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critical limb ischemia

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https://www.readbyqxmd.com/read/29124029/femoro-supragenicular-popliteal-bypass-with-a-bridging-stent-graft-in-a-diffusely-diseased-distal-target-popliteal-artery-alternative-to-below-knee-popliteal-polytetrafluoroethylene-bypass
#1
Joung Hun Byun, Tae Gyu Kim, Yun Gyu Song
Background: Lesions in distal target arteries hinder surgical bypass procedures in patients with peripheral arterial occlusive disease. Methods: Between April 2012 and October 2015, 16 patients (18 limbs) with lifestyle-limiting claudication (n=12) or chronic critical limb ischemia (n=6) underwent femoral-above-knee (AK) polytetrafluoroethylene (PTFE) bypass grafts with a bridging stent graft placement between the distal target popliteal artery and the PTFE graft...
October 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29124028/inter-facility-transport-on-extracorporeal-life-support-clinical-outcomes-and-comparative-analysis-with-in-house-patients
#2
Tae Hee Hong, Heemoon Lee, Jae Jun Jung, Yang Hyun Cho, Kiick Sung, Ji-Hyuk Yang, Young-Tak Lee, Su Hyun Cho
Background: Extracorporeal life support (ECLS) is widely used in refractory heart or lung failure, and the demand for inter-facility transportation on ECLS is expanding. However, little is known about post-transportation outcomes, the clinical safety of such transportation, or the characteristics of the transported patients. Methods: This was a retrospective review of a 3-year, single-institution experience with inter-facility ECLS transport, as well as a comparative analysis of clinical outcomes with those of in-house patients...
October 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29122449/long-term-effectiveness-of-the-zilver-ptx-drug-eluting-stent-for-femoropopliteal-peripheral-artery-disease-in-patients-with-no-patent-tibial-runoff-vessels-results-from-the-zilver-ptx-japan-post-market-surveillance-study
#3
Stefano Cipollari, 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: To evaluate 2-year results of the Zilver PTX (Cook Medical, Bloomington, Indiana) drug-eluting stent (DES) for femoropopliteal peripheral artery disease (PAD) in patients with no continuous patent infrapopliteal runoff arteries compared with patients with ≥ 1 continuous patent runoff vessels. MATERIALS AND METHODS: A retrospective analysis of patients with femoropopliteal PAD enrolled in the Zilver PTX Post-Market Surveillance Study in Japan was performed...
November 7, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29117818/one-year-outcomes-following-directional-atherectomy-of-popliteal-artery-lesions-subgroup-analysis-of-the-prospective-multicenter-definitive-le-trial
#4
Aljoscha Rastan, James F McKinsey, Lawrence A Garcia, Krishna J Rocha-Singh, Michael R Jaff, Stuart Harlin, Suraj Kamat, Sean Janzer, Thomas Zeller
PURPOSE: To report the effectiveness of directional atherectomy for the treatment of popliteal artery occlusive disease. METHODS: This subset of the prospective, multicenter, single-arm DEFINITIVE LE trial included 158 patients (mean age 72.0±10.9 years; 82 men) who underwent directional atherectomy in 162 popliteal artery lesions between 2009 and 2011. Forty-eight (30.4%) patients were suffering from critical limb ischemia (CLI). The mean lesion length was 5.8±3...
November 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29103849/the-effect-of-skin-pigmentation-on-determination-of-limb-ischemia
#5
Elizabeth M Polfer, Ryan M Zimmerman, Eshetu Tefera, Ryan D Katz, James P Higgins, Kenneth R Means
PURPOSE: Timely identification of tissue ischemia is critical, both in the traumatized limb and following free tissue transfer. The purpose of this study was to determine if skin pigmentation affects the ability to detect limb ischemia. METHODS: We conducted a study of healthy controls exposed to limb ischemia. The subjects were classified based on skin pigmentation using a defined skin type assessment tool, a visual color scale, and self-description of race. Participants were randomized by limb and tourniquet status; surgeons were blinded to both...
November 2, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29100807/predictors-of-delayed-wound-healing-after-successful-isolated-below-the-knee-endovascular-intervention-in-patients-with-ischemic-foot-ulcers
#6
Sushant Kumar Das, Yi Feng Yuan, Mao Quan Li
OBJECTIVE: The purpose of this study was to explore the predictors of delayed wound healing and their use in risk stratification for endovascular treatment (EVT) of patients with critical limb ischemia (CLI) due to isolated below-the-knee lesions. METHODS: Wound healing rates were analyzed retrospectively in patients who underwent successful below-the-knee percutaneous transluminal balloon angioplasty for CLI with tissue loss between May 2008 and June 2013. We also analyzed the independent predictors of delayed wound healing and their use in risk stratification...
October 31, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29088925/predictive-value-of-underweight-status-for-patients-with-peripheral-artery-disease-with-claudication
#7
Keisuke Senda, Takashi Miura, Masatoshi Minamisawa, Yasushi Ueki, Tomoaki Mochidome, Hidetomo Nomi, Wataru Shoin, Satoko Higuchi, Yasutaka Oguchi, Hitoshi Nishimura, Tatsuya Saigusa, Soichiro Ebisawa, Hirohiko Motoki, Atsushi Izawa, Jun Koyama, Uichi Ikeda, Koichiro Kuwahara
We evaluated whether underweight status is associated with poor prognosis in patients with peripheral artery disease (PAD) with claudication, excluding critical limb ischemia. We identified 441 claudicants hospitalized for cardiovascular disease between 2005 and 2012. Patients were divided into 4 groups according to body mass index (BMI): an underweight group (BMI < 18.5 kg/m(2); n = 48), a normal group (BMI = 18.5-25.0 kg/m(2); n = 286), an overweight group (BMI = 25.0-30.0 kg/m(2); n = 92), and an obese group (BMI ≥ 30...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/29079519/n-acetylcysteine-effects-on-a-murine-model-of-chronic-critical-limb-ischemia
#8
Wallace Aguiar de Medeiros, Leandro Almeida da Silva, Dhébora Mozena Dall'Igna, Monique Michels, Andressa Manfredini, Juliano Dos Santos Cardoso, Larissa de Souza Constantino, Giselli Scaini, Francieli Vuolo, Emílio L Streck, Cristiane Ritter, Felipe Dal-Pizzol
During chronic limb ischemia, oxidative damage and inflammation are described. Besides oxidative damage, the decrease of tissue oxygen levels is followed by several adaptive responses. The purpose of this study was to determine whether supplementation with N-acetylcysteine (NAC) is effective in an animal model of chronic limb ischemia. Chronic limb ischemia was induced and animals were treated once a day for 30 consecutive days with NAC (30mg/kg). After this time clinical scores were recorded and soleus muscle was isolated and lactate levels, oxidative damage and inflammatory parameters were determined...
October 24, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/29074110/evaluation-of-a-new-model-of-hind-limb-ischemia-in-rabbit
#9
Costantino Del Giudice, Gabriel Ifergan, Guillaume Goudot, Valerie Bellamy, Emmanuel Messas, Olivier Clement, Patrick Bruneval, Philippe Menasche, Marc Sapoval
OBJECTIVE: Various animal models of critical limb ischemia have been developed in the past. However, there is no animal model that can undergo endovascular treatment, while providing reproducible true critical limb ischemia with arterial ulcers and rest pain. We evaluated the efficacy of a new model of rabbit hindlimb ischemia created through a percutaneous approach using embolization with calibrated particles. METHODS: Through a percutaneous transauricular artery approach and selective catheterization of the superficial femoral artery, embolization of distal limb vessels was performed using a mixture of 300- to 500-μm calibrated microparticles (Embosphere, Merit Medical, Salt Lake City, Utah), saline solution, and iodine contrast...
October 23, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29072090/hospital-cost-impact-of-orbital-atherectomy-with-angioplasty-for-critical-limb-ischemia-treatment-a-modeling-approach
#10
Nicolas W Shammas, Christopher W Boyes, Swetha R Palli, John A Rizzo, Brad J Martinsen, Harry Kotlarz, J A Mustapha
AIM: The incremental cost of peripheral orbital atherectomy system (OAS) plus balloon angioplasty (BA) versus BA-only for critical limb ischemia was estimated. MATERIALS & METHODS: A deterministic simulation model used clinical and healthcare utilization data from the CALCIUM 360° trial and current cost data. Incremental cost of OAS + BA versus BA-only included differential utilization during the procedure and adverse-event costs at 3, 6 and 12-months. RESULTS: For every 100 procedures, incremental annual costs to the hospital were USD$350,930 lower with OAS + BA compared with BA-only...
October 26, 2017: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/29054354/strategies-to-reduce-ischemia-reperfusion-injury-in-vascularized-composite-allotransplantation-of-the-limb
#11
REVIEW
Kavit R Amin, Jason K F Wong, James E Fildes
An important and often underinvestigated contributor to solid organ transplant rejection is ischemia reperfusion injury. This pathophysiological response releases damaging reactive oxygen species and cell stress signals that initiate inflammation, which has a critical role in priming the immune system for allorecognition. In time, this renders graft dysfunction and how this response is mediated in composite tissues remains unknown. Current protocols are drawn from solid organ transplantation with little scientific basis as to how this informs current hand transplantation practices...
October 18, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29043840/comparison-of-two-methods-based-on-photoplethysmography-for-the-diagnosis-of-peripheral-arterial-disease
#12
Christian Høyer, Nikolaj Schandorph Nielsen, Malene Kragh Overvad Jordansen, Helle Damgaard Zacho
AIM: To examine the interchangeability of two methods for distal pressure measurement based on photoplethysmography using a truncated or full display of the arterial inflow curve, respectively. METHODS: Toe and ankle pressures were obtained from 69 patients suspected of peripheral arterial disease (PAD). Observer reproducibility of the curve readings was examined by blinded reassessment of the pressure curves in a randomly selected subgroup (60 limbs). RESULTS: There were no significant differences in mean pressures between the two methods (p for all > ...
October 18, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/29038874/ultrasound-guided-popliteal-sciatic-block-provides-adequate-analgesia-during-urgent-endovascular-treatment-of-critical-limb-ischemia-with-resting-pain
#13
Derya Tureli, Sinan Deniz, Aytekin Unlukaplan, Levent Oguzkurt
PURPOSE: To demonstrate feasibility and safety of ultrasound-guided popliteal sciatic nerve block for providing analgesia during urgent endovascular treatment of critical limb ischemia with resting pain. MATERIALS AND METHODS: Ultrasound-guided popliteal sciatic blocks were performed by an interventional radiologist in angiography suite immediately prior to commencement of urgent endovascular treatment of 30 critical limb ischemia patients. Subjective pain levels prior to and following sciatic block were assessed using the visual analog scale (VAS)...
October 16, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29038476/pro-angiogenic-effect-of-rantes-loaded-polysaccharide-based-microparticles-for-a-mouse-ischemia-therapy
#14
N Suffee, C Le Visage, H Hlawaty, R Aid-Launais, V Vanneaux, J Larghero, O Haddad, O Oudar, N Charnaux, A Sutton
Peripheral arterial disease results from the chronic obstruction of arteries leading to critical hindlimb ischemia. The aim was to develop a new therapeutic strategy of revascularization by using biodegradable and biocompatible polysaccharides-based microparticles (MP) to treat the mouse hindlimb ischemia. For this purpose, we deliver the pro-angiogenic chemokine Regulated upon Activation, Normal T-cell Expressed and Secreted (RANTES)/CCL5 in the mouse ischemic hindlimb, in solution or incorporated into polysaccharide-based microparticles...
October 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29034032/current-perspective-on-hemodialysis-patients-with-peripheral-artery-disease
#15
REVIEW
Shin Okamoto, Osamu Iida, Toshiaki Mano
The prevalence of peripheral artery disease is substantially higher in patients on chronic hemodialysis than in the general population. The presence of calcified lesions characteristic of hemodialysis patients has an adverse influence on the initial success and long-term outcomes of both surgical bypass and endovascular therapy. Although the selection of revascularization strategy depends on whether an autologous vein is available and if the patient has a life expectancy of at least two years, it is difficult to predict the life expectancy in a real-world clinical situation...
June 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29034014/improving-the-outcome-of-vein-grafts-should-vascular-surgeons-turn-veins-into-arteries
#16
REVIEW
Toshihiko Isaji, Takuya Hashimoto, Kota Yamamoto, Jeans M Santana, Bogdan Yatsula, Haidi Hu, Hualong Bai, Guo Jianming, Tambudzai Kudze, Toshiya Nishibe, Alan Dardik
Autogenous vein grafts remain the gold standard conduit for arterial bypass, particularly for the treatment of critical limb ischemia. Vein graft adaptation to the arterial environment, i.e., adequate dilation and wall thickening, contributes to the superior performance of vein grafts. However, abnormal venous wall remodeling with excessive neointimal hyperplasia commonly causes vein graft failure. Since the PREVENT trials failed to improve vein graft outcomes, new strategies focus on the adaptive response of the venous endothelial cells to the post-surgical arterial environment...
March 24, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29032905/analysis-of-wound-healing-time-and-wound-free-period-as-outcomes-after-surgical-and-endovascular-revascularization-for-critical-lower-limb-ischemia
#17
Jin Okazaki, Daisuke Matsuda, Kiyoshi Tanaka, Masaru Ishida, Sosei Kuma, Koichi Morisaki, Tadashi Furuyama, Yoshihiko Maehara
BACKGROUND: Traditional end points, such as amputation-free survival, used to assess the clinical effectiveness of lower limb revascularization have shortcomings because they do not account independently for wound nonhealing and recurrence or patient survival. Wound healing process and maintenance of a wound-free state after revascularization were not well-studied. The aim of this study was to elucidate the long-term clinical course of ischemic wounds after revascularization. We focused on initial wound healing process as well as the maintenance of a wound-free state after achievement of wound healing...
October 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29025216/assisted-salvage-of-ischemic-fasciocutaneous-flap-using-adipose-derived-mesenchymal-stem-cells-in-situ-revascularization
#18
Michael H Carstens, Mauricio Mendieta, Cecilia Pérez, Esperanza Villareal, Rodolfo Garcia
Adipose-derived mesenchymal stem cells (ASCs) have been shown to produce vascular endothelial growth factor (VEGF) and can increase perfusion in patients with critical limb ischemia. We will show that this concept can be applied to augment blood flow in zones of flap ischemia. We presented a case study of a 26-year-old man with a complex hand injury covered by a reverse radial perforator fasciocutaneous flap, which developed ischemic necrosis and was treated by debridement, transplantation of ASCs to enhance vascular support, and saline dressings...
July 1, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/29022506/autologous-cell-therapy-for-vascular-regeneration-the-role-of-proangiogenic-cells
#19
Vanessa Bianconi, Francesca Fallarino, Massimo Raffaele Mannarino, Francesco Bagaglia, Meisam Naeimi Kararoudi, Caterina Oriana Aragona, Rita Romani, Matteo Pirro
Autologous cell therapy represents a novel treatment option for vascular regeneration in different disease conditions. Both experimental and clinical studies indicate a therapeutic potential for different proangiogenic cells (PCs), including endothelial progenitor cells (EPCs) in the treatment of peripheral artery disease. A significant improvement of ischemic symptoms has been reported in different trials evaluating PCs for the treatment of critical limb ischemia. However, contrasting results from different meta-analyses question the efficacy of PC-based approaches on long-term outcomes, including amputation and survival...
October 12, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28988828/epigenetics-and-cardiovascular-regenerative-medicine-in-the-elderly
#20
REVIEW
Sarah Costantino, Giovanni G Camici, Shafeeq Ahmed Mohammed, Massimo Volpe, Thomas F Lüscher, Francesco Paneni
Cardiovascular disease (CVD) is a recognized age-dependent condition whose incidence is set to increase due to the gradual aging of the population. Moreover, ischemic cardiovascular diseases (i.e. stroke, myocardial infarction, critical limb ischemia) requiring blood vessel growth are associated with a worse outcome in elderly patients. Therefore, understanding the molecular cues regulating the vascular repair process is of paramount importance to prevent undesirable cardiovascular complications in this setting...
September 27, 2017: International Journal of Cardiology
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