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critical limb ischemia

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https://www.readbyqxmd.com/read/28527930/outcomes-of-open-and-endovascular-lower-extremity-revascularization-in-active-smokers-with-advanced-peripheral-arterial-disease
#1
Samuel L Chen, Matthew D Whealon, Nii-Kabu Kabutey, Isabella J Kuo, Michael D Sgroi, Roy M Fujitani
OBJECTIVE: Concern over perioperative and long-term durability of lower extremity revascularizations among active smokers is a frequent deterrent for vascular surgeons to perform elective lower extremity revascularization. In this study, we examined perioperative outcomes of lower extremity endovascular (LEE) revascularization and open lower extremity bypass (LEB) in active smokers with intermittent claudication (IC) and critical limb ischemia (CLI). METHODS: Active smokers undergoing LEE or LEB from 2011 to 2014 were identified in the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) targeted vascular data set...
June 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
#2
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...
May 13, 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
#3
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/28511618/midterm-results-of-low-profile-stents-to-treat-atherosclerotic-iliac-artery-disease
#4
Nicola Troisi, Leonardo Ercolini, Emiliano Chisci, Piefrancesco Frosini, Enrico Barbanti, Stefano Michelagnoli
PURPOSE: To evaluate the safety and effectiveness of low-profile 4-F stents for the treatment of atherosclerotic iliac artery lesions. METHODS: Between January 2009 and December 2015, 63 patients (mean age 69.3 years; 42 men) received low-profile stents (Astron Pulsar or Pulsar-18) at the discretion of the operator to treat iliac artery occlusive disease. The majority of patients (40, 63.5%) had critical limb ischemia; 36 of 82 lesions were total occlusions. All procedures were performed with 4-F equipment...
June 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28508349/the-contemporary-role-of-stents-and-angioplasty-for-the-treatment-of-infrapopliteal-disease-in-critical-limb-ischemia
#5
REVIEW
Tarek A Hammad, Anand Prasad
PURPOSE OF REVIEW: Critical limb ischemia (CLI) is associated with significant morbidity, mortality, and increased health care expenses. Revascularization has a central role in the treatment of CLI. Following publication of BASIL (bypass versus angioplasty in severe ischemia of the leg) trial a decade ago, an "endovascular first" approach had gained momentum and the technologies available for endovascular therapy have exponentially increased. Both the development of technology and technique, highlighted in this review, have allowed operators to treat complex infrapopliteal lesions which are central to CLI pathology...
July 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28507873/inferior-limb-salvage-by-combined-free-tissue-transfer-and-the-crane-principle-revisited
#6
Alessandro Thione, Pedro C Cavadas
Aggressive treatment of ischemia of the lower extremities has decreased the number of amputations in both diabetic and nondiabetic patients; combined vascular reconstruction and microvascular free-flap transfer has been used to improve distal perfusion and cover large tissue defects caused by the critical limb ischemia during the past 30 years. We present our experience with a 71-year-old diabetic patient who underwent revascularization with a vascular bypass and a simultaneous microvascular flap reconstruction for limb salvage after domestic trauma...
April 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28502550/lower-extremity-computed-tomography-angiography-can-help-predict-technical-success-of-endovascular-revascularization-in-the-superficial-femoral-and-popliteal-artery
#7
Nathan K Itoga, Tanner Kim, Anna M Sailer, Dominik Fleischmann, Matthew W Mell
OBJECTIVE: Preprocedural computed tomography angiography (CTA) assists in evaluating vascular morphology and disease distribution and in treatment planning for patients with lower extremity peripheral artery disease (PAD). The aim of the study was to determine the predictive value of radiographic findings on CTA and technical success of endovascular revascularization of occlusions in the superficial femoral artery-popliteal (SFA-pop) region. METHODS: Medical records and available imaging studies were reviewed for patients undergoing endovascular intervention for PAD between January 2013 and December 2015 at a single academic institution...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28502548/lifelong-limb-preservation-a-patient-centered-description-of-lower-extremity-arterial-reconstruction-outcomes
#8
Katie E Shean, Peter A Soden, Marc L Schermerhorn, Sara L Zettervall, Sarah E Deery, Jeremy D Darling, Allen Hamdan, Frank W LoGerfo
BACKGROUND: Life expectancy is short for patients with critical limb ischemia (CLI), many of whom may fear amputation more than death. In light of the reduced life expectancy of these patients, the traditional 5-year freedom from amputation (FFA) statistic may not accurately address their concern. We developed a more relevant patient-centered calculation of major amputation risk during a patient's remaining lifetime to better answer the question, Will I ever lose my leg? METHODS: We identified all limbs undergoing first-time intervention for CLI in a large institutional database from 2005 to 2013...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28502546/cryopreserved-saphenous-vein-as-a-last-ditch-conduit-for-limb-salvage
#9
Leigh Ann O'Banion, Bian Wu, Charles M Eichler, Linda M Reilly, Michael S Conte, Jade S Hiramoto
OBJECTIVE: In patients lacking autogenous vein suitable for infrainguinal bypass, cryopreserved saphenous vein (CSV) allograft (CryoLife, Inc, Kennesaw, Ga) may be an acceptable alternative. The purpose of this study was to examine outcomes of CSV conduit for infrainguinal revascularization. METHODS: Between February 2008 and August 2015, 70 patients underwent infrainguinal bypass grafts in 73 limbs using CSV. All patients lacked suitable arm or leg vein. Demographic data and patient outcomes were retrospectively collected using electronic medical records...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28495537/impact-of-nutritional-state-on-critical-limb-ischemia-early-outcomes-denucriticc-study
#10
Lucie Salomon du Mont, Betty Leclerc, Marie-Catherine Morgant, Guillaume Besch, Aline Laubriet, Eric Steinmetz, Simon Rinckenbach
INTRODUCTION: Despite current progress, the prognosis of critical limb ischemia (CLI) remains poor. The ageing of the population, the increasing prevalence of diabetes mellitus, and the stability of tabacco use will increase the prevalence of CLI. CLI patients have risk factors for malnutrition and the impact of malnutrition on morbidity and mortality has been demonstrated in the general population. However, we have little information on the consequences of the consequences of undernutrition in the CLI population...
May 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28488306/physician-initiated-first-in-human-clinical-study-using-a-novel-angiogenic-peptide-ag30-5c-for-patients-with-severe-limb-ulcers
#11
Hironori Nakagami, Toshifumi Yamaoka, Misa Hayashi, Atsushi Tanemura, Yasushi Takeya, Hitomi Kurinami, Ken Sugimoto, Ayumi Nakamura, Kazunori Tomono, Katsuto Tamai, Ichiro Katayama, Hiromi Rakugi, Yasufumi Kaneda
AIM: In patients with diabetes or ischemia, angiogenesis and infection control are required for chronic leg ulcers, which substantially impair patients' quality of life. We developed a novel functional peptide, named AG30/5C, with angiogenic and anti-microbial properties. Treatment with AG30/5C significantly accelerated the wound healing of full-thickness defects in mice. To evaluate the safety of AG30/5C in the treatment of leg ulcers, a physician-initiated clinical study was carried out...
May 10, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28488101/impact-of-chronic-renal-failure-on-safety-and-effectiveness-of-paclitaxel-eluting-stents-for-femoropopliteal-artery-disease-subgroup-analysis-from-zilver-ptx-post-market-surveillance-study-in-japan
#12
Yukihisa Ogawa, Hiroyoshi Yokoi, Takao Ohki, Kimihiko Kichikawa, Masato Nakamura, Kimihiro Komori, Shinsuke Nanto, Erin E O'Leary, Aaron E Lottes, Alan T Saunders, Michael D Dake
PURPOSE: Favorable long-term outcomes of the Zilver PTX drug-eluting stent (DES) in femoropopliteal lesions have been demonstrated. Chronic renal failure (CRF) has been shown to be a risk factor for restenosis and decreased limb salvage. The results of the DES in patients with CRF have not previously been reported. This study compares the results with the DES in patients with CRF and those without CRF. METHODS: This retrospective analysis from the Zilver PTX Japan Post-Market Surveillance Study included 321 patients with CRF and 584 patients without CRF...
May 9, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28483016/change-of-serum-angiopoietin-like-protein-2-and-its-significance-in-patients-with-arteriosclerotic-occlusion
#13
Yue Liang, Hao Nie, Hualiang Ren, Fangda Li, Cui Tian, Huihua Li, Yuehong Zheng
Objective To investigated the changes of angiopoietin-like protein 2(Angptl2) in patients with arteriosclerotic occlusion (ASO). Methods A total of 140 subjects including 75 ASO patients (ASO group) and 65 healthy subjects (control group) were enrolled in this study. Angptl2 and adiponectin were evaluated by using enzyme-linked immunosorbent assay. Biochemical data and high sensitive C reactive protein were measured and recorded as well. Results Compared to the control group,the ASO group presented with significantly higher level of plasma Angptl2 [(13...
April 20, 2017: Zhongguo Yi Xue Ke Xue Yuan Xue Bao. Acta Academiae Medicinae Sinicae
https://www.readbyqxmd.com/read/28479452/cumulative-number-of-treatment-interventions-predicts-health-related-quality-of-life-in-patients-with-critical-limb-ischemia
#14
Matthew A Corriere, Matthew P Goldman, Ryan Barnard, Santiago Saldana, Jeanette M Stafford, Douglas Easterling, Edward H Ip, Gregory L Burke
INTRODUCTION: Health-related quality of life (QOL) is usually assessed after a defined interval following a single intervention, but critical limb ischemia (CLI) is a chronic condition where multiple interventions are often required over a patient's lifetime. We hypothesized that the impact of CLI treatment interventions on QOL is diminished in the setting of multiple previous interventions. To test this hypothesis, we performed a cross-sectional study evaluating associations between cumulative number of previous PAD treatment interventions and QOL adjusting for both comorbidity and disease severity...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28479446/laser-atherectomy-for-the-treatment-of-peripheral-arterial-disease
#15
Alexandros Mallios, John Blebea, Bryan Buster, Ryan Messiner, Kevin Taubman, Harry Ma
OBJECTIVE: To investigate the clinical results of laser atherectomy in the treatment of peripheral arterial disease. METHODS: Retrospective analysis of consecutive patients undergoing laser atherectomy at a single institution during a seven year period by vascular surgeons and interventional cardiologists in a tertiary university-affiliated hospital. Clinical data was retrieved from patient charts and hospital electronic medical records along with the associated arteriograms...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28479423/treating-peripheral-artery-disease-in-the-wake-of-rising-costs-and-protracted-length-of-stay
#16
Grace J Wang, Benjamin M Jackson, Paul J Foley, Scott M Damrauer, Venkat Kalapatapu, Michael A Golden, Ronald M Fairman
OBJECTIVE: There has been growing scrutiny in the treatment of patients with peripheral artery disease (PAD) due to the utilization of resources to manage this complex patient population. The purpose of this study was to determine the factors associated with prolonged length of stay (LOS>7 days) following lower extremity bypass using data from the Vascular Quality Initiative (VQI) as well as to define the additional costs incurred due to prolonged LOS in our health system. METHODS: Summary statistics were performed of patients undergoing lower extremity bypass from 2010-2015...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28479421/outcomes-of-isolated-tibial-endovascular-intervention-for-rest-pain-in-patients-on-dialysis
#17
Hallie E Baer-Bositis, Taylor D Hicks, Georges M Haidar, Matthew J Sideman, Lori L Pounds, Mark G Davies
BACKGROUND: Tibial interventions for critical limb ischemia are frequent in patients with ESRD presenting with critical ischemia. The aim of this study was to examine impact of ESRD on the patient centered outcomes following tibial endovascular Intervention for rest pain METHODS: A database of patients undergoing lower extremity endovascular interventions between 2006 and 2016 was retrospectively queried. Patients with rest pain (Rutherford 4) were identified. Patients with claudication (Rutherford1 to 3) and Tissue Loss (Rutherford 5 and 6) were excluded...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28479156/multi-center-feasibility-study-of-microwave-radiometry-thermometry-for-non-invasive-differential-diagnosis-of-arterial-disease-in-diabetic-patients-with-suspected-critical-limb-ischemia
#18
Stavros Spiliopoulos, Vasiliki Theodosiadou, Nikolaos Barampoutis, Konstantinos Katsanos, Periklis Davlouros, Lazaros Reppas, Panagiotis Kitrou, Konstantinos Palialexis, Chrysostomos Konstantos, Elias Siores, Dimitrios Alexopoulos, Dimitris Karnabatidis, Elias Brountzos
AIMS: Diagnosis of vascular involvement in diabetic foot ulceration (DFU) remains challenging. We conducted a proof of concept study to investigate the feasibility of microwave radiometry (MWR) thermometry for non-invasive differential diagnosis of critical limb ischemia (CLI) in subjects with DFU. METHODS: This prospective, multi-center, study included 80 participants, divided into four groups (group N: normal control subjects; group DN: participants with diabetes and verified neuropathic ulcers without vascular involvement; group DC: participants with diabetes and CLI and group NDC: participants with CLI without diabetes)...
April 28, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28478711/ct-angiography-of-peripheral-arterial-disease-by-256-slice-scanner-accuracy-advantages-and-disadvantages-compared-to-digital-subtraction-angiography
#19
Atul Mishra, Narendra Jain, Anand Bhagwat
BACKGROUND: Peripheral arterial occlusive disease (PAOD) may cause disabling claudication or critical limb ischemia. Multidetector computed tomography (CT) technology has evolved to the level of 256-slice CT scanners which has significantly improved the spatial and temporal resolution of the images. This has provided the capability of chasing the contrast bolus at a fast speed enabling angiographic imaging of long segments of the body. These images can be reconstructed in various planes and various modes for detailed analysis of the peripheral vascular diseases which helps in making treatment decision...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28471016/a-novel-lesion-crossing-technique-balloon-deployment-using-forcible-manner-badform-technique
#20
Keisuke Nakabayashi, Hiroshi Ando, Nobuhito Kaneko, Manabu Shiozaki, Daisuke Sunaga, Akihiro Matsui, Kazuhiko Tanaka, Minoru Shimizu
OBJECTIVES: We evaluated the efficacy and safety of a novel endovascular technique for crossing arterial lesions: The BAlloon Deployment using FORcible Manner (BADFORM) technique. BACKGROUND: Endovascular treatment (EVT) for peripheral artery disease has been widely adopted, and developments in device technology and techniques have resulted in acceptable success rates. However, it may be difficult to deliver devices even after wire externalization, especially in the presence of an extremely long chronic total occlusion or severely calcified lesion...
May 4, 2017: Catheterization and Cardiovascular Interventions
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