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Diabetes And Endovascular And Revascularization

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https://www.readbyqxmd.com/read/30321911/vascular-surgery-trends-in-australia-2001-2015-less-open-surgery-less-limb-loss-and-more-endovascular-intervention
#1
Melissa Anne Wright, Daniel Steffens, Ravi Lee Huilgol
BACKGROUND: The prevalence of peripheral arterial disease (PAD) in Australia is currently poorly characterized. The risk factor profile for PAD is changing with the population ageing, diabetes increasing and smoking rates declining. The management of PAD is also evolving, with advances in medical management and endovascular technique. The trends in PAD prevalence and surgical management have implications for preventative medicine, the Australian health system and vascular surgery. We report and analyse trends in PAD surgical intervention performed between 2001 and 2015...
October 15, 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/30261955/cardiovascular-outcomes-after-lower-extremity-endovascular-or-surgical-revascularization-the-euclid-trial
#2
Iris Baumgartner, Lars Norgren, F Gerry R Fowkes, Hillary Mulder, Manesh R Patel, Jeffrey S Berger, W Schuyler Jones, Frank W Rockhold, Brian G Katona, Kenneth Mahaffey, William R Hiatt
BACKGROUND: Lower extremity revascularization (LER) is a common treatment in patients with peripheral artery disease (PAD), but long-term outcomes are poorly defined. OBJECTIVES: The aim was to analyze LER in the EUCLID (Examining Use of tiCagreLor In paD) trial to determine predictors and cardiovascular outcomes. METHODS: Patients were grouped according to whether they received a post-randomization LER (n = 1,738) or not (n = 12,147)...
October 2, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/30139446/major-adverse-limb-events-and-1-year-outcomes-after-peripheral-artery-revascularization
#3
Connie N Hess, R Kevin Rogers, Tracy Y Wang, Rao Fu, Jacob Gundrum, Nancy M Allen LaPointe, William R Hiatt
BACKGROUND: Revascularization is important for symptom treatment and limb salvage in peripheral artery disease, yet little data exist on the incidence of post-procedure major adverse limb events (MALE) and longer-term outcomes. OBJECTIVES: This study sought to characterize hospitalizations and outpatient endovascular revascularizations after peripheral artery revascularization, assess temporal trends for outcomes, and identify factors associated with subsequent MALE hospitalization...
August 28, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/30099169/evaluation-of-the-basil-survival-prediction-model-in-patients-undergoing-infrapopliteal-interventions-for-critical-limb-ischemia
#4
Marcus Vinícius Martins Cury, Francisco Cardoso Brochado Neto, Marcelo Fernando Matielo, Rafael de Athayde Soares, Rui Manoel Dos Santos Póvoa, Larissa Soares Bezerra Santos Torres de Melo, Christiano Stchelkunoff Pecego, Roberto Sacilotto
BACKGROUND: Survival prediction models are clinical tools that help professionals make the best treatment decisions. In the treatment of critical limb ischemia, several scoring methods have emerged; however, many are limited because they are not reproducible in different populations. This study analyze the Bypass versus Angioplasty in Severe Ischemia of the Leg survival prediction model (BASIL SPM), exclusively in patients who underwent infrapopliteal (InfraPo) revascularization for the treatment of critical limb ischemia...
August 10, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/30092444/comparison-of-the-cost-of-drug-eluting-stents-versus-bare-metal-stents-in-the-treatment-of-critical-limb-ischemia-in-the-united-states
#5
Satinderjit S Locham, Nawar Paracha, Hanaa Dakour Aridi, Besma Nejim, Muhammad Rizwan, Mahmoud B Malas
OBJECTIVE: Despite significant technical advancement in the last decade, the durability of endovascular management of critical limb ischemia (CLI) remains highly debatable. Drug eluting stents (DES) are being popularized for the management of CLI after its precedent success in coronary intervention. Initial reports on the durability of DES are promising. However little is known on the additional cost of this relatively newer technology. The aim of this study is to compare the cost of the traditional bare metal stents (BMS) to the newly introduced DES in a large cohort of CLI patients...
August 6, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/30081159/metformin-is-associated-with-improved-survival-and-decreased-cardiac-events-with-no-impact-on-patency-and-limb-salvage-after-revascularization-for-peripheral-arterial-disease
#6
Sikandar Z Khan, Mariel Rivero, Nader D Nader, Gregory S Cherr, Linda M Harris, Maciej L Dryjski, Hasan H Dosluoglu
BACKGROUND: The incidence of cardiovascular and limb-specific adverse outcomes is higher in peripheral arterial disease (PAD) patients with diabetes. Metformin is associated with improved cardiovascular morbidity and mortality. However, the effect of metformin on limb-specific outcomes is unclear. The objective of this study was to assess the effect of metformin on outcomes after intervention for PAD. METHODS: Patients who underwent revascularization for chronic limb ischemia (Rutherford 3-6) between June 2001 and December 2014 were retrospectively identified...
August 4, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/30064834/outcomes-of-upper-extremity-interventions-for-chronic-critical-ischemia
#7
Tracy J Cheun, Lalithapriya Jayakumar, Maureen K Sheehan, Matthew J Sideman, Lori L Pounds, Mark G Davies
BACKGROUND: Critical hand ischemia owing to below-the-elbow atherosclerotic occlusive disease is relatively uncommon. The aim of this study was to examine the outcomes in patients presenting with critical ischemia owing to below-the-elbow arterial atherosclerotic disease who underwent nonoperative and operative management. METHODS: A database of patients undergoing operative and nonoperative management for symptomatic below-the-elbow atherosclerotic disease between 2006 and 2016 was retrospectively queried...
July 28, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/30053546/peripheral-blood-mononuclear-cells-therapy-for-treatment-of-lower-limb-ischemia-in-diabetic-patients-a-single-center-experience
#8
Francesca Persiani, Alessandra Paolini, Daniele Camilli, Luca Mascellari, Alessandro Platone, Alessandra Magenta, Sergio Furgiuele
BACKGROUND: The aim of this study is to analyze the effects of peripheral blood mononuclear cells (PBMNCs) therapy in diabetic patients with critical limb ischemia (CLI), with particular regard to its application, as adjuvant therapy in patients underwent endovascular revascularization. METHODS: Fifty diabetic patients affected by CLI were enrolled. All patients underwent PBMNCs therapy. Thirty-two patients underwent PBMNCs therapy associated with endovascular revascularization (adjuvant therapy group)...
July 25, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29970328/efficacy-and-safety-of-adjunctive-drug-coated-balloon-therapy-in-endovascular-treatment-of-common-femoral-artery-disease
#9
Hafiz M Imran, Omar N Hyder, Peter A Soukas
BACKGROUND: Surgical endarterectomy with or without patch angioplasty has been considered the gold standard for treatment of symptomatic common femoral artery (CFA) disease. Surgical risks include wound infection, hematoma and lymph leak in approximately 17% of patients. Endovascular therapy has less procedure-related morbidity and mortality. Endovascular approaches achieve patency rates of 60% to 90% at 1 and 2 years utilizing atherectomy and balloon angioplasty. CFA stenting has been limited due to concerns of stent kinking, thrombosis and restenosis...
June 25, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29968501/one-year-results-of-first-line-treatment-strategies-in-patients-with-critical-limb-ischemia-critisch-registry
#10
Konstantinos Stavroulakis, Matthias Borowski, Giovanni Torsello, Theodosios Bisdas
PURPOSE: To examine the outcomes of all first-line strategies for the treatment of critical limb ischemia (CLI), identify factors that influenced the treatment choice, and determine the risk of amputation or death after each treatment. METHODS: CRITISCH ( ClinicalTrials.gov identifier NCT01877252) is a multicenter, national, prospective registry evaluating all available treatment strategies applied in 1200 consecutive CLI patients in 27 vascular centers in Germany...
June 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29930661/real-world-experience-with-a-paclitaxel-coated-balloon-for-the-treatment-of-atherosclerotic-infrainguinal-arteries-12-month-interim-results-of-the-biolux-p-iii-registry-first-year-of-enrolment
#11
Marianne Brodmann, Thomas Zeller, Johnny Christensen, Christoph Binkert, Lubomir Spak, Henrik Schröder, Paolo Righini, Giovanni Nano, Gunnar Tepe
Background: Endovascular management of atherosclerotic infrainguinal arteries recently shifted towards drug eluting devices, designed to locally prevent the restenosis process. Numerous clinical studies report an advantage of drug coated balloons over uncoated balloon angioplasty in treating lower extremity peripheral artery disease. However, as coating and balloon platforms are different, each device requires dedicated clinical evaluations. Objective: The aim of the study is to further investigate the safety and effectiveness of a Paclitaxel-Coated Balloon for the treatment of atherosclerotic infrainguinal arteries in a real-world setting...
October 2017: Jornal vascular brasileiro
https://www.readbyqxmd.com/read/29793677/efficacy-of-cord-blood-platelet-gel-application-for-enhancing-diabetic-foot-ulcer-healing-after-lower-limb-revascularization
#12
RANDOMIZED CONTROLLED TRIAL
Pietro Volpe, Daniela Marcuccio, Giuseppe Stilo, Antonino Alberti, Giovanni Foti, Alberto Volpe, Domenica Princi, Rosangela Surace, Giulia Pucci, Mafalda Massara
The efficacy of umbilical cord blood platelet gel (CBPG) application on healing foot ulcers was analyzed in 10 diabetic patients treated for critical lower limb ischemia by surgical or endovascular arterial revascularization. During a 9-month period, 20 diabetic patients affected by critical lower limb ischemia with tissue loss were enrolled in this nonblinded, consecutive series, randomized clinical trial. After clinical evaluation, patients underwent endovascular or surgical revascularization of the affected limb, followed by minor amputations or surgical debridement of ischemic lesions...
December 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/29784901/symptomatic-total-aortic-occlusion
#13
Bogdan Dutu, Dumitru Zdrenghea, Dana Pop, Gabriel Cismaru, Alexandru Martis, Adrian C Iancu
BACKGROUND Aortic occlusion, whether acute or subacute, is a rare but very serious entity with disastrous consequences if not treated in a timely fashion. Rapid diagnosis is crucial in this setting. In surgically treated patients there is a high degree of mortality and morbidity; therefore, percutaneous revascularization, whenever possible and independent of the available techniques, is much more desirable. CASE REPORT A 62-year-old woman with a history of diabetes mellitus, dyslipidemia, hypertension, and peripheral vascular disease, with previous femoral-femoral bypass for right common iliac artery occlusion, and with recent conventional angiography showing near occlusion of the ostial left common iliac artery (the donor vessel for the previous bypass), was referred to our hospital for conventional angioplasty...
May 22, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29783031/a-unique-all-payer-rate-setting-system-controls-the-cost-but-not-the-racial-disparity-in-lower-extremity-revascularization-procedures
#14
Besma Nejim, Robert J Beaulieu, Husain Alshaikh, Mohammed Hamouda, Joseph Canner, Mahmoud B Malas
BACKGROUND: Patients with peripheral arterial disease often have high comorbidity burden that may complicate post-interventional course and drive increased health-care expenditures. Racial disparity had been observed in lower extremity revascularization (LER) patterns and outcomes. In 2014, Maryland adopted an all-payer rate-setting system to limit the rising hospitalization costs. This resulted in an aggregate payment system in which hospital compensation takes place as an overall per capita expenditure for hospital services...
October 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29733065/impact-of-revascularization-and-factors-associated-with-limb-salvage-in-patients-with-diabetic-foot
#15
Carlos A Hinojosa, Estefanía Boyer-Duck, Javier E Anaya-Ayala, Ana E Núñez-Salgado, Hugo Laparra-Escareno, René Lizola
Introduction: Diabetic foot is a common cause of hospitalization. Objective: To examine the impact of revascularization on lower limb salvage. Method: Retrospective study of diabetic patients with foot ulcers. The extent of tissue loss was assessed according to the PEDIS and Wagner classifications, and revascularization indications and techniques were evaluated. Factors involved with major amputation and limb salvage were assessed with Fisher's and chi-square tests...
2018: Gaceta Médica de México
https://www.readbyqxmd.com/read/29688737/endovascular-procedures-in-treatment-of-infrapopliteal-arterial-occlusive-disease-single-center-experience-with-69-infrapopliteal-procedures
#16
Pasternak J Janko, Budakov B Nebojsa, Petres V Andrej
BACKGROUND: Peripheral arterial occlusive disease (PAD) includes acute and chronic disorders of the blood supply as a result of obstruction of blood flow in the arteries of the limb. Treatment of PAD can be conservative, surgical and endovascular. Percutaneous transluminal angioplasty with or without stenting has become a recognized method, which is increasingly used in treatment of arterial occlusive disease. This study aimed to determine early results of endovascular treatment of critical limb ischemia (CLI) patients with infrapopliteal lesions...
March 1, 2018: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/29679687/indocyanine-green-angiography-to-prognosticate-healing-of-foot-ulcer-in-critical-limb-ischemia-a-novel-technique
#17
Hiten M Patel, Shahzad S Bulsara, Shubhabrata Banerjee, Tapish Sahu, Virender K Sheorain, Tarun Grover, Rajiv Parakh
BACKGROUND: To predict wound healing in patients with critical limb ischemia (CLI) is an ongoing issue. Current methods such as ankle-brachial index (ABI), color Doppler and transcutaneous oxygen pressure (TCPO2 ), and computed tomography angiography are lacking in demonstrating regional perfusion. Indocyanine green angiography (ICGA) has the potential to provide regional perfusion information lacking in other methods. This study was conducted to demonstrate successes of revascularization procedure in CLI patients based on ICGA data...
August 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29589075/-operative-treatment-of-diabetics-with-vascular-complications-secondary-data-analysis-of-diagnosis-related-groups-statistics-from-2005-to-2014-in-germany
#18
M Olm, A Kühnl, E Knipfer, M Salvermoser, H-H Eckstein, A Zimmermann
BACKGROUND: In Germany approximately 40,000 amputations per year are performed on patients with diabetes mellitus, often with accompanying vascular complications. OBJECTIVE: The aim of this study was to present the various degrees of severity of the vascular complications and the temporal changes of the treatment options in diabetics with vascular complications in Germany. MATERIAL AND METHODS: The microdata of the diagnosis-related groups (DRG) statistics of the Federal Statistical Office were analyzed over the period from 2005 to 2014...
July 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/29576404/treatment-outcomes-in-diabetic-patients-with-chronic-limb-threatening-ischemia
#19
COMPARATIVE STUDY
Patric Liang, Peter A Soden, Sara L Zettervall, Katie E Shean, Sarah E Deery, Raul J Guzman, Allen D Hamdan, Marc L Schermerhorn
OBJECTIVE: There are conflicting reports about outcomes after infrainguinal bypass for chronic limb-threatening ischemia (CLTI) in patients with diabetes. We compared perioperative outcomes between patients with and patients without diabetes in the current era. METHODS: The National Surgical Quality Improvement Program vascular module, 2011 to 2014, was used to identify patients undergoing infrainguinal revascularization for CLTI. Patients with and without diabetes were compared in terms of presentation, comorbidities, operative approach, and 30-day outcomes...
August 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29562828/the-effect-of-malignancy-on-outcomes-following-revascularization-for-critical-limb-ischemia-a-case-control-study
#20
MULTICENTER STUDY
Tom Calderbank, Ahmed Karim, Mike Wall, Arooj Syed, Robert S M Davies, Athanasios Saratzis
AIM: Malignancy is common in patients presenting with critical lower limb ischemia (CLI). However, outcomes in patients with concomitant active malignancy and CLI have not been well defined in comparative prospective analyses. Using contemporary prospective data, we aimed to assess outcomes following revascularization in patients with CLI and active malignancy. METHODS: A nested case-control study was performed using data from 2 tertiary referral centers for vascular disease...
July 2018: Vascular and Endovascular Surgery
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