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critical limb ischemia

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https://www.readbyqxmd.com/read/29786411/bad-transmission-and-sad-distribution-a-new-scenario-for-critical-limb-ischemia
#1
Roberto Ferraresi, Giovanni Mauri, Fabrizio Losurdo, Nicola Troisi, Diego Brancaccio, Carlo M Caravaggi, Luca Neri
BACKGROUND: Most of the studies on peripheral artery disease (PAD) focused on above-the-ankle artery disease, while less is known about foot artery disease. We hypothesize a scenario were two different diseases can be present in PAD patients, big artery disease (BAD) and small artery disease (SAD), overlapping at the foot level; the aim of this study is to evaluate their prevalence and their correlation with risk factors and critical limb ischemia (CLI) in a large cohort of patients with symptomatic PAD...
May 22, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29786410/percutaneous-deep-venous-arterialization-in-patients-with-critical-limb-ischemia-a-technical-note
#2
Steven Kum, Eline Huizing, Michiel A Schreve, Çagdas Ünlü, Roberto Ferraresi, Lasitha B Samarakoon, Daniel A van den Heuvel
Critical limb ischemia (CLI) is the presentation of end stage peripheral arterial disease and typically presents with rest pain, ulceration and gangrene. The outcome of conservative treatment is poor and often leads to amputations. Arterial revascularization plays an important role in amputation prevention. Unfortunately, a significant percentage of CLI patients cannot be revascularized and subsequently end up with a palliative amputation. This has led to the need and exploration of new treatment options in this no option subgroup of CLI...
May 22, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29783031/a-unique-all-payer-rate-setting-system-controls-the-cost-but-not-the-racial-disparity-in-lower-extremity-revascularization-procedures
#3
Besma Nejim, Robert J Beaulieu, Husain Alshaikh, Mohammed Hamouda, Joseph Canner, Mahmoud B Malas
BACKGROUND: Patients with peripheral arterial disease (PAD) often have high comorbidity burden that may complicate post-interventional course and drive increased healthcare expenditures. Racial disparity had been observed in lower extremity revascularization (LER) patterns and outcomes. In 2014, Maryland adopted an all-payer rate setting system to limit the rising hospitalization costs. This resulted in an aggregate payment system in which hospital compensation takes place as an overall per capita expenditure for hospital services...
May 18, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29778609/emergency-department-utilization-after-lower-extremity-bypass-for-critical-limb-ischemia
#4
Vangelina Osteguin, Thomas W Cheng, Alik Farber, Mohammad H Eslami, Jeffrey A Kalish, Douglas W Jones, Denis Rybin, Stephen J Raulli, Jeffrey J Siracuse
OBJECTIVES: Patients with critical limb ischemia (CLI) utilize hospital resources at high rates. One major driver for resource utilization are Emergency Department (ED) visits. Our goal was to assess perioperative ED visits after lower extremity bypass (LEB) for CLI. METHODS: All patients undergoing LEB for CLI from 2008 to 2017 at our institution were analyzed. Emergency department visits and details of the visit within 30 and 90 days of discharge from index admission were recorded...
May 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29777842/nationally-representative-readmission-factors-in-patients-with-claudication-and-critical-limb-ischemia
#5
Rennier A Martinez, Michelle Shnayder, Joshua Parreco, Lukas Gaffney, Marcus Eby, Nicholas Cortolillo, Michael Lopez, Jack Zeltzer
INTRODUCTION: Hospital readmissions are not only associated with increased mortality, morbidity and costs but also, with current healthcare reform, tied to significant financial and administrative penalties. Some studies show that patients undergoing vascular surgery may have higher than average readmission rates. The recently released Nationwide Readmission Database (NRD) is the most comprehensive national source of readmission data, gathering discharge information from 22 geographically dispersed states, accounting for 51...
May 16, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29772334/quality-of-life-and-mortality-after-endovascular-surgical-or-conservative-treatment-of-elderly-patients-suffering-from-critical-limb-ischemia
#6
Stijn L Steunenberg, Jolanda de Vries, Jelle W Raats, Willem J Thijsse, Nathalie Verbogt, Paul Lodder, Geert-Jan van Eijck, Eelco J Veen, Hans G W de Groot, Gwan H Ho, Lijckle van der Laan
INTRODUCTION: Revascularisation to relieve ischemic pain and prevent limb loss is the cornerstone of critical limb ischemia (CLI) treatment, however not all elderly patients are deemed fit for revascularisation. Patient related outcome measurements are important in these patients. Quality of Life (QoL) results regarding the effect of endovascular, surgical, and conservative treatment on the quality of life (QoL) in the elderly are scarce in current literature. Goal of this study is to explore the outcome of the different treatment modalities in elderly patients suffering from CLI, with a specific focus on QoL...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29765431/skin-perfusion-pressure-for-the-prediction-of-wound-healing-in-critical-limb-ischemia-a-meta-analysis
#7
REVIEW
Xuanliang Pan, Chuangang You, Guoxian Chen, Huawei Shao, Chunmao Han, Lizhu Zhi
Introduction: The purpose of this meta-analysis was to determine the value and efficacy of skin perfusion pressure (SPP) for the prediction of wound healing in patients with critical limb ischemia. Material and methods: Medline, Cochrane, EMBASE, and Google Scholar databases were searched from inception until December 31, 2014 using combinations of the following keywords: skin perfusion pressure, limb ischemia, wound healing, prediction. Randomized controlled trials, 2-arm prospective studies, and retrospective studies that measured SPP in patients with limb ischemia were included...
April 2018: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/29760308/cardiovascular-outcome-and-mortality-in-patients-undergoing-endovascular-treatment-for-symptomatic-peripheral-artery-disease-short-term-results-of-the-toma-code-registry
#8
Michiaki Higashitani, Yukari Uemura, Atsushi Mizuno, Makoto Utsunomiya, Tetsuo Yamaguchi, Akihiro Matsui, Shunsuke Ozaki, Kazuki Tobita, Atsushi Tosaka, Akitsugu Oida, Kenji Suzuki, Takahide Kodama, Kentaro Jujo, Tatsuki Doijiri, Yasuhiro Takahashi, Shunsuke Matsuno, Nobuhito Kaneko, Akira Moriguchi, Shohei Kishi, Hitoshi Anzai
BACKGROUND: The present study was performed to clarify whether the preoperative clinical symptoms for endovascular therapy (EVT) can predict post-EVT death and cardiovascular prognosis in Japanese patients with peripheral artery disease (PAD), including acute disease.Methods and Results:The TOkyo taMA peripheral vascular intervention research COmraDE (Toma-Code) Registry is a Japanese prospective cohort of 2,321 consecutive patients with PAD treated with EVT, in 34 hospitals in the Kanto and Kōshin'etsu regions, from August 2014 to August 2016...
May 11, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29759039/common-femoral-artery-endarterectomy-in-the-age-of-endovascular-therapy
#9
Mohamed Elsherif, Wael Tawfick, Mohamed Elsharkawi, Ruth Campell, Niamh Hynes, Sherif Sultan
Objectives Common femoral artery endarterectomy (CFE) is the standard treatment for common femoral artery occlusive disease. We aim to assess the medium term outcomes of CFE with or without further concomitant procedures. Design A retrospective observational study. Methods All patients who underwent either isolated CFE (ICFE), CFE with angioplasty for occlusive arterial disease (CFEA) or concomitant CFE with endovascular aortic aneurysm repair (CFEE) were included. Patient demographics follow up, clinical improvement, types of CFE closure, patency rates, and survival-free amputation were noted...
January 1, 2018: Vascular
https://www.readbyqxmd.com/read/29758937/the-controversial-origin-of-pericytes-during-angiogenesis-implications-for-cell-based-therapeutic-angiogenesis-and-cell-based-therapies
#10
Anna Blocki, Sebastian Beyer, Friedrich Jung, Michael Raghunath
Pericytes reside within the basement membrane of small vessels and are often in direct cellular contact with endothelial cells, fulfilling important functions during blood vessel formation and homeostasis. Recently, these pericytes have been also identified as mesenchymal stem cells. Mesenchymal stem cells, and especially their specialized subpopulation of pericytes, represent promising candidates for therapeutic angiogenesis applications, and have already been widely applied in pre-clinical and clinical trials...
2018: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/29756521/cost-analysis-of-initial-treatment-with-endovascular-revascularization-open-surgery-or-primary-major-amputation-in-patients-with-peripheral-artery-disease
#11
Linda Tang, Sharath C V Paravastu, Shannon D Thomas, Elaine Tan, Eric Farmer, Ramon L Varcoe
PURPOSE: To compare the total initial treatment costs for open surgery, endovascular revascularization, and primary major amputation within a single-payer healthcare system. METHODS: A multicenter, retrospective analysis was undertaken to evaluate 1138 patients with symptomatic peripheral artery disease (PAD) who underwent 1017 endovascular procedures, 86 open surgeries, and 35 major amputations between 2013 and 2016. A cost-mix analysis was performed on individual patient data generated for selected diagnosis-related groups...
May 1, 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29753232/traditional-and-nontraditional-glycemic-markers-and-risk-of-peripheral-artery-disease-the-atherosclerosis-risk-in-communities-aric-study
#12
Ning Ding, Lucia Kwak, Shoshana H Ballew, Bernard Jaar, Ron C Hoogeveen, Christie M Ballantyne, A Richey Sharrett, Aaron R Folsom, Gerardo Heiss, Maya Salameh, Josef Coresh, Alan T Hirsch, Elizabeth Selvin, Kunihiro Matsushita
BACKGROUND AND AIMS: Traditional glycemic markers, fasting glucose and hemoglobin A1c (HbA1c), predict incident peripheral artery disease (PAD). However, it is unknown whether nontraditional glycemic markers, fructosamine, glycated albumin, and 1,5-anhydroglucitol, are associated with PAD and whether these glycemic markers demonstrate particularly strong associations with severe PAD, critical limb ischemia (CLI). METHODS: We quantified the associations of these five glycemic markers with incident PAD (hospitalizations with PAD diagnosis or leg revascularization) in 11,634 ARIC participants using Cox regression models...
April 30, 2018: Atherosclerosis
https://www.readbyqxmd.com/read/29750878/perfusion-scintigraphy-in-the-assessment-of-autologous-cell-therapy-in-diabetic-patients-with-critical-limb-ischemia
#13
A Nemcova, A Jirkovska, M Dubsky, R Bem, V Fejfarova, V Woskova, A Pysna, M Buncova
Perfusion scintigraphy with technetium-99-methoxy-isobutyl-isonitrile ((99m)Tc-MIBI) is often used for assessing myocardial function but the number of studies concerning lower limb perfusion is limited. The aim of our study was to assess whether (99m)Tc-MIBI was an eligible method for evaluation of the effect of cell therapy on critical limb ischemia (CLI) in diabetic patients. (99m)Tc-MIBI of calf muscles was performed before and 3 months after autologous cell therapy (ACT) in 24 diabetic patients with CLI...
May 10, 2018: Physiological Research
https://www.readbyqxmd.com/read/29748311/radiotracer-imaging-allows-for-noninvasive-detection-and-quantification-of-abnormalities-in-angiosome-foot-perfusion-in-diabetic-patients-with-critical-limb-ischemia-and-nonhealing-wounds
#14
Jessica L Alvelo, Xenophon Papademetris, Carlos Mena-Hurtado, Sangchoon Jeon, Bauer E Sumpio, Albert J Sinusas, Mitchel R Stacy
BACKGROUND: Single photon emission computed tomography (SPECT)/computed tomography (CT) imaging allows for assessment of skeletal muscle microvascular perfusion but has not been quantitatively assessed in angiosomes, or 3-dimensional vascular territories, of the foot. This study assessed and compared resting angiosome foot perfusion between healthy subjects and diabetic patients with critical limb ischemia (CLI). Additionally, the relationship between SPECT/CT imaging and the ankle-brachial index-a standard tool for evaluating peripheral artery disease-was assessed...
May 2018: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29743899/drug-coated-balloon-in-superficial-femoral-artery-in-stent-restenosis
#15
REVIEW
Donato Gerardi, Arturo Alfani, Tullio Tesorio, Angelo Cioppa, Giovanni Esposito, Eugenio Stabile
The femoropopliteal artery is one of the commonest sites of involvement in peripheral artery disease (PAD) leading to intermittent claudication and/or critical limb ischemia. Endovascular therapy for superficial femoral artery (SFA) disease has been recognized as a safe and efficient therapy and is recommended by current guidelines as the first-line approach. Although the widespread use of new-generation, self-expanding, nitinol stents in SFA stenosis has reduced the shortcomings associated with plain old balloon angioplasty (POBA), lumen renarrowing at the stented (in-stent restenosis - ISR) level still represents a relevant clinical problem, because of higher risk of recurrent ISR, occlusion and surgical revascularization compared to de-novo lesions...
2018: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/29731636/critical-limb-ischemia-current-challenges-and-future-prospects
#16
REVIEW
Luigi Uccioli, Marco Meloni, Valentina Izzo, Laura Giurato, Stefano Merolla, Roberto Gandini
Critical limb ischemia (CLI) is considered the most severe pattern of peripheral artery disease. It is defined by the presence of chronic ischemic rest pain, ulceration or gangrene attributable to the occlusion of peripheral arterial vessels. It is associated with a high risk of major amputation, cardiovascular events and death. In this review, we presented a complete overview about physiopathology, diagnosis and holistic management of CLI. Revascularization is the first-line treatment, but several challenging cases are not treatable by conventional techniques...
2018: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29724818/hypoxia-and-ischemia-promote-a-maladaptive-platelet-phenotype
#17
Scott J Cameron, Doran S Mix, Sara K Ture, Rachel A Schmidt, Amy Mohan, Daphne Pariser, Michael C Stoner, Punit Shah, Lijun Chen, Hui Zhang, David J Field, Kristina L Modjeski, Sandra Toth, Craig N Morrell
OBJECTIVE: Reduced blood flow and tissue oxygen tension conditions result from thrombotic and vascular diseases such as myocardial infarction, stroke, and peripheral vascular disease. It is largely assumed that while platelet activation is increased by an acute vascular event, chronic vascular inflammation, and ischemia, the platelet activation pathways and responses are not themselves changed by the disease process. We, therefore, sought to determine whether the platelet phenotype is altered by hypoxic and ischemic conditions...
May 3, 2018: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/29718063/the-protective-effects-of-hgf-against-apoptosis-in-vascular-endothelial-cells-caused-by-peripheral-vascular-injury
#18
Wu Zhong, Yu Zhao, Ye Tian, Muhu Chen, Xue Lai
Closed vascular injuries have danger of developing critical tissue ischemia with a high risk of amputation and limb loss. However, limited effective strategies exist at present. In this study, we investigate the role of hepatocyte growth factor (HGF) on apoptosis of vascular endothelial cells (VECs). First, apoptosis of VECs was induced by hypoxia treatment with or without HGF. Annexin V-7AAD apoptosis assay revealed that HGF overexpression significantly reduced VEC apoptosis. Then a closed peripheral vascular injury animal model was created by balloon catheter in female New Zealand rabbit...
April 30, 2018: Acta Biochimica et Biophysica Sinica
https://www.readbyqxmd.com/read/29717398/successful-limb-salvage-through-staged-bypass-combined-with-free-gracilis-muscle-transfer-for-critical-limb-ischemia-with-osteomyelitis-after-failed-endovascular-therapy
#19
Keisuke Miyake, Shinsuke Kikuchi, Hiroko Okuda, Atsuhiro Koya, Satomi Abe, Yoshiki Sawa, Tetsuo Ota, Nobuyoshi Azuma
BACKGROUND: Critical limb ischemia with osteomyelitis is so difficult to treat that even appropriate revascularization and wound therapy cannot achieve limb salvage because of uncontrollable infection. It is still difficult to judge the possibility of limb salvage before revascularization. CASE PRESENTATION: A 73-year-old male complained of a small ulcer on his left toe, which was treated with multiple endovascular therapy. After failed endovascular therapy, he suffered extensive tissue loss with tibial osteomyelitis...
May 2, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29713026/low-mean-platelet-volume-is-associated-with-critical-limb-ischemia-in-peripheral-arterial-occlusive-disease
#20
Peter Rief, Reinhard B Raggam, Alexander Avian, Franz Hafner, Mahdi Sareban, Martin Wehrschuetz, Marianne Brodmann, Thomas Gary
Mean platelet volume (MPV) was recently published as a possible marker of coronary artery disease in patients at high risk for major adverse cardiac events. Because platelets play an important role in atherosclerosis, we examined the relationship between critical limb ischemia (CLI) and MPV in patients with peripheral arterial occlusive disease (PAOD). Our study comprised 2124 PAOD patients. Univariate logistic regression was performed to analyze potential predictors for CLI. Nagelkerke's R² is reported. Cross validation was performed using the leave-one-out principle...
April 30, 2018: Scientific Reports
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