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Diabetes And Endovascular And Revascularization

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https://www.readbyqxmd.com/read/30099169/evaluation-of-the-basil-survival-prediction-model-in-patients-undergoing-infrapopliteal-interventions-for-critical-limb-ischemia
#1
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
OBJECTIVES: To analyze the survival prediction function of the Bypass versus Angioplasty in Severe Ischaemia of the Leg survival prediction model (BASIL SPM), exclusively in patients who underwent infrapopliteal (InfraPo) revascularization for the treatment of critical limb ischemia. METHODS: In this retrospective cohort, patients who underwent InfraPo interventions during a 4-year period (2009-2013) were consecutively included, according to the primary intervention (endovascular or open repair), irrespective of combined treatment in the femoropopliteal and InfraPo segments...
August 9, 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
#2
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
#3
Sikandar Z Khan, Mariel Rivero, Gregory S Cherr, Linda M Harris, Maciej L Dryjski, Nader D Nader, Hasan H Dosluoglu
OBJECTIVE: The incidence of cardiovascular and limb-specific adverse outcomes is higher in 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 following intervention for PAD. METHODS: Patients who underwent revascularization for chronic limb ischemia (Rutherford 3-6) between 06/2001-12/2014 were retrospectively identified...
August 3, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/30064834/outcomes-of-upper-extremity-interventions-for-chronic-critical-ischemia
#4
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-patient-a-single-center-experience
#5
Francesca Persiani, Alessandra Paolini, Daniele Camilli, Luca Mascellari, Alessandro Platone, Alessandra Magenta, Sergio Furgiuele
OBJECTIVE: 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 to endovascular revascularization. METHODS: Fifty diabetic patients affected by CLI were enrolled. All patients underwent to PBMNCs therapy. Thirty-two patients underwent to PBMNCs therapy associated to endovascular revascularization (adjuvant therapy group)...
July 24, 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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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...
May 19, 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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
https://www.readbyqxmd.com/read/29501595/heel-wounds-predict-mortality-but-not-amputation-after-infrapopliteal-revascularization
#18
Abhisekh Mohapatra, Jon C Henry, Efthimios D Avgerinos, Rabih A Chaer, Steven A Leers, Aureline Boitet, Michael J Singh, Eric S Hager
BACKGROUND: Ischemic heel ulcerations are generally thought to carry a poor prognosis for limb salvage. We hypothesized that patients undergoing infrapopliteal revascularization for heel wounds, either bypass or endovascular intervention, would have lower wound healing rates and amputation-free survival (AFS) than patients with forefoot wounds. METHODS: A retrospective chart review was performed on patients who presented between 2006 and 2013 to our institution with ischemic foot wounds and infrapopliteal arterial disease and underwent either pedal bypass or endovascular tibial artery intervention...
August 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29459014/regional-variation-in-racial-disparities-among-patients-with-peripheral-artery-disease
#19
COMPARATIVE STUDY
Thomas F X O'Donnell, Chloe Powell, Sarah E Deery, Jeremy D Darling, Kakra Hughes, Kristina A Giles, Grace J Wang, Marc L Schermerhorn
OBJECTIVE: Prior studies identified significant racial disparities as well as regional variation in outcomes of patients with peripheral artery disease (PAD). We aimed to determine whether regional variation contributes to these racial disparities. METHODS: We identified all white or black patients who underwent infrainguinal revascularization or amputation in 15 deidentified regions of the Vascular Quality Initiative between 2003 and 2017. We excluded three regions with <100 procedures...
August 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29428535/diabetic-foot-limb-salvage-a-series-of-809-attempts-and-predictors-for-endovascular-limb-salvage-failure
#20
Zhiwen Joseph Lo, Zhimin Lin, Uei Pua, Lawrence Han Hwee Quek, Bien Ping Tan, Sundeep Punamiya, Glenn Wei Leong Tan, Sriram Narayanan, Sadhana Chandrasekar
BACKGROUND: To review patient characteristics and outcomes of in-patient diabetic foot limb salvage and identify risk factors predicting for endovascular limb salvage failure. METHODS: Retrospective study of limb salvage attempts in 809 patients between August 2013 and July 2015. RESULTS: Sixty-eight percent of our study population were male with mean age at 65 years and 73% presented with Rutherford grade 6 critical limb ischemia, with the remaining 27% Rutherford grade 5...
May 2018: Annals of Vascular Surgery
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