wang
BACKGROUND: The safety and efficacy of autologous bone marrow-derived mononuclear cell (BM-MNC) transplantation in the treatment of lower limb ischemia is becoming established, although common treatment protocols are not yet agreed upon. We hypothesized that bone marrow mobilization with Granulocyte Colony-Stimulating Factor (G-CSF) improves the safety and effectiveness of cellular therapy. METHODS: 44 patients were randomly assigned to receive two injections of G-CSF (300 μg) prior to BM-MNC transplantation...
December 13, 2016: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/27909207/below-knee-amputation-failure-and-poor-functional-outcomes-are-higher-than-predicted-in-contemporary-practice
#17
Jesse A Columbo, Brian W Nolan, Ryland S Stucke, Eva M Rzucidlo, Karen L Walker, Richard J Powell, Bjoern D Suckow, David H Stone
OBJECTIVE: The perceived functional benefit of below-knee amputation (BKA) must be carefully weighed against the need for potential reinterventions. This study sought to examine the contemporary clinical and functional outcomes of patients undergoing BKA in the endovascular era. METHODS: All patients who underwent BKA from January 2008 to December 2014 at a single tertiary medical center were retrospectively reviewed. Demographics, comorbidities, ambulation status, and transcutaneous oximetry (TcPO2) values were recorded...
November 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27871769/effect-of-mechanical-vibration-on-transcutaneous-oxygen-levels-in-the-feet-of-type-2-diabetes-mellitus-patients
#18
Gerardo Rodríguez Reyes, Lidia Núñez Carrera, Aldo Alessi Montero, Adriana Solís Vivanco, Ivett Quiñones Uriostegui, Alberto Isaac Pérez Sanpablo
BACKGROUND AND OBJECTIVE: Foot conditions in patients with diabetes mellitus (DM) are major causes of morbidity and disability. Whole body vibration may promote blood circulation in the lower limbs, hence facilitating perfusion and promoting the supply of nutrients and oxygen to comprised tissues. Transcutaneous oxygen levels (TcPO2)>40mmHg in cases of diabetic foot syndrome are associated with a good prognosis in the resolution of ulcers. The objective of this study was to determine whether whole body vibration favors some parameters of interest related to complications associated with the diabetic foot syndrome...
January 6, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/27869551/critical-limb-ischaemia-and-the-response-to-bone-marrow-derived-cell-therapy-according-to-tcpo2-measurement
#19
MULTICENTER STUDY
Mario Maufus, Marie Antoinette Sevestre-Pietri, Carmine Sessa, Bernard Pignon, Harald Egelhofer, Stephane Dupas, Philippe Nguyen, Celine Genty, Gilles Pernod
BACKGROUND: Cell therapy is an emerging potential biotherapy for critical limb ischaemia (CLI) patients who are not eligible for revascularization. However, the findings on this technique's efficacy are inconsistent. Trials investigating this topic focused on the more severe CLI patients who were often beyond any therapy. Therefore, identifying those who may truly benefit from cell transplantation is now warranted. To this end, we studied the prognostic value of tcPO2 for major amputation after 1 year in patients treated with bone marrow-derived cells...
January 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/27818472/a-single-session-of-neuromuscular-electrical-stimulation-enhances-vascular-endothelial-function-and-peripheral-blood-circulation-in-patients-with-acute-myocardial-infarction
#20
RANDOMIZED CONTROLLED TRIAL
Shinya Tanaka, Takashi Masuda, Kentaro Kamiya, Nobuaki Hamazaki, Ayako Akiyama, Yumi Kamada, Emi Maekawa, Chiharu Noda, Minako Yamaoka-Tojo, Junya Ako
This study aimed to investigate whether a single session of neuromuscular electrical stimulation (NMES) can enhance vascular endothelial function and peripheral blood circulation in patients with acute myocardial infarction (AMI). Thirty-four male patients with AMI were alternately assigned to 2 groups, and received NMES with muscle contraction (NMES group, n = 17) or without muscle contraction (control group, n = 17) after admission. NMES was performed for quadriceps and gastrocnemius muscles of both legs for 30 minutes...
December 2, 2016: International Heart Journal
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