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peripheral vascular intervention

Charlie C-T Hsu, Gigi Nc Kwan, Dalveer Singh, John A Rophael, Chris Anthony, Mieke L van Driel
BACKGROUND: Chronic limb-threatening ischaemia (CLTI) is a manifestation of peripheral arterial disease (PAD) that includes chronic ischaemic rest pain or ischaemic skin lesions, ulcers, or gangrene for longer than two weeks. The severity of the disease depends on the extent of arterial stenosis and the availability of collateral circulation. Treatment for CLTI aims to relieve ischaemic pain, heal ischaemic ulcers, prevent limb loss, improve quality of life, and prolong survival. CLTI due to occlusive disease in the infrapopliteal arterial circulation (below-knee circulation) can be treated via an endovascular technique by a balloon opening the narrowed vessel, so called angioplasty, with or without the additional deployment of a scaffold made of metal alloy or other material, so called stenting...
December 8, 2018: Cochrane Database of Systematic Reviews
David E Janhofer, Chrisovalantis Lakhiani, Paul J Kim, Cameron Akbari, Iram Naz, Eshetu A Tefera, Christopher E Attinger, Karen Kim Evans
BACKGROUND: In patients with lower extremity wounds, free tissue transfer is often the last option before amputation, making it crucial to optimize preoperative planning in order to prevent flap breakdown. No consensus exists regarding preoperative vascular work ups before lower extremity free tissue transfer. Here we analyzed the utility of using arteriography for lower extremity free flap planning. METHODS: A retrospective review was performed of 57 patients who underwent lower extremity arteriography and 59 free flap operations for lower extremity wounds between November 2014 and August 2017...
November 26, 2018: Plastic and Reconstructive Surgery
Jeffrey J Siracuse, Alik Farber, Thomas W Cheng, Stephen J Raulli, Douglas W Jones, Jeffrey A Kalish, Matthew R Smeds, Denis Rybin, Marc L Schermerhorn
OBJECTIVE: Ipsilateral antegrade access (AA) is an alternative access option for contralateral retrograde access (RA) in treating infrainguinal occlusive disease. Our goal was to assess whether AA is associated with higher access site complications. METHODS: The Vascular Quality Initiative database was searched from 2010 to 2017 for all infrainguinal peripheral vascular interventions. Cases without access through the common femoral artery or those with multiple accesses were excluded...
December 4, 2018: Journal of Vascular Surgery
Christian-Alexander Behrendt, Tilo Kölbel, Thea Schwaneberg, Holger Diener, Ralf Hohnhold, Eike Sebastian Debus, Henrik Christian Rieß
BACKGROUND: Worldwide prevalence of peripheral artery disease (PAD) is increasing and peripheral vascular intervention (PVI) has become the primary invasive treatment. There is evidence that multidisciplinary team decision-making (MTD) has an impact on in-hospital outcomes. This study aims to depict practice patterns and time changes regarding MTD of different medical specialties. METHODS: This is a retrospective cross-sectional study design. 20,748 invasive, percutaneous PVI of PAD conducted in the metropolitan area of Hamburg (Germany) were consecutively collected between January 2004 and December 2014...
December 10, 2018: VASA. Zeitschrift Für Gefässkrankheiten
Yusuke Suwa, Jun Watanabe, Mitsuyoshi Ota, Shinsuke Suzuki, Hirokazu Suwa, Kazuteru Watanabe, Shuji Saito, Koutaro Nagamine, Masashi Momiyama, Atsushi Ishibe, Yusuke Saigusa, Takeharu Yamanaka, Itaru Endo
PURPOSE: Capeox is widely used as an adjuvant chemotherapy regimen of colorectal cancer that does not require central vein catheter insertion. However, oxaliplatin-related vascular pain with peripheral administration is a major adverse event. We assessed the preventive effect of Celecoxib on oxaliplatin-related vascular pain. METHODS: A multicenter study of the Yokohama Clinical Oncology Group (YCOG) in Japan. This study was an open label, randomized non-comparative phase II study between Capeox without Celecoxib (C+ Group) and with it (C- group)...
December 6, 2018: Cancer Chemotherapy and Pharmacology
C Antza, I Doundoulakis, M Natsis, V Kotsis
Artery disease can be identified from ankle-brachial index (peripheral artery disease), pulse wave velocity (arterial stiffness), carotid intima media thickness (atherosclerosis) and flow-mediated dilation (endothelial disfunction). Arterial stiffness is a marker of cardiovascular disease associated with cardiovascular events. Increased vascular ageing is the acceleration of arterial stiffness inappropriate for the given chronological age. Treatment of early vascular ageing seems to be important if we target on primary cardiovascular prevention...
December 4, 2018: Current Pharmaceutical Design
Amy Rees, Georgina F Dodd, Jeremy P E Spencer
Research has suggested a number of beneficial effects arising from the consumption of dietary flavonoids, found in foods such as cocoa, apples, tea, citrus fruits and berries on cardiovascular risk factors such as high blood pressure and endothelial dysfunction. These effects are thought to have a significant impact upon both vascular and cerebrovascular health, ultimately with the potential to prevent cardiovascular and potentially neurodegenerative disease with a vascular component, for example vascular dementia...
December 1, 2018: Nutrients
Yana Etkin, Benjamin M Jackson, Joanna S Fishbein, Krisiva Shyta, Amit Rao, Hana Baig, Gregg S Landis
OBJECTIVES: Prosthetic grafts are often used as alternative conduits in patients with peripheral vascular disease who do not have an adequate autologous vein for bypass. Prosthetic grafts, unfortunately, carry an increased risk of infection and are associated with increased morbidity and mortality. The goal of this study was to identify potential risk factors and subsequent outcomes associated with lower extremity prosthetic graft infections. METHODS: 272 lower extremity prosthetic bypasses and patches were performed at an academic medical center between 2014 and 2016...
November 27, 2018: Annals of Vascular Surgery
David M Hurley, Ewan R Williams, Jeff M Cross, Brad R Riedinger, Ronald A Meyer, George S Abela, Jill M Slade
Microvascular function is reduced with age, disease, and inactivity. Exercise is well known to improve vascular health and has the potential to improve microvascular function in aging and disease. PURPOSE: The study aimed to assess changes in peripheral microvascular function in sedentary older adults following aerobic exercise training. METHODS: Twenty-three, sedentary older adults (67±5 yrs, BMI=29±5, mean±SD) successfully completed a randomized 12-week graded treadmill walking intervention...
November 26, 2018: Medicine and Science in Sports and Exercise
Simon von Gunten, Dominic A Theuns, Michael Kühne, Tobias Reichlin, Christian Sticherling, Beat Schaer
BACKGROUND: Guidelines of heart failure therapy include cardiac resynchronization as standard of care in patients with severely depressed left ventricular function and wide QRS complex. It has been shown that patients benefit regarding mortality and morbidity. However, early mortality precludes long-term benefits from the device. The aim of the study was to identify predictors for early occurrence of both death and first-ever implantable cardioverter-defibrillator (ICD) therapy using a large combined database of patients with cardiac resynchronization therapy with defibrillator (CRT-D)...
November 28, 2018: Cardiology Journal
Z R Wei, G T Huang, D L Wang
In the 60th anniversary of Chinese burn medicine, I am honored to review the development of Department of Burns and Plastic Surgery in the Affiliated Hospital of Zunyi Medical College. The Affiliated Hospital of Dalian Medical college was relocated to Zunyi in 1969 to support the development of southwestern China and renamed Affiliated Hospital of Zunyi Medical College. Only a few medical workers stayed in Zunyi when the State Council decided to reestablish Dalian Medical University in 1978. In the last 30 years, our department made great progress in the field of burns treatment with Chinese and Western medicine and complex wounds repair with flap, especially with perforator flap...
November 20, 2018: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
Wendy J Hollands, Henri Tapp, Marianne Defernez, Natalia Perez Moral, Mark S Winterbone, Mark Philo, Alice J Lucey, Mairead E Kiely, Paul A Kroon
Background: The reported effects of flavanol-rich foods such as cocoa, dark chocolate, and apples on blood pressure and endothelial function may be due to the monomeric flavanols [mainly (-)-epicatechin (EC)], the oligomeric flavanols [procyanidins (PCs)], or other components. Reports of well-controlled intervention studies that test the effects of isolated oligomeric flavanols on biomarkers of cardiovascular health are lacking. Objective: We studied the acute and chronic effects of an EC-rich apple flavanol extract and isolated apple PCs on systolic blood pressure (BP) and other cardiometabolic biomarkers...
November 1, 2018: American Journal of Clinical Nutrition
Marianne Brodmann, Martin Werner, Andrew Holden, Gunnar Tepe, Dierk Scheinert, Arne Schwindt, Florian Wolf, Michael Jaff, Alexandra Lansky, Thomas Zeller
OBJECTIVE: DISRUPT PAD II was designed to evaluate the safety and performance of intravascular lithotripsy (IVL), a novel approach using pulsatile sonic pressure waves, to modify intimal and medial calcium in stenotic peripheral arteries. BACKGROUND: Vascular calcification restricts vessel expansion, increases the risk of vascular complications, and may impair the effect of anti-proliferative therapy. METHODS: Disrupt PAD II was a non-randomized, multi-center study that enrolled 60 subjects with complex, calcified peripheral arterial stenosis at eight sites...
November 25, 2018: Catheterization and Cardiovascular Interventions
Viola Pomozi, Charnelle B Julian, Janna Zoll, Kevin Pham, Sheree Kuo, Natália Tőkési, Ludovic Martin, András Váradi, Olivier Le Saux
Pseudoxanthoma elasticum (PXE) is a heritable disease caused by ABCC6 deficiency. Patients develop ectopic calcification in skin, eyes and vascular tissues. ABCC6, primarily found in liver and kidneys, mediates the cellular efflux of ATP, which is rapidly converted into pyrophosphate (PPi), a potent inhibitor of calcification. PXE patients and Abcc6-/- mice display reduced PPi levels in plasma and peripheral tissues. PXE is currently incurable, although some palliative treatments exist. In recent years, we have successfully developed therapeutic methodologies to compensate the PPi deficit in animal models and humans...
November 20, 2018: Journal of Investigative Dermatology
Talha Butt, Erika Lilja, Hedvig Örneholm, Jan Apelqvist, Anders Gottsäter, Magnus Eneroth, Stefan Acosta
BACKGROUND: Heel ulcers in patients with diabetes mellitus (DM) and peripheral arterial disease (PAD) are hard to heal. The aim of the present study was to evaluate the difference in amputation-free survival (AFS) between open and endovascular revascularization in patients with DM, PAD, and heel ulcers. METHODS: Retrospective comparative study of results of open versus endovascular surgery in patients with DM, PAD, and heel ulcer presented at the multidisciplinary diabetes foot clinic between 1983 and 2013...
November 22, 2018: Vascular and Endovascular Surgery
Ahmed Ismaeel, Ramon Lavado, Robert S Smith, Jack L Eidson, Ian Sawicki, Jeffrey S Kirk, William T Bohannon, Panagiotis Koutakis
Revascularization procedures to treat patients with peripheral artery disease are among the most common operations performed by vascular surgeons. However, there are major limitations to revascularizations, readmission rates due to procedural complications are high, and greater risks of cardiovascular and limb adverse outcomes have been reported for patients with peripheral artery disease undergoing limb revascularization. Specifically, surgical revascularization may be associated with increased generation of reactive oxygen species based on the ischemia reperfusion injury theory, as restored blood flow and reoxygenation of ischemic areas may be accompanied by increased oxidative stress...
December 2018: Journal of Surgical Research
Melissa Sutton, Kathryn Kreider, Julie Thompson, Samir Germanwala, Jonathan Greifenkamp
The benefits of risk-factor reduction associated with peripheral arterial disease (PAD) is established and supported by the literature. The purpose of this quality-improvement project was to reduce modifiable risk factors such as diabetes mellitus (DM), hypertension (HTN), hyperlipidemia (HLD), and tobacco use in patients with PAD, as well as to demonstrate improvement in quality of life (QoL) and 6-minute-walk distances. For this quality-improvement project, 29 patients from three providers within a cardiology office were identified over a 6-week period...
December 2018: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
F Gilbert, C Schneemann, C J Scholz, R Kickuth, R H Meffert, R Wildenauer, U Lorenz, R Kellersmann, A Busch
BACKGROUND: Vascular damage in polytrauma patients is associated with high mortality and morbidity. Therefore, specific clinical implications of vascular damage with fractures in major trauma patients are reassessed. METHODS: This comprehensive nine-year retrospective single center cohort study analyzed demography, laboratory, treatment and outcome data from 3689 patients, 64 patients with fracture-associated vascular injuries were identified and were compared to a control group...
November 20, 2018: BMC Musculoskeletal Disorders
Amir Kaki, Nimrod Blank, M Chadi Alraies, Marvin Kajy, Cindy L Grines, Reema Hasan, Wah Wah Htun, James Glazier, Tamam Mohamad, Mahir Elder, Theodore Schreiber
Femoral and radial artery access continue to be the standard of care for percutaneous coronary interventions. Cardiac catheterization has progressed to encompass a wide range of diagnostic and interventional procedures including coronary, peripheral, endovascular, and structural heart disease interventions. Despite advanced technology to make these procedures safe, bleeding, and vascular complications continue to be a substantial source of morbidity, especially in patients undergoing large-bore access procedures...
November 19, 2018: Journal of Interventional Cardiology
Ann N Tescher, Susan L Thompson, Heather E McCormack, Brenda A Bearden, Mark W Christopherson, Catherine L Mielke, Beth A Sievers
Preventing, identifying, and treating deep tissue injury (DTI) remains a challenge. PURPOSE: The purpose of the current research was to describe the characteristics of DTIs and patient/care variables that may affect their development and outcomes at the time of hospital discharge. METHODS: A retrospective, descriptive, single-site cohort study of electronic medical records was conducted between October 1, 2010, and September 30, 2012, to identify common demographic, intrinsic (eg, mobility status, medical comorbidities, and incontinence), extrinsic (ie, surgical and procedural events, medical devices, head-of-bed elevation), and care and treatment factors related to outcomes of hospital-acquired DTIs; additional data points related to DTI development or descriptive of the sample (Braden Scale scores and subscale scores, hospital length of stay [LOS], intensive care unit [ICU] LOS, days from admission to DTI, time in the operating room, serum albumin levels, support surfaces/specialty beds, and DTI locations) also were retrieved...
November 2018: Ostomy/wound Management
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