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critical limb ischemia

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https://www.readbyqxmd.com/read/27921154/peripheral-stent-thrombosis-leading-to-acute-limb-ischemia-and-major-amputation-incidence-and-risk-factors-in-the-aortoiliac-and-femoropopliteal-arteries
#1
Konstantinos Katsanos, Said A M Al-Lamki, Aneeta Parthipun, Stavros Spiliopoulos, Sanjay Dhanji Patel, Ioannis Paraskevopoulos, Hany Zayed, Athanasios Diamantopoulos
PURPOSE: To report the real-world incidence and risk factors of stent thrombosis in the aortoiliac and femoropopliteal arteries in case of bare nitinol stent (BNS) or covered nitinol stent (CNS) placement from a single-centre retrospective audit. MATERIALS AND METHODS: Medical records of consecutive patients treated with peripheral stent placement for claudication or critical limb ischemia were audited for definite stent thrombosis defined as imaging confirmed stent thrombosis that presented as acute limb-threatening ischemia...
December 5, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27916029/-evaluation-between-bypass-surgery-and-endovascular-therapy-to-peripheral-arterial-disease-patients-with-critical-limb-ischemia
#2
S K Shen, D M Wu, C G Wang, L K Zhang, Q W Gang
Bypass surgery(BSX) and endovascular therapy(EVT) are the most important therapeutic method to critical limb ischemia.EVT has potential advantages in reducing surgical trauma and early postoperative complications, shortening hospital stay and so on. Concerning long-term results, BSX is better in reducing long-term mortality and improving long-term patency than EVT group. Therefore, control indications reasonably and select individualized methods, avoid the abuse of EVT are more meaningful for patients.
December 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27914820/cell-therapy-in-critical-limb-ischemia-a-comprehensive-analysis-of-two-cell-therapy-products
#3
Claire Tournois, Bernard Pignon, Marie-Antoinette Sevestre, Rida Al-Rifai, Valerie Creuza, Gaël Poitevin, Caroline François, Philippe Nguyen
BACKGROUND: Cell therapy has been proposed as a salvage limb procedure in critical limb ischemia (CLI). In spite of the fact that clinical trials found some efficacy, the mechanism of action remains elusive. The objective of this study was to characterize two autologous cell therapy products (CTPs) obtained from patients with advanced peripheral arterial disease. METHODS: Bone marrow (BM-CTPs) (n = 20) and CTPs obtained by non-mobilized cytapheresis (peripheral blood [PB]-CTPs) (n = 20) were compared...
November 30, 2016: Cytotherapy
https://www.readbyqxmd.com/read/27910185/drug-eluting-balloon-angioplasty-for-below-the-knee-lesions-in-end-stage-renal-disease-patients-with-critical-limb-ischemia-midterm-results
#4
Burak Teymen, Süleyman Aktürk
BACKGROUND: The 1-year restenosis rate after standard balloon angioplasty (BA) of long lesions in below-the-knee arteries may be as high as 70%. Our aim was to investigate the efficacy and safety of paclitaxel drug-eluting balloon (DEB) for treatment of below the knee lesions in end stage renal disease patients (ESRD) with critical limb ischemia (CLI). METHODS: Our study is a retrospective, single-center study. Inclusion criteria were ESRD, critical limb ischemia (Rutherford class 4 or higher) and significant stenosis or occlusion of at least 1 below-the-knee vessel...
December 2, 2016: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/27908824/arteriographic-patterns-of-atherosclerosis-and-the-association-between-diabetes-mellitus-and-ethnicity-in-chronic-critical-limb-ischemia
#5
Jayer Chung, J Gregory Modrall, Martyn Knowles, Qun Xiang, Lawrence A Lavery, Carlos H Timaran, R James Valentine
BACKGROUND: Disparate outcomes in critical limb ischemia (CLI) persist between ethnicities. The contribution of modifiable factors versus intrinsic biologic differences remains unclear. Hence, we aimed to quantify the associations between ethnicity and anatomic patterns of arterial occlusive disease in CLI, adjusting for known atherosclerotic risk factors. METHODS: We performed a retrospective, single-center review of consecutive patients presenting to the vascular surgery service with CLI...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27903480/long-term-outcomes-of-common-femoral-artery-stenting
#6
Bahaa Nasr, Adrien Kaladji, Pierre-Alexandre Vent, Philippe Chaillou, Alain Costargent, Thibault Quillard, Yann Gouëffic
OBJECTIVES: The purpose of this study was to report the 5-years outcome relative to endovascular repair of the common femoral artery for occlusive disease. MATERIALS/METHODS: 36 consecutive patients (40 limbs) underwent stenting for common femoral artery lesions. Patients were followed up systematically within a prospectively maintained database over 5 years. Follow-up included clinical examination, duplex scan and biplane x-ray at 1, 6, 12 months and yearly thereafter...
November 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27896226/use-of-the-directional-atherectomy-for-the-treatment-of-femoro-popliteal-lesions-in-patients-with-critical-lower-limb-ischemia
#7
Umberto Marcello Bracale, Gaetano Vitale, Guido Bajardi, Donatella Narese, Ettore Dinoto, Anna Maria Giribono, Doriana Ferrara, Luca Del Guercio, Massimo Midiri, Felice Pecoraro
: Femoro-popliteal PTA for the treatment of critical limb ischemia is frequently associated with unsatisfactory procedural success rates while directional atherectomy (DCA) has improved success rate since claudicant patients undergoing percutaneous treatment of femoro-popliteal obstructive disease. The aim of this prospective study is to evaluate the safety, efficacy and procedural success of DCA, at one year, in the percutaneous treatment of femoro-popliteal obstructive disease in patients with critical limb ischemia...
November 2016: Translational Medicine @ UniSa
https://www.readbyqxmd.com/read/27896186/use-of-a-temporary-shunt-as-a-salvage-technique-for-distal-extremity-amputations-requiring-repair-by-vessel-grafting-during-critical-ischemia
#8
Bilsev Ince, Mehmet Dadaci, Zeynep Altuntas
BACKGROUND: Although the use of temporary shunts in proximal extremity amputations has been reported, no study has described the use of temporary shunts in distal extremity amputations that require vein grafting. Moreover, the total volume of blood loss when temporary shunts are used has not been reported. The aim of this study was to investigate the applicability of a temporary shunt for distal extremity amputations requiring repair by vessel grafting with an ischemia time of >6 hours...
November 2016: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/27890836/microcirculation-evaluated-by-intraoperative-fluorescence-angiography-after-tibial-bypass-surgery
#9
Ulrich Rother, Werner Lang, Raymund E Horch, Ingo Ludolph, Alexander Meyer, Susanne Regus
OBJECTIVE: Intact microperfusion of the foot in the critical ischemic limb remains a crucial condition for ulcer healing. Aim of this clinical study was to evaluate the immediate effect of tibial bypass surgery on the microcirculation by usage of fluorescence angiography. METHODS: Prospective analysis of 33 patients presenting with critical limb ischemia (Rutherford 4 to 6) undergoing tibial bypass surgery was performed. Macroperfusion was investigated by measurement of ankle-brachial index...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27879958/evaluation-of-a-6-year-old-multicentric-standard-endovascular-treatment-of-critical-limb-ischemia-in-the-drug-eluting-era
#10
Vincenzo Brizzi, Caroline Caradu, Xavier Berard, Gerard Sassoust, Dominique Midy, Eric Ducasse
BACKGROUND: There has been increasing evidence to support the endovascular- first approach in the treatment of below the knee (BTK) lesions. Plain Old Balloon Angioplasty (POBA), with bailout bare-metal stent scaffolding in case of flow limiting dissection or recoil, have been considered the standard treatment of choice but industries are continually developing innovative equipment and dedicated technologies, such as drug-eluting platforms whose use is increasingly extended, despite significant costs and lack of high-quality evidence to support a well- established strategy...
November 23, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27876523/quality-of-life-assessment-as-an-outcomes-measure-in-critical-limb-ischemia
#11
Olamide Alabi, Matthew Roos, Gregory Landry, Gregory Moneta
Critical limb ischemia (CLI) is a diagnosis plagued by significant comorbidity and high mortality rates. Overall survival remains poor in this population regardless of the procedure-related success as demonstrated by freedom from amputation, intervention, and patency. The literature has traditionally focused on physician-centered and lesion-centered outcomes with regards to limb salvage procedures, but there remains a relative paucity of studies of CLI patients describing patient-centered outcomes such as quality of life (QoL), independent living, and ambulation status...
November 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27876517/clinical-effects-of-single-or-double-tibial-artery-revascularization-in-critical-limb-ischemia-patients-with-tissue-loss
#12
Norihiro Kobayashi, Keisuke Hirano, Masahiro Yamawaki, Motoharu Araki, Hideyuki Takimura, Yasunari Sakamoto, Shinsuke Mori, Yoshiaki Ito
OBJECTIVE: The achievement of single vessel inflow to the wound is an acceptable end point of peripheral vascular intervention for patients with critical limb ischemia (CLI) with tissue loss. However, CLI patients often have multitibial artery lesions. We evaluated the clinical effects of single or double tibial artery revascularization for CLI patients. METHODS: This study was conducted retrospectively in a single center. Between April 2007 and January 2015, we treated 123 CLI patients (137 limbs) who had lesions in both the anterior tibial artery and the posterior tibial artery...
November 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27876411/disruption-of-mitochondrial-quality-control-in-peripheral-artery-disease-new-therapeutic-opportunities
#13
REVIEW
Cintia B Ueta, Katia S Gomes, Márcio A Ribeiro, Daria Mochly-Rosen, Julio C B Ferreira
Peripheral artery disease (PAD) is a multifactorial disease initially triggered by reduced blood supply to the lower extremities due to atherosclerotic obstructions. It is considered a major public health problem worldwide, affecting over 200 million people. Management of PAD includes smoking cessation, exercise, statin therapy, antiplatelet therapy, antihypertensive therapy and surgical intervention. Although these pharmacological and non-pharmacological interventions usually increases blood flow to the ischemic limb, morbidity and mortality associated with PAD continue to increase...
November 19, 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/27871493/diabetes-does-not-worsen-outcomes-following-infrageniculate-bypass-or-endovascular-intervention-for-patients-with-critical-limb-ischemia
#14
Caitlin W Hicks, Alireza Najafian, Alik Farber, Matthew T Menard, Mahmoud B Malas, James H Black, Christopher J Abularrage
OBJECTIVE: Both open surgery and endovascular peripheral interventions have been shown to effectively improve outcomes in patients with peripheral arterial disease, but minimal data exist comparing outcomes performed at and below the knee among patients with diabetes (DM) specifically. The purpose of this study is to compare outcomes following open bypass (lower extremity bypass [LEB]) and peripheral vascular intervention (PVI) at and below the knee in patients with DM vs patients without DM (non-DM) with critical limb ischemia...
December 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27866700/angiopoietin-related-growth-factor-is-independently-associated-with-lower-extremity-peripheral-arterial-disease
#15
Hao Nie, Yue Liang, Hong-Xia Wang, Hua-Liang Ren, Yue-Wei Wang, Fang-Da Li, Yue-Hong Zheng
AIMS: The present study investigated the association of serum levels of angiopoietin-related growth factor (AGF) with lower extremity peripheral arterial disease (LEPAD). METHODS: The study group is comprised of 105 patients with lower extremity peripheral arterial disease. The control group consisted of 80 individuals without lower extremity peripheral arterial disease. Serum AGF concentrations were determined by enzyme-linked immunosorbent assay. The relationship between AGF and clinical and biochemical parameters was studied...
October 27, 2016: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/27865638/incidence-and-clinical-outcomes-of-the-slow-flow-phenomenon-after-infrapopliteal-balloon-angioplasty
#16
Takahiro Tokuda, Keisuke Hirano, Yasunari Sakamoto, Hideyuki Takimura, Norihiro Kobayashi, Motoharu Araki, Masahiro Yamawaki, Yoshiaki Ito
OBJECTIVE: This study investigated the incidence and clinical relevance of the slow-flow phenomenon after infrapopliteal balloon angioplasty. METHODS: This retrospective, single-center study included 161 consecutive patients with critical limb ischemia (173 limbs) who underwent endovascular treatment for infrapopliteal lesions between January 2012 and May 2015. The overall technical success rate was 88%. Of these lesions, 30 limbs presented with slow flow after angioplasty...
November 16, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27862880/feasibility-and-1-year-outcomes-of-subintimal-revascularization-with-supera-%C3%A2-stenting-of-long-femoropopliteal-occlusions-in-critical-limb-ischemia-the-supersub-study
#17
Luis M Palena, Larry J Diaz-Sandoval, Enrico Sultato, Cesare Brigato, Alessandro Candeo, Enrico Brocco, Marco Manzi
BACKGROUND: Stent-based revascularization of long femoro-popliteal (FP) lesions has been mainly studied in claudicants and compromised by restenosis and stent fractures. The Supera(®) stent's biomimetic design allows enhanced fracture resistance. Data for Supera(®) stenting to treat long chronic total occlusions (CTOs) in patients with critical limb ischemia (CLI), are scarce. OBJECTIVE: To assess long-term outcomes of subintimal revascularization with Supera(®) stenting, for long FP CTOs in patients with CLI...
November 12, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27856799/reloadable-multidrug-capturing-delivery-system-for-targeted-ischemic-disease-treatment
#18
Jasmine P J Wu, Bill Cheng, Steve R Roffler, David J Lundy, Christopher Y T Yen, Peilin Chen, James J Lai, Suzie H Pun, Patrick S Stayton, Patrick C H Hsieh
Human clinical trials of protein therapy for ischemic diseases have shown disappointing outcomes so far, mainly because of the poor circulatory half-life of growth factors in circulation and their low uptake and retention by the targeted injury site. The attachment of polyethylene glycol (PEG) extends the circulatory half-lives of protein drugs but reduces their extravasation and retention at the target site. To address this issue, we have developed a drug capture system using a mixture of hyaluronic acid (HA) hydrogel and anti-PEG immunoglobulin M antibodies, which, when injected at a target body site, can capture and retain a variety of systemically injected PEGylated therapeutics at that site...
November 16, 2016: Science Translational Medicine
https://www.readbyqxmd.com/read/27853962/enhanced-peripheral-dopamine-impairs-post-ischemic-healing-by-suppressing-angiotensin-receptor-type-1-expression-in-endothelial-cells-and-inhibiting-angiogenesis
#19
Chandrani Sarkar, Ramesh K Ganju, Vincent J Pompili, Debanjan Chakroborty
Increased circulating catecholamines have been linked with cardiovascular anomalies as well as with peripheral vascular diseases. Although the roles of epinephrine and norepinephrine have received considerable attention, the role of the other catecholamine, dopamine, has been less studied. Since dopamine is a potent endogenous inhibitor of angiogenesis and as angiogenesis is essential for ischemic healing, we therefore studied the role played by dopamine during ischemic healing using dopamine D2 receptor knockout (KOD2) mice...
November 16, 2016: Angiogenesis
https://www.readbyqxmd.com/read/27847443/increasing-injection-frequency-enhances-the-survival-of-injected-bone-marrow-derived-mesenchymal-stem-cells-in-a-critical-limb-ischemia-animal-model
#20
Woong Chol Kang, Pyung Chun Oh, Kyounghoon Lee, Taehoon Ahn, Kyunghee Byun
Critical limb ischemia (CLI) is one of the most severe forms of peripheral artery diseases, but current treatment strategies do not guarantee complete recovery of vascular blood flow or reduce the risk of mortality. Recently, human bone marrow derived mesenchymal stem cells (MSCs) have been reported to have a paracrine influence on angiogenesis in several ischemic diseases. However, little evidence is available regarding optimal cell doses and injection frequencies. Thus, the authors undertook this study to investigate the effects of cell dose and injection frequency on cell survival and paracrine effects...
November 2016: Korean Journal of Physiology & Pharmacology
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