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critical limb ischemia

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https://www.readbyqxmd.com/read/28807382/association-between-statin-therapy-and-amputation-free-survival-in-patients-with-critical-limb-ischemia-in-the-critisch-registry
#1
Konstantinos Stavroulakis, Matthias Borowski, Giovanni Torsello, Theodosios Bisdas
OBJECTIVE: Secondary prevention in patients with critical limb ischemia (CLI) is crucial for the reduction of cardiovascular morbidity and mortality. Nonetheless, current recommendations are extrapolated from other high-risk populations because of the lack of CLI-dedicated trials. The aim of this explorative study was to evaluate the association of statin therapy with the outcomes of CLI patients. METHODS: The First-Line Treatments in Patients With Critical Limb Ischemia (CRITISCH) registry is a prospective multicenter registry analyzing the effectiveness of all available treatment strategies in 1200 CLI patients...
August 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28806175/point-of-care-ultrasound-facilitated-detection-of-femoral-occlusive-septic-emboli-during-mitral-valve-surgery-a-case-report
#2
Melissa L Bellomy, Susan Eagle, Mias Pretorius, Ben R Barton, Yafen Liang
Acute lower extremity ischemia from septic emboli is a surgical emergency. Timely diagnosis and management are critical to improve patient outcome. However, traditional diagnostic modalities such as intraoperative angiogram are time-consuming, require special equipment and personnel, and introduce contrast exposure for critically ill patients. There are limited reports of utilization of point-of-care ultrasound to detect peripheral septic emboli. We present a case where femoral occlusive septic emboli were identified by point-of-care ultrasound after mitral valve replacement...
August 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28802661/efficacy-of-isolated-limb-perfusion-ilp-in-patients-with-merkel-cell-carcinoma-mcc-a-multicenter-experience
#3
L M van Veenendaal, M F Madu, M E T Tesselaar, C Verhoef, D J Grünhagen, A C J van Akkooi
BACKGROUND: Merkel cell carcinoma (MCC) is a rare and potentially aggressive neuroendocrine tumor of the skin, with a propensity for locoregional metastases. In two expert referral centers, isolated limb perfusion (ILP) is used to obtain locoregional control in selected locoregionally advanced MCC patients. This study describes our experience. METHOD: Patients who underwent ILP for MCC were analyzed. ILP was performed with melphalan and tumor necrosis factor (TNF) combination therapy...
August 3, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28799724/characteristics-and-clinical-outcomes-of-repeat-endovascular-therapy-after-infrapopliteal-balloon-angioplasty-in-patients-with-critical-limb-ischemia
#4
Norihiro Kobayashi, Keisuke Hirano, Masahiro Yamawaki, Motoharu Araki, Tsuyoshi Sakai, Yasunari Sakamoto, Shinsuke Mori, Masakazu Tsutsumi, Yohsuke Honda, Takahiro Tokuda, Kenji Makino, Shigemitsu Shirai, Yoshiaki Ito
OBJECTIVES: We clarified characteristics and clinical outcomes of critical limb ischemia (CLI) patients who underwent repeat endovascular therapy (EVT) for infrapopliteal lesions. BACKGROUND: High restenosis rate after infrapopliteal EVT remains a major concern. METHODS: Patients with CLI who underwent EVT between April 2007 and February 2014, were divided into the following three groups according to how often EVT was repeated: Group A, no repeat of EVT; Group B, EVT repeated once/twice; and Group C, EVT repeated ≥3 times...
August 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28790926/moderate-exercise-allows-for-shorter-recovery-time-in-critical-limb-ischemia
#5
Anne Lejay, Gilles Laverny, Stéphanie Paradis, Anna-Isabel Schlagowski, Anne-Laure Charles, François Singh, Joffrey Zoll, Fabien Thaveau, Evelyne Lonsdorfer, Stéphane Dufour, Fabrice Favret, Valérie Wolff, Daniel Metzger, Nabil Chakfe, Bernard Geny
Whether and how moderate exercise might allow for accelerated limb recovery in chronic critical limb ischemia (CLI) remains to be determined. Chronic CLI was surgically induced in mice, and the effect of moderate exercise (training five times per week over a 3-week period) was investigated. Tissue damages and functional scores were assessed on the 4th, 6th, 10th, 20th, and 30th day after surgery. Mice were sacrificed 48 h after the last exercise session in order to assess muscle structure, mitochondrial respiration, calcium retention capacity, oxidative stress and transcript levels of genes encoding proteins controlling mitochondrial functions (PGC1α, PGC1β, NRF1) and anti-oxidant defenses markers (SOD1, SOD2, catalase)...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28789654/serum-high-mobility-group-box-1-and-osteoprotegerin-levels-are-associated-with-peripheral-arterial-disease-and-critical-limb-ischemia-in-type-2-diabetic-subjects
#6
Silvia Giovannini, Giovanni Tinelli, Federico Biscetti, Giuseppe Straface, Flavia Angelini, Dario Pitocco, Luciana Mucci, Raffaele Landolfi, Andrea Flex
BACKGROUND: High mobility group box-1 (HMGB-1) is a nuclear protein also acting as inflammatory mediator, whilst osteoprotegerin (OPG), member of tumor necrosis factor receptor superfamily, is indicated as marker of vascular calcification. Peripheral artery disease (PAD) and type 2 diabetes (T2D) are clinical conditions characterized by elevated serum inflammatory markers and vascular calcification enhancement. The aim of this study was to investigate the potential role of HMGB-1, OPG and several inflammatory mediators such as C-reactive protein (HsCRP), tumor necrosis factor-alpha and interleukin-6 (IL-6) on the presence and severity of peripheral artery disease in patients with T2D...
August 8, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28783593/amplification-of-near-infrared-fluorescence-in-semiconducting-polymer-nanoprobe-for-grasping-the-behaviors-of-systemically-administered-endothelial-cells-in-ischemia-treatment
#7
Duo Mao, Jie Liu, Shenglu Ji, Ting Wang, Yu Hu, Donghui Zheng, Renqiang Yang, Deling Kong, Dan Ding
To date, there have been few studies on using fluorescent cell trackers for non-invasively monitoring the in vivo fate of systemically administered cells. This is because only a relatively small number of cells can reach the disease site post systemic infusion, and thus achieving ideal in vivo cell tracking requires that the fluorescent cell trackers should hold combined merits of ultrahigh near-infrared (NIR) fluorescence, negligible interference on cell behavior and function, excellent retention within cells, as well as accurate long-term cell tracking ability...
August 2, 2017: Biomaterials
https://www.readbyqxmd.com/read/28767168/the-possibility-of-free-tissue-transfer-as-a-nutrient-flap-for-critical-ischemic-foot-a-case-report
#8
Kentaro Tanaka, Kimihiro Igari, Mitsuhiro Kishino, Satoshi Usami, Tsutomu Homma, Takahiro Toyofuku, Yoshinori Inoue, Mutsumi Okazaki
Microsurgical procedure of free tissue transfer in critical limb ischemia patients with large ulceration has already been established. The nutrient flap concept was that transferred tissue functioned not only to cover the skin defect but also as a supplementary blood supply to the ischemic lower leg. This report showed the justification for this concept, which was rarely discussed. A 58-year-old male patient with progressive forefoot gangrene caused by arteriosclerosis obliterans was presented. The distal bypass procedure was performed as revascularization surgery, and a latissimus dorsi (LD) myocutaneous flap was transplanted to cover ulceration...
August 2, 2017: Microsurgery
https://www.readbyqxmd.com/read/28765738/baseline-characteristics-of-a-retrospective-patient-cohort-in-the-korean-vascular-intervention-society-endovascular-therapy-in-lower-limb-artery-diseases-k-vis-ella-registry
#9
Young-Guk Ko, Chul-Min Ahn, Pil-Ki Min, Jae-Hwan Lee, Chang-Hwan Yoon, Cheol Woong Yu, Seung Whan Lee, Sang-Rok Lee, Seung Hyuk Choi, Yoon Seok Koh, In-Ho Chae, Donghoon Choi
BACKGROUND AND OBJECTIVES: The Korean Vascular Intervention Society Endovascular Therapy in Lower Limb Artery Diseases (K-VIS ELLA) Registry is a multicenter observational study with retrospective and prospective cohorts of patients with lower extremity peripheral artery disease (PAD) undergoing endovascular treatment. In this study, we report the baseline characteristics of this retrospective cohort. SUBJECTS AND METHODS: In the present study we analyzed datasets of 3073 patients with 3972 target limbs from a retrospective cohort treated with endovascular therapy in 31 Korean hospitals...
July 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28764607/recycling-and-reinforcing-intimomedial-flap-of-the-infrarenal-aorta-using-anterior-longitudinal-ligament-in-patients-with-acute-trauma-with-bowel-injuries
#10
Milan Jovanovic, Milan Radojkovic, Predrag Djordjevic, Dejan Rancic, Nemanja Jovanovic, Zoran Rancic
We present a patient with blunt abdominal trauma with severe acute right limb ischemia and clinical signs of diffuse peritonitis. Computed tomography angiography showed circumferential dissection of the infrarenal aorta with occlusion of the right common iliac artery. We opted for simultaneous abdomen exploration and open repair of injured aorta. Critical weakening of the aortic wall with imminent rupture was identified intraoperatively. Aortotomy cranially from bifurcation showed circumferential intimomedial dissection...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28762154/the-aortic-bifurcation-angle-as-a-factor-in-application-of-the-outback-for-femoropopliteal-lesions-in-ipsilateral-versus-contralateral-approaches
#11
Daniel Raskin, Boris Khaitovich, Shmuel Balan, Daniel Silverberg, Moshe Halak, Uri Rimon
PURPOSE: To assess the technical success of the Outback reentry device in contralateral versus ipsilateral approaches for femoropopliteal arterial occlusion. MATERIALS AND METHODS: A retrospective review of patients treated for critical limb ischemia (CLI) using the Outback between January 2013 and July 2016 was performed. Age, gender, length and site of the occlusion, approach site, aortic bifurcation angle, and reentry site were recorded. Calcification score was assigned at both aortic bifurcation and reentry site...
July 31, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28761352/use-of-angiotensin-converting-enzyme-inhibitors-and-freedom-from-amputation-after-lower-extremity-revascularization
#12
Jared E Kray, Viktor Y Dombrovskiy, Todd R Vogel
OBJECTIVE: Angiotensin-converting enzyme inhibitors (ACEIs) have not been well evaluated in conjunction with lower extremity revascularization (LER). This study evaluated freedom from amputation in patients who underwent either an open (OPEN) or endovascular (ENDO) revascularization with and without utilization of an ACEI. MATERIALS AND METHODS: Patients who underwent LER were identified from 2007-2008 Medicare Provider Analysis and Review files. Demographics, comorbidities, and disease severity were obtained...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28760065/risk-of-major-amputation-or-death-among-patients-with-critical-limb-ischemia-initially-treated-with-endovascular-intervention-surgical-bypass-minor-amputation-or-conservative-management
#13
Ehrin J Armstrong, Michael P Ryan, Erin R Baker, Brad J Martinsen, Harry Kotlarz, Candace Gunnarsson
AIMS: Patients with critical limb ischemia (CLI) have an increased risk of major amputation. The initial treatment approach for CLI may significantly impact the subsequent risk of major amputation or death. The objective of this study was to describe the initial treatment approaches of patients with CLI and the limb outcomes associated with each approach. METHODS: Data from MarketScan Commercial and Medicare Supplemental Databases from January 2006-December 2014 was utilized...
August 16, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28743226/endovascular-therapy-outcomes-and-intravascular-ultrasound-findings-in-thromboangiitis-obliterans-buerger-s-disease
#14
Osami Kawarada, Teruyoshi Kume, Shinobu Ayabe, Takako Nakaya, Michikazu Nakai, Kunihiro Nishimura, Teruo Noguchi, Yoshiaki Yokoi, Hisao Ogawa, Satoshi Yasuda
PURPOSE: To investigate outcomes of contemporary endovascular therapy and intravascular ultrasound (IVUS) findings in thromboangiitis obliterans (TAO) patients. METHODS: Between April 2007 and January 2016, 20 patients (mean age 45±8 years; 16 men) underwent endovascular therapy for TAO-related lesions in 25 consecutive limbs. Subjects exhibited a broad array of clinical symptoms, including critical limb ischemia (n=15) and claudication (10) in the lower (n=20) and upper (n=5) limbs...
August 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28741334/endovascular-treatment-of-chronic-occluded-popliteal-artery-aneurysm-early-and-mid-term-outcomes
#15
Vincenzo Ardita, Alessia Giaquinta, Matteo Orrico, Sonia Ronchey, Massimiliano Veroux, Nicola Mangialardi, Pierfrancesco Veroux
BACKGROUND: Critical limb ischemia (CLI) may be the consequence of chronic occluded popliteal artery aneurysm (PAA). Open repair (OR) offers better 5-year results than endovascular treatment, but in patients with severe comorbidities or unfit to OR, endovascular repair (ER) could represent a valid treatment option. The purpose of this retrospective study was to review our experience of endovascular popliteal aneurism repair (EVPAR) in patients with chronic occluded PAA. METHODS: The endpoints assessed were: 1- and 3-year primary and secondary patency rates, technical success, 30-day major adverse events, major amputation free-survival, re-intervention and survival rates...
July 24, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28741197/axillobifemoral-bypasses-reappraisal-of-an-extra-anatomic-bypass-by-analysis-of-results-and-prognostic-factors
#16
D Dickas, F Verrel, J Kalff, A Koscielny
BACKGROUND: Axillobifemoral bypass (AFB) is method of second choice. It is reserved for patients at high operative risk or to bypass infected vessels or grafts. In this study, we analyzed prognostic factors for AFB patency and limb salvage rate to facilitate the choice of procedure. METHODS: Between Jan 2006 and Aug 2013, 45 patients underwent AFB surgery in our department, 24 for critical limb ischemia (CLI) and 23 for infection. Endpoints of study were graft occlusion, graft infection, amputation and patient's death...
July 24, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28740785/coronary-artery-disease-in-patients-with-critical-limb-ischemia-undergoing-major-amputation-or-not
#17
Akio Nishijima, Naoto Yamamoto, Ryuichi Yoshida, Koji Hozawa, Satoshi Yanagibayashi, Megumi Takikawa, Rie Hayasaka, Junko Nishijima, Masahiko Gosho, Haruo Nishijima
BACKGROUND: Due to the increase of elderly and diabetes patients, surgeons encounter patients requiring treatment of critical limb ischemia (CLI) in the presence of systemic arteriosclerotic diseases. In this study, we retrospectively investigated the prevalence of coronary artery disease (CAD) in patients with CLI who underwent major (above-the-ankle) amputation or nonmajor amputation (below-the-ankle amputation or debridement of wound). METHODS: We retrospectively investigated 129 consecutive patients surgically managed for CLI in our institution between January 2013 and December 2015...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28739459/comparison-of-direct-and-less-invasive-techniques-for-the-treatment-of-severe-aorto-iliac-occlusive-disease
#18
Kimberly C Zamor, Andrew W Hoel, Irene B Helenowski, Adam W Beck, Joseph R Schneider, Karen J Ho
BACKGROUND: Severe aorto-iliac occlusive disease (AIOD) is traditionally treated with aorto-bifemoral (ABF) or aorto-unifemoral (AUF) bypass. However, cross-femoral bypass (CFB) and hybrid femoral endarterectomy and patch angioplasty with iliac stenting (EPS) have gained popularity as less invasive options. We sought to compare 1-year survival, primary patency, and major amputation rates between open surgical (ABF and AUF) and two less invasive reconstruction techniques (CFB and EPS) using a large, multicenter cohort...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28739455/decision-making-in-critical-limb-ischemia-a-markov-simulation
#19
Aaron J Deutsch, C Charles Jain, Kimberly G Blumenthal, Mark W Dickinson, Anne M Neilan
BACKGROUND: Critical limb ischemia (CLI) is a feared complication of peripheral vascular disease that often requires surgical management and may require amputation of the affected limb. OBJECTIVE: To use a decision model to inform clinical management for a 63-year-old woman with CLI and multiple medical comorbidities, including advanced heart failure and diabetes. METHODS: Markov decision model evaluating four strategies: amputation, surgical bypass, endovascular therapy (e...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28721011/effect-of-picroside-ii-on-hind-limb-ischemia-reperfusion-injury-in-rats
#20
Yiğit Kılıç, Abdullah Özer, Tolga Tatar, Mustafa Hakan Zor, Mehmet Kirişçi, Hakan Kartal, Ali Doğan Dursun, Deniz Billur, Mustafa Arslan, Ayşegül Küçük
INTRODUCTION: Many structural and functional damages are observed in cells and tissues after reperfusion of previously viable ischemic tissues. Acute ischemia reperfusion (I/R) injury of lower extremities occurs especially when a temporary cross-clamp is applied to the abdominal aorta during aortic surgery. Research regarding the treatment of I/R injury has been increasing day-by-day. In this study, we aimed to investigate the effect of picroside II on skeletal muscle of rats experiencing simulated I/R...
2017: Drug Design, Development and Therapy
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