keyword
https://read.qxmd.com/read/38417837/epidemiology-clinical-features-and-prognostic-factors-in-patients-with-covid-19-and-acute-limb-ischaemia-a-single-center-study
#1
JOURNAL ARTICLE
Irina Ciumanghel, Iulian Buzincu, Adi Ionut Ciumanghel, Eliza Barbuta, Diana Cimpoesu
BACKGROUND: The aim of this study was to determine the incidence, clinical and paraclinical characteristics and outcomes of Covid-19 positive patients presenting in the Emergency Department (ED) with and treated for acute limb ischaemia (ALI) during a 2-year period. METHODS: This retrospective study was conducted in the ED of St. Spiridon County Clinical Emergency Hospital in Iasi, north-east region of Romania. The patients included in this study presented in the ED between March 1st , 2020 and February 28th , 2022 with ALI and Covid-19...
February 28, 2024: Vascular
https://read.qxmd.com/read/38312331/critical-limb-ischaemia-in-octogenarians-treatment-outcomes-compared-with-younger-patients
#2
JOURNAL ARTICLE
Amaia Ormaechevarria, Melina Vega de Céniga, June Blanco, Laura Yáñez, June Fernández, Luis Estallo
OBJECTIVE: A growing proportion of patients with chronic limb threatening ischaemia (CLTI) are elderly, the most challenging for management decisions. The aim was to study the patient profile and outcome of CLTI in octogenarian patients, comparing them with younger patients. METHODS: Retrospective cohort of consecutive patients hospitalised for CLTI with infrainguinal disease in a Spanish centre (2013-2020). Data on age, comorbidity, anatomical characteristics, and treatment were gathered...
2024: EJVES vascular forum
https://read.qxmd.com/read/38255145/long-term-outcome-of-lower-extremity-bypass-surgery-in-diabetic-and-non-diabetic-patients-with-critical-limb-threatening-ischaemia-in-germany
#3
JOURNAL ARTICLE
Johanna Surmann, Philipp Meyer, Jasmin Epple, Thomas Schmitz-Rixen, Dittmar Böckler, Reinhart T Grundmann
AIM: To present the short- and long-term outcomes of lower extremity bypass (LEB) surgery in patients with critical limb-threatening ischaemia (CLTI), comparing diabetic (DM) and non-diabetic (non-DM) patients. METHODS: Retrospective analysis of anonymised data from a nationwide health insurance company (AOK). Data from 22,633 patients (DM: n = 7266; non-DM: n = 15,367; men: n = 14,523; women: n = 8110; mean patient age: 72.5 years), who underwent LEB from 2010 to 2015, were analysed...
December 22, 2023: Biomedicines
https://read.qxmd.com/read/38141957/validation-of-jclimb-spinach-and-vqi-calculators-for-prediction-of-two-year-survival-in-patients-with-chronic-limb-threatening-ischaemia-after-infra-inguinal-surgical-or-endovascular-revascularisation
#4
JOURNAL ARTICLE
Koichi Morisaki, Daisuke Matsuda, Atsushi Guntan, Shogo Kawanami, Shinichiro Yoshino, Kentaro Inoue, Kenichi Honma, Terutoshi Yamaoka, Shinsuke Mii, Tomoharu Yoshizumi
OBJECTIVE: This study aimed to evaluate three survival prediction models: the JAPAN Critical Limb Ischemia Database (JCLIMB), Surgical Reconstruction Versus Peripheral Intervention in Patients With Critical Limb Ischemia (SPINACH), and Vascular Quality Initiative (VQI) calculators. METHODS: Multicentre data of patients who underwent infra-inguinal revascularisation for chronic limb threatening ischaemia between 2018 and 2021 were retrospectively analysed. The prediction models were validated using a calibration plot analysis with the intercept and slope...
December 21, 2023: European Journal of Vascular and Endovascular Surgery
https://read.qxmd.com/read/38077714/cutaneous-hydrophilic-polymer-embolism-in-a-patient-with-acute-kidney-injury-post-endovascular-procedure
#5
JOURNAL ARTICLE
Mostafa Mohrag, Mohammed Binsalman, Mohammed Abdulrasak
BACKGROUND: Hydrophilic polymer gel coatings are used on different intravascular devices to prevent vasospasm and thrombosis. However, it may become dislodged from these devices, leading to ischaemic complications in various organs including the skin, kidneys, brain, heart or lungs. Hydrophilic polymer embolisation (HPE) is a rare complication following endovascular procedures that is currently not fully recognised. The current knowledge of this phenomenon is based on reports consisting of histologic evidence of foreign polymers in the affected organ...
2023: European Journal of Case Reports in Internal Medicine
https://read.qxmd.com/read/38058241/a-substantial-number-of-patients-with-rest-pain-ulceration-or-gangrene-are-unable-to-undergo-current-non-invasive-perfusion-testing-could-another-modality-be-utilised
#6
JOURNAL ARTICLE
Odette Hart, Qiantai Hong, Khai Tuck Lee, Sinead Gormley, Peta Tehan, Jill Sommerset, Manar Khashram
Rest pain, ulceration, and gangrene are hallmark features of chronic limb-threatening ischaemia (CLTI). Wound healing can be challenging, and this is compounded by an inability to measure lower limb perfusion via non-invasive tools such as toe pressure (TP). Novel perfusion tests, such as pedal acceleration time (PAT), may overcome some limitations. This study aimed to quantify the proportion of patients with CLTI that were unable to undergo TP measurement. Over a three-year duration, 344 consecutive patients with CLTI underwent PAT assessment (403 limbs)...
December 6, 2023: Wound Repair and Regeneration
https://read.qxmd.com/read/37926151/survival-limb-salvage-and-management-of-patients-with-lower-limb-acute-ischaemia-a-french-national-retrospective-observational-study
#7
JOURNAL ARTICLE
Olivier Espitia, Costantino Del Giudice, Olivier Hartung, Eléonore Herquelot, Aurélie Schmidt, Marc Sapoval, Jonathan Sobocinski
OBJECTIVE: The aim was to describe the baseline characteristics of French patients referred with acute limb ischaemia (ALI), and their clinical management and outcome (death, amputation). METHODS: This retrospective observational cohort study used the National Health Data System. All adults hospitalised for ALI who underwent revascularisation with an endovascular or open surgical approach between 1 January 2015 and 31 December 2020 were included and followed up until death or the end of the study (31 December 2021)...
November 3, 2023: European Journal of Vascular and Endovascular Surgery
https://read.qxmd.com/read/37880945/oxygen-saturation-or-tissue-oxygen-determinations-on-skin-whose-viability-is-at-risk
#8
REVIEW
Mark Richardson, Raj Mani
The triad of ischaemia, neuropathy, and infection are among the principal causes of lower extremity wounds that are commonly prevalent in patients with diabetic foot (DF) a condition in which peripheral arterial disease commonly co-exists. The prevalence of this condition is increasing globally and with it, the mounting costs of its management. One aspect of management is saving limbs and or digits, a crucial part of this process is assessing tissue viability of skin which is a focus of this review: there are other aspects which are well described in the literature...
October 25, 2023: International Journal of Lower Extremity Wounds
https://read.qxmd.com/read/37726754/hospital-clinicians-perceptions-and-experiences-of-care-pathways-for-chronic-limb-threatening-ischaemia-a-qualitative-study
#9
JOURNAL ARTICLE
Eleanor Atkins, Ian Kellar, Panagiota Birmpili, Jonathan R Boyle, Arun D Pherwani, Ian Chetter, David A Cromwell
BACKGROUND: Chronic limb-threatening ischaemia (CLTI) is a condition associated with significant risks of lower limb loss and mortality, which increase with delays in management. Guidance recommends urgent referral and assessment, but delays are evident at every stage of the CLTI patient pathway. This study uses qualitative methods to explore hospital clinicians' experiences and perceptions of the existing CLTI pathway. METHODS: A qualitative interview study was conducted...
September 19, 2023: Journal of Foot and Ankle Research
https://read.qxmd.com/read/37591622/acute-lower-limb-ischaemia-secondary-to-aortic-compression-from-uterine-fibroid
#10
JOURNAL ARTICLE
Siti Hajar Nawawi, Wan Zulkafli Wan Ibrahim, Mohd Mazri Yahya, Roziana Ramli
A woman in her early 50s with uncontrolled diabetes mellitus and a huge uterine fibroid presented to the emergency department with diabetic ketoacidosis and bilateral acute lower limb ischaemia. Vascular and advanced imaging studies confirmed distal aortic compression by a huge uterine fibroid, resulting in extensive lower limb arterial thrombosis. After resuscitation, the patient underwent emergency hysterectomy, thromboembolectomy and amputation of the right leg. She remained critically ill and died of fulminant sepsis and multiorgan failure 10 days later...
August 17, 2023: BMJ Case Reports
https://read.qxmd.com/read/37509673/understanding-the-impact-of-covid-19-on-angioplasty-service-and-outcome-of-patients-treated-for-chronic-limb-threatening-ischaemia-a-single-centre-retrospective-cohort-study
#11
JOURNAL ARTICLE
Alexander D Rodway, Jenny Harris, Lydia Hanna, Charlotte Allan, Felipe Pazos Casal, Ciara Giltinan, Ali Dehghan-Nayeri, Andre Santos, Martin B Whyte, Nikolaos Ntagiantas, Ivan Walton, Richard Brown, Simon S Skene, Ajay Pankhania, Benjamin C T Field, Gary D Maytham, Christian Heiss
We evaluated the impact of COVID-19 restriction on the angioplasty service and outcome of chronic limb-threatening ischaemia (CLTI) patients undergoing lower-limb angioplasty in a UK secondary care setting. Consecutive patients were analysed retrospectively. Pre-COVID-19 (08/2018-02/2020), 106 CLTI patients (91% Fontaine 4; 60% diabetes mellitus) and during COVID-19 (03/2020-07/2021) 94 patients were treated (86% Fontaine 4; 66% diabetes mellitus). While the average monthly number of patients treated did not change, the proportion of day cases significantly increased (53% to 80%), and hospitalised patients decreased...
July 19, 2023: Biomedicines
https://read.qxmd.com/read/37464779/revascularisation-options-for-chronic-limb-threatening-ischaemia-in-diabetes-implications-from-two-recent-trials
#12
REVIEW
Jaime H X Lin, Nikolaos Papanas, Hany Zayed, Prashanth R J Vas
Chronic limb-threatening ischaemia (CLTI) is a severe form of peripheral arterial disease (PAD) and is associated with an increased risk of amputation, mortality, and significantly impaired quality of life. International guidelines recommend considering timely revascularisation and optimal medical therapy to improve limb perfusion in individuals with CLTI. The 2 primary revascularization approaches for CLTI are open bypass surgery (BS) and endovascular therapy (EV), however, there is currently no consensus on the best initial treatment strategy for CLTI, leading to uncertainty among clinicians...
July 18, 2023: International Journal of Lower Extremity Wounds
https://read.qxmd.com/read/37150644/risk-of-amputation-under-diuretics-in-patients-with-or-at-risk-of-lower-extremity-arterial-disease-a-systematic-review-and-meta-analysis
#13
REVIEW
Khadija Ba, Mamadou Adama Sow, Julien Magne, Laurence Salle, Philippe Lacroix, Lucie Chastaingt, Victor Aboyans
BACKGROUND: Recently, increased risk of amputation under sodium glucose cotransporter-2 inhibitors has been debated. Similar concerns have been raised with other "traditional" diuretics, more particularly in patients with or at risk of lower extremity arterial disease (LEAD). AIM: To collect all available data on any potential risk of amputation associated with diuretics in patients with or at risk of LEAD. Additionally, we looked for other limb-related events in these patients...
2023: Archives of Cardiovascular Diseases
https://read.qxmd.com/read/37139338/microdialysis-as-a-tool-for-antibiotic-assessment-in-patients-with-diabetic-foot-a-review
#14
REVIEW
Vladimíra Fejfarová, Radka Jarošíková, Jan Polák, Blanka Sommerová, Jitka Husáková, Veronika Wosková, Michal Dubský, Petr Tůma
Diabetic foot is a serious late complication frequently caused by infection and ischaemia. Both require prompt and aggressive treatment to avoid lower limb amputation. The effectiveness of peripheral arterial disease therapy can be easily verified using triplex ultrasound, ankle-brachial/toe-brachial index examination, or transcutaneous oxygen pressure. However, the success of infection treatment is difficult to establish in patients with diabetic foot. Intravenous systemic antibiotics are recommended for the treatment of infectious complications in patients with moderate or serious stages of infection...
2023: Frontiers in Endocrinology
https://read.qxmd.com/read/37081800/should-long-term-survival-in-elderly-patients-presenting-with-diabetic-foot-complications-impact-treatment-decision-making
#15
JOURNAL ARTICLE
Erwin Yii, Jonathan Tiong, Sam Farah, Husein Al-Talib, Jonathan Clarke, Ming Kon Yii
Patients presenting with diabetic foot ulceration (DFU) and associated complications often require revascularisation. Although current evidence advocates for an open bypass first strategy if patients are expected to live more than two years, this may not be appropriate in octogenarians. We sought to investigate the survival of patients aged over 70 years presenting with complicated DFU and chronic limb threatening ischaemia (CLTI) to clarify its prognosis and guide subsequent management. A database of patients admitted into a large tertiary service over the age of 70 years with DFU and CLTI between 2014 and 2017 were included...
April 20, 2023: International Journal of Lower Extremity Wounds
https://read.qxmd.com/read/37039865/foot-dorsal-and-plantar-flexion-to-enhance-crossing-of-tortuous-highly-calcific-ankle-vessels-during-lower-limb-revascularization-procedures-a-technical-note
#16
JOURNAL ARTICLE
Roberto Gandini, Vittorio Semeraro, Fabio Salimei
PURPOSE: To describe a crossing technique of stenotic/occluded and tortuous highly calcific ankle vessels during complex percutaneous limb salvage intervention in diabetic patients with ischaemic foot ulcers (Rutherford 5 and 6). TECHNIQUE: We propose a simple technique to achieve "straightening" of the tortuous vessel and allow safe devices passage into the foot arteries, Patients were asked to hold their foot in plantar or dorsal flexion, accordingly to the treated artery...
April 11, 2023: Cardiovascular and Interventional Radiology
https://read.qxmd.com/read/36979700/overcoming-barriers-to-wound-healing-in-a-neuropathic-and-neuro-ischaemic-diabetic-foot-cohort-using-a-novel-bilayer-biodegradable-synthetic-matrix
#17
JOURNAL ARTICLE
Frank P Guerriero, Robyn A Clark, Michelle Miller, Christopher L Delaney
Diabetes-related foot ulceration presents an increasing risk of lower limb amputation globally, driving the search for new treatment technologies. Our single-centre prospective observational study reports on the impact of bilayer biodegradable synthetic matrix technology (NovoSorb® BTM) on the healing and amputation rates of a diabetic foot ulceration cohort. Consecutive patients with a diabetes-related foot ulceration treated with NovoSorb BTM, between December 2019 and October 2021, were followed for 12 months...
February 27, 2023: Biomedicines
https://read.qxmd.com/read/36963855/vitamin-d-as-adjuvant-therapy-for-diabetic-foot-ulcers-systematic-review-and-meta-analysis-approach
#18
JOURNAL ARTICLE
Edwin Kinesya, Donni Santoso, Ngakan Gde Arya, Elen Putri Cintya, Putu Seriari Ambarini, Billi Kinesya, Melissa Stephanie Kartjito, Yusuf Mannagalli
BACKGROUND: Diabetic Foot Ulcer (DFU) is a combination of neuropathy and ischaemia on diabetic patient's lower limbs. It has a high burden of limb amputation rate, mortality rate, disability, economic burden, and lower quality of life on diabetic patients. It took mostly 3-6 months and up to 1 year for DFU to heal. DFU patients also have an increased risk of vitamin D deficiency. Meanwhile vitamin D has effects on immune response, insulin secretion, and sensitivity. The long duration of DFU healing is a problem for the patient's health, job, income, quality of life, economy and healthcare...
April 2023: Clinical Nutrition ESPEN
https://read.qxmd.com/read/36888982/amputation-and-advance-care-plans-an-observational-study-exploring-decision-making-and-long-term-outcomes-in-a-vascular-centre
#19
JOURNAL ARTICLE
Robert Grange, Ben Carter, Charlotte Chamberlain, Marcus Brooks, Ramya Nitharsan, Christopher Twine, Philip Braude
BACKGROUND: Half of those undergoing major lower limb amputation for peripheral arterial disease die within 1 year. Advance care planning reduces days in hospital and increases the chance of dying in a preferred place. AIM: To investigate the prevalence and content of advance care planning for people having a lower limb amputation due to acute or chronic limb-threatening ischaemia or diabetes. Secondary aims were to explore its association with mortality, and length of hospital stay...
March 8, 2023: Vascular
https://read.qxmd.com/read/36614897/ankle-doppler-for-cuffless-ankle-brachial-index-estimation-and-peripheral-artery-disease-diagnosis-independent-of-diabetes
#20
JOURNAL ARTICLE
Alexander D Rodway, Darren Cheal, Charlotte Allan, Felipe Pazos-Casal, Lydia Hanna, Benjamin C T Field, Ajay Pankhania, Philip J Aston, Simon S Skene, Gary D Maytham, Christian Heiss
Ankle brachial pressure index (ABPI) is the first-line test to diagnose peripheral artery disease (PAD). Its adoption in clinical practice is poor and its validity, particularly in diabetes, is limited. We hypothesised that ABPI can be accurately and precisely estimated based on cuffless Doppler waveforms. Retrospective analysis of standard ABPI and handheld Doppler waveform characteristics ( n = 200). Prospective analysis of angle-corrected Doppler acceleration index (AccI, n = 148) and standard ABPI with testing of performance to diagnose PAD as assessed with imaging reference standards in consecutive patients...
December 22, 2022: Journal of Clinical Medicine
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