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critical limb ischemia

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https://www.readbyqxmd.com/read/28654852/adductor-canal-compression-syndrome-in-an-18-year-old-female-patient-leading-to-acute-critical-limb-ischemia-a-case-report
#1
Yi Zhou, Evan J Ryer, Robert P Garvin, Jeremy L Irvan, James R Elmore
BACKGROUND: Adductor canal compression syndrome is a rare non-atherosclerotic cause of arterial occlusion and limb ischemia. PRESENTATION OF CASE: The patient is an 18-year-old healthy female who presented to the emergency department with acute left lower extremity ischemia. Her symptoms began as sudden onset mild foot pain approximately two months ago. Over the 72h prior to presentation, she developed severe pain, pallor, paralysis, loss of pedal pulses, paresthesia, and poikilothermia...
June 17, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28654542/percutaneous-vascular-interventions-versus-bypass-surgeries-in-patients-with-critical-limb-ischemia-a-comprehensive-meta-analysis
#2
Jiarong Wang, Chi Shu, Zhoupeng Wu, Jichun Zhao, Yukui Ma, Bin Huang, Ding Yuan, Yi Yang, He Bian, Yazhou He, Ziqiang Wang
OBJECTIVE: The aim of our study was to compare percutaneous vascular interventions (PVI) versus bypass surgeries (BSX) in patients with critical limb ischemia (CLI). BACKGROUND: Previous relevant reviews with limited numbers of included studies did not strictly confine the inclusion criteria to CLI, also involving patients with severe claudication, which may introduce bias in the decision-making of CLI revascularization. Current treatment strategies for CLI still remain controversial...
June 26, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28648651/the-impact-of-functional-status-on-the-outcomes-of-endovascular-lower-extremity-revascularization-for-critical-limb-ischemia-in-the-elderly
#3
Isidore Dinga Madou, Martin D Slade, Kristine C Orion, Timur Sarac, Cassius Iyad Ochoa Chaar
INTRODUCTION: Functional status is an important predictor of outcomes after infrainguinal bypass surgery. There is little data on the effect of functional status on the outcomes of endovascular LE interventions, especially in the elderly frail population. METHODS: This is a retrospective analysis of the American College of Surgeons - National Surgical Quality Improvement Program (ACS-NSQIP) files for the years 2011-2013 to assess the impact of functional status on outcome after endovascular intervention for critical limb ischemia...
June 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28648324/drug-coated-balloon-angioplasty-for-the-management-of-recurring-infrapopliteal-disease-in-diabetic-patients-with-critical-limb-ischemia
#4
Luis M Palena, Larry J Diaz-Sandoval, Efren Gòmez Jabalera, Olga Peypoch Perez, Enrico Sultato, Cesare Brigato, Enrico Brocco, Marco Manzi
OBJECTIVE: To describe the 1-year outcomes of recurring infrapopliteal disease after endovascular revascularization with the Lutonix drug-coated balloons (LDCB) in diabetic patients with critical limb ischemia (CLI), and to benchmark our findings with previously published objective performance goals (OPG) addressing safety and efficacy of new catheter-based therapies for CLI. METHODS: The present study was a retrospective, single-center, and single-arm trial of symptomatic diabetic patients with CLI, who underwent LDCB-angioplasty for recurring infrapopliteal disease...
June 20, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28647640/bypass-surgery-after-endovascular-therapy-for-infrapopliteal-lesion-is-not-a-poor-outcome-compared-with-initial-bypass-surgery-by-vascular-surgeons
#5
Koichi Morisaki, Terutoshi Yamaoka, Kazuomi Iwasa, Takahiro Ohmine
PURPOSE: It is unclear whether prior endovascular therapy (EVT) adversely affects bypass surgery. The aim of this study is to investigate treatment outcomes between initial bypass (bypass-first) and bypass surgery after EVT (EVT-first). METHODS: We conducted a retrospective analysis of critical limb ischemia patients undergoing infrapopliteal bypass between November 2006 and December 2015. Graft patency, limb salvage (LS), amputation-free survival (AFS), and overall survival (OS) were examined between bypass-first and EVT-first groups...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28647629/histological-analysis-of-a-new-route-after-subintimal-crural-angioplasty
#6
Daijirou Akamatsu, Fumiyoshi Fujisima, Hitoshi Goto, Munetaka Hashimoto, Ken Tsuchida, Keiichirou Kawamura, Yuta Tajima, Michihisa Umetsu, Syunya Suzuki, Takashi Kamei
BACKGROUND: Subintimal angioplasty is an alternative approach in treating critical limb ischemia with crural artery disease. However, route or location of the newly created channel is not understood. CASE PRESENTATION: A 68-year-old man was referred to our hospital with ischemic gangrene of the right big toe. We performed endovascular treatment because he was a poor candidate for bypass surgery. The posterior tibial artery was treated using subintimal angioplasty, though it resulted in early occlusion...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28647199/influence-of-frailty-on-treatment-outcomes-after-revascularization-in-patients-with-critical-limb-ischemia
#7
Koichi Morisaki, Terutoshi Yamaoka, Kazuomi Iwasa, Takahiro Ohmine
OBJECTIVE: It is unclear whether frailty adversely affects treatment outcomes in patients with critical limb ischemia (CLI). The aim of this study was to investigate the influence of frailty on CLI patients after revascularization. METHODS: Patients undergoing infrapopliteal revascularization between 2007 and 2015 were retrospectively analyzed. The patient was defined as CLI frail when two or more of the following were present: low Geriatric Nutritional Risk Index, low skeletal muscle mass index, or nonambulatory status...
June 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28646446/innovations-in-the-endovascular-management-of-critical-limb-ischemia-retrograde-tibiopedal-access-and-advanced-percutaneous-techniques
#8
REVIEW
Jihad A Mustapha, Larry J Diaz-Sandoval, Fadi Saab
PURPOSE OF REVIEW: Retrograde tibiopedal access and interventions have contributed to advance of endovascular techniques to treat critical limb ischemia (CLI) patients. This review encompasses the spectrum from advanced diagnostic imaging and technical therapeutic approaches for infrapopliteal occlusions, to a discussion of current standards and future directions. RECENT FINDINGS: Contemporary studies of infrapopliteal angioplasty show suboptimal short-term and 1-year clinical outcomes...
August 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28632147/crossover-iliofemoral-bypass-graft-through-tension-free-abdominal-wall-repair-mesh
#9
Mircea Muresan, Ovidiu Jimborean, Gabriela Jimborean, Radu Neagoe, Serban Bancu, Muresan Simona, Cristian Borz
INTRODUCTION: In vascular surgery the crossover iliofemoral bypass grafting is a well-known surgical technique. In general surgery the repair of an abdominal defect using a Polypropylene mesh is also a standard procedure. A particular technique is defined by the performance of these 2 separate procedures inside a single operation in which the crossover arterial graft is directed from the retroperitoneal space toward the contra-lateral femoral bifurcation through a Polypropylene mesh which closes the musculoaponeurotic layers of the abdominal wall...
June 8, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28630267/a-structured-review-of-antithrombotic-therapy-in-peripheral-artery-disease-with-a-focus-on-revascularization-a-tasc-intersociety-consensus-for-the-management-of-peripheral-artery-disease-initiative
#10
REVIEW
Connie N Hess, Lars Norgren, Gary M Ansel, Warren H Capell, John P Fletcher, F Gerry R Fowkes, Anders Gottsäter, Kerry Hitos, Michael R Jaff, Joakim Nordanstig, William R Hiatt
Peripheral artery disease affects >200 million people worldwide and is associated with significant limb and cardiovascular morbidity and mortality. Limb revascularization is recommended to improve function and quality of life for symptomatic patients with peripheral artery disease with intermittent claudication who have not responded to medical treatment. For patients with critical limb ischemia, the goals of revascularization are to relieve pain, help wound healing, and prevent limb loss. The baseline risk of cardiovascular and limb-related events demonstrated among patients with stable peripheral artery disease is elevated after revascularization and related to atherothrombosis and restenosis...
June 20, 2017: Circulation
https://www.readbyqxmd.com/read/28629476/stromal-vascular-fraction-cells-for-the-treatment-of-critical-limb-ischemia-a-pilot-study
#11
Adas Darinskas, Mindaugas Paskevicius, Gintaras Apanavicius, Gintaris Vilkevicius, Liutauras Labanauskas, Thomas E Ichim, Rytis Rimdeika
BACKGROUND: Cell-based therapy is being explored as an alternative treatment option for critical limb ischemia (CLI), a disease associated with high amputation and mortality rates and poor quality of life. However, therapeutic potential of uncultured adipose-derived stromal vascular fraction (SVF) cells has not been evaluated as a possible treatment. In this pilot study, we investigated the efficacy of multiple injections of autologous uncultured adipose-derived SVF cells to treat patients with CLI...
June 19, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28618138/expansion-of-umbilical-cord-blood-aldehyde-dehydrogenase-expressing-cells-generates-myeloid-progenitor-cells-that-stimulate-limb-revascularization
#12
David M Putman, Tyler T Cooper, Stephen E Sherman, Ayesh K Seneviratne, Mark Hewitt, Gillian I Bell, David A Hess
Uncompromised by chronic disease-related comorbidities, human umbilical cord blood (UCB) progenitor cells with high aldehyde dehydrogenase activity (ALDH(hi) cells) stimulate blood vessel regeneration after intra-muscular transplantation. However, implementation of cellular therapies using UCB ALDH(hi) cells for critical limb ischemia, the most severe form of severe peripheral artery disease, is limited by the rarity (<0.5%) of these cells. Our goal was to generate a clinically-translatable, allogeneic cell population for vessel regenerative therapies, via ex vivo expansion of UCB ALDH(hi) cells without loss of pro-angiogenic potency...
June 15, 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28612128/-vascular-diagnostics-in-peripheral-arteries
#13
REVIEW
C Espinola-Klein, G Weißer
Peripheral artery disease (PAD) is the most frequent cause for reduced perfusion in peripheral arteries. Patients with PAD have often manifestations of atherosclerosis in other vascular territories. Typical symptoms are intermittent claudication or rest pain and acral lesions in patients with critical limb ischemia. The majority of PAD patients are clinically asymptomatic; therefore, it makes sense to screen for PAD in patients with cardiovascular risk factors. The ankle brachial index (ABI) is regarded as an easy and cost-effective method for baseline diagnostics...
June 13, 2017: Der Internist
https://www.readbyqxmd.com/read/28603176/autologous-bone-marrow-mononuclear-cell-implantation-and-its-impact-on-the-outcome-of-patients-with-critical-limb-ischemia%C3%A3-results-of-a-randomized-double-blind-placebo-controlled-trial
#14
Bernard Pignon, Marie-Antoinette Sevestre, Lukshe Kanagaratnam, Gilles Pernod, Dominique Stephan, Joseph Emmerich, Claude Clement, Gabrielle Sarlon, Carine Boulon, Claire Tournois, Philippe Nguyen
BACKGROUND: Cell therapy is a therapeutic option for patients presenting with nonrevascularizable critical limb ischemia (CLI). However there is a lack of firm evidence on its efficacy because of the paucity of randomized controlled trials.Methods and Results:The BALI trial was a multicenter, randomized, controlled, double-blind clinical trial that included 38 patients. For all of them, 500 mL of bone marrow were collected for preparation of a BM-MNC product that was implanted in patients assigned to active treatment...
June 10, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28600024/efficacy-of-cilostazol-for-below-the-knee-artery-disease-after-balloon-angioplasty-in-patients-with-severe-limb-ischemia-cabbage-trial
#15
Yoshimitsu Soga, Mitsuyoshi Takahara, Osamu Iida, Yasutaka Yamauchi, Keisuke Hirano, Masashi Fukunaga, Kan Zen, Kenji Suzuki, Yoshiaki Shintani, Yusuke Miyashita, Taketsugu Tsuchiya, Terutoshi Yamaoka, Kenji Ando
BACKGROUND: Optimal medical therapy after endovascular therapy in patients with critical limb ischemia (CLI) remains unclear. Therefore, we investigated whether cilostazol reduce restenosis after balloon angioplasty for infrapopliteal lesions in CLI patietns. METHODS: This study was performed as a multicenter prospective randomized open-label blinded-endpoint study with independent angiographic core lab adjudication. Sixty patients were eligible and 53 patients were enrolled and allocated...
June 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28595883/prognostic-impact-of-revascularization-in%C3%A2-poor-risk-patients-with-critical%C3%A2-limb%C3%A2-ischemia-the-priority-registry-poor-risk-patients-with-and-without-revascularization-therapy-for-critical-limb-ischemia
#16
Osamu Iida, Mitsuyoshi Takahara, Yoshimitsu Soga, Nobuyoshi Azuma, Shinsuke Nanto, Masaaki Uematsu
OBJECTIVES: The authors sought to investigate the prognostic impact of revascularization for poor-risk CLI patients in real-world settings. BACKGROUND: Critical limb ischemia (CLI) is often accompanied with various comorbidities, and frailty is not rare in the population. Although previous studies suggested favorable outcomes of revascularization for CLI patients, those studies commonly included the healthier, that is, less frail patients. METHODS: This was a multicenter prospective observational study, registering patients who presented with CLI and who required assistance for their daily lives because of their disability in activities of daily living (ADL) and/or impairment of cognitive function...
June 12, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28595481/retrograde-popliteal-access-to-percutaneous-peripheral-intervention-for-chronic-total-occlusion-of-superficial-femoral-arteries
#17
Mert Dumantepe
OBJECTIVE: The aim of this study is to present our initial experience with the use of the retrograde popliteal artery access in patients with chronic total occlusions of superficial femoral artery (SFA). METHOD: From July 2012 to May 2014, a total of 28 patients (20 men, mean age 61.2 ± 11.5 years) with total occlusion of the SFA and good distal runoff were treated with percutaneous atherectomy, balloon angioplasty, and stenting (mean length 165.3 ± 57.5 mm, range 72-336 mm)...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28593656/clinical-outcome-and-its-predictors-in-hemodialysis-patients-with-critical-limb-ischemia-undergoing-endovascular-therapy
#18
Shohei Kataoka, Junichi Yamaguchi, Masashi Nakao, Kentaro Jujo, Nobuhisa Hagiwara
OBJECTIVES: This study aimed to examine prognosis and causes of death in hemodialysis (HD) patients with critical limb ischemia (CLI) after endovascular therapy (EVT). BACKGROUND: EVT is becoming a first-line treatment in patients with CLI. Nonetheless, only a few studies have examined prognosis and its predictors in HD patients with CLI undergoing EVT, who are known to be at high-risk. Moreover, causes of death in this population are not clarified to date. METHODS: We examined 175 consecutive patients who underwent EVT for CLI between March 2009 and March 2014...
June 8, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28589655/cannulation-related-complications-on-veno-arterial-extracorporeal-membrane-oxygenation-prevalence-and-effect-on-mortality
#19
Joshua K Wong, Amber L Melvin, Devang J Joshi, Candice Y Lee, William J Archibald, Ron E Angona, Vakhtang Tchantchaleishvili, Howard T Massey, George L Hicks, Peter A Knight
Cannulation-related complications are a known source of morbidity in patients supported on veno-arterial extracorporeal membrane oxygenation (VA-ECMO). Despite its prevalence, little is known regarding the outcomes of patients who suffer such complications. This is a single institution review of cannulation-related complications and its effect on mortality in patients supported on VA-ECMO from January 2010-2015 using three cannulation strategies: axillary, femoral, and central. Complications were defined as advanced if they required major interventions (fasciotomy, amputation, site conversion)...
June 7, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28578624/outcomes-after-endovascular-revascularization-in-octogenarians-and-non-octogenarians-with-critical-limb-ischemia
#20
Theodosios Bisdas, Markus Steinbauer, Giovanni Torsello, Christian Uhl
PURPOSE: To determine the outcome and periprocedural risk of endovascular revascularization in octogenarians with critical limb ischemia (CLI) compared with their younger counterparts. METHODS: The multicenter, prospective registry for First-line Treatments in Patients With Critical Limb Ischemia (CRITISCH) enrolled 642 patients treated with endovascular techniques ( ClinicalTrials.gov identifier NCT01877252). The patients were dichotomized according to age <80 years (n=421; mean age 69 years, 292 men; group 1) or ≥80 years (n=221; mean age 85 years, 113 men; group 2)...
June 1, 2017: Journal of Endovascular Therapy
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