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Critic limb ischemia

Xing-Yu Hong, Jie Lin, Wei-Wei Gu
Aberrant blood vessel functioning and systemic circulation are key causes for vascular disorders; cardiovascular, cerebrovascular, renal artery stenosis, and peripheral artery diseases. Epidemiological and basic science evidence supported genetic reasons, compounded by obesity, hypercholesterolemia, hypertension, diabetes, and smoking as risk factors. This is an umbrella review of risk factors and therapies in vascular disorders, exploring systematic reviews and meta-analyses studies in PubMed, Cochrane, Embase, and Central published in January 2000-May 2018...
October 14, 2018: Journal of Cellular Physiology
Biao Cheng, Ju-Yi Li, Xiao-Chao Li, Xiu-Fang Wang, Zhong-Jing Wang, Jue Liu, Ai-Ping Deng
Type 2 diabetes mellitus (T2DM) is a major contributor to peripheral artery disease (PAD), especially in cases that advance to critical limb ischemia (CLI). Accumulating evidence indicates that miRNAs play an important role in the development of PAD and T2DM. Due to the limited value of current diagnostic methods for CLI in T2DM patients, we compared the miRNA expression profiles of Chinese T2DM patients with or without CLI to find out whether distinctive miRNAs could serve as potential diagnostic biomarkers...
October 10, 2018: Scientific Reports
Dalila Masic, Edith Liang, Christina Long, Ethan J Sterk, Brian Barbas, Megan A Rech
The purpose of this systematic review is to evaluate the safety and efficacy of intravenous (IV) lidocaine for the treatment of acute pain in adult patients. The PubMed database was searched for randomized controlled trials, retrospective cohort studies, case series, and case reports evaluating use of IV lidocaine for the treatment of acute pain in adult patients, published between January 1970 and January 2018. The primary outcome was pain reduction via Visual Analog Scale, Verbal Rating Scale, or Numeric Rating Scale among patients treated with IV lidocaine and placebo or active controls...
October 10, 2018: Pharmacotherapy
Chung Yeop Lee, Kyunghak Choi, Hyunwook Kwon, Gi-Young Ko, Youngjin Han, Tae-Won Kwon, Yong-Pil Cho
We aimed to compare the clinical outcomes between endovascular treatment and inframalleolar bypass surgery for critical limb ischemia (CLI) in patients with thromboangiitis obliterans (TAO) and to assess the role of bypass surgery in the era of innovative endovascular treatment. Between January 2007 and December 2017, a total of 33 consecutive patients with the diagnosis of TAO presenting with CLI who underwent endovascular treatment (endovascular group, n = 22) or bypass surgery to the pedal or plantar vessels (bypass group, n = 11) were included and analyzed retrospectively...
2018: PloS One
Jeffrey D Crawford, Salvatore T Scali, Kristina A Giles, Martin R Back, Javairiah Fatima, Dean K Arnaoutakis, Scott A Berceli, Gilbert J Upchurch, Thomas S Huber
OBJECTIVE: Thoracofemoral bypass (TFB) is an alternative to aortofemoral bypass (AFB) or extra-anatomic bypass for severe aortoiliac occlusive disease (AIOD). TFB may be particularly useful in select patients with concurrent visceral aortic branch vessel disease, infrarenal aortic occlusions, or after failed AFB. However, there are few contemporary series describing the indications and outcomes for TFB. Therefore, the purpose of this analysis was to review our experience with TFB. METHODS: All patients undergoing TFB for occlusive disease from 2002 to 2017 were reviewed...
October 3, 2018: Journal of Vascular Surgery
Alexander Zimmermann, Stefanie Balk, Andreas Kuehnl, Hans-Henning Eckstein
BACKGROUND: Based on prospective vein bypass trials for lower leg ischemia, objective performance goals (OPG) were established by the Society for Vascular Surgery (SVS) and are used as a benchmark tool for open and endovascular treatments. This study aims to analyze OPG of all patients with critical leg ischemia (CLI) treated by open revascularization techniques at a tertiary care facility in routine practice. METHODS: From 01/2005 to 03/2013, 315 patients (mean age 72 years) with CLI were retrospectively included in this study...
October 1, 2018: Annals of Vascular Surgery
Ian Wee, Andrew Mtl Choong
Background Whilst autologous vein conduits have been heralded as the first-line approach for patients undergoing lower limb bypass grafting procedures, patients with peripheral arterial occlusive disease may have exhausted venous options given prior use for cardiac surgery, varicose vein surgery, or lower limb revascularization. Hence, the use of a radial artery graft may serve as a viable alternative. Methods The systematic review was performed in accordance to the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines...
September 30, 2018: Vascular
Sayaka Funabashi, Osami Kawarada, Toru Hirano, Shinobu Ayabe, Takeshi Yagyu, Teruo Noguchi, Satoshi Yasuda
No abstract text is available yet for this article.
September 29, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Akihiko Yokohama, Keiko Yokote, Takayuki Maruhashi
Peripheral blood stem cells (PBSCs) are currently one of the most important stem cell sources for hematopoietic stem cell transplantation as well as cell therapy for ischemic heart disease or critical limb ischemia. Thus, it is sometimes necessary to collect autologous PBSCs from donors who have comorbidities. In terms yield, a sufficient number of PBSCs can be collected from donors with comorbidities for performing cell therapy if their age is < 60 years or up to a maximum of 70 years, although the number of PBSCs collected from older donors would probably be lower than that obtained from younger donors...
September 18, 2018: Transfusion and Apheresis Science
Hiroko Hagiwara, Akira Higashibata, Shiho Ogawa, Shigeyuki Kanazawa, Hiroshi Mizuno, Rica Tanaka
Endothelial progenitor cell (EPC) transplantation is beneficial for ischemic diseases such as critical limb ischemia and ischemic heart disease. The scarcity of functional EPCs in adults is a limiting factor for EPC transplantation therapy. The quality and quantity culture (QQc) system is an effective ex vivo method for enhancing the number and angiogenic potential of EPCs. Further, microgravity environments have been shown to enhance the functional potential of stem cells. We therefore hypothesized that cells cultured with QQc under microgravity may have enhanced functionality...
September 24, 2018: Scientific Reports
Kjell E J Håkansson, Ove Sollie, Karin H Simons, Paul H A Quax, Jørgen Jensen, A Yaël Nossent
Circulating microRNAs have proven to be reliable biomarkers, due to their high stability, both in vivo in the circulation, and ex vivo during sample preparation and storage. Small nucleolar RNAs (snoRNAs) are a different type of small non-coding RNAs that can also be reliably measured in plasma, but have only been studied sporadically. In this study, we aimed to identify RNA-biomarkers that can distinguish between different exercise regimes and that entail clues about muscle repair and recovery after prolonged exhaustive endurance exercise...
2018: Frontiers in Physiology
Andrea Kolkenbeck-Ruh, Angela J Woodiwiss, Ravi Naran, Eitzaz Sadiq, Chanel Robinson, Tshegofatso H Motau, Taalib Monareng, Philanathi Mabena, Nomvuyo Manyatsi, Pitchou Z Gazwa, Talib Abdool-Carrim, Olebogeng H I Majane, Martin Veller, Girish Modi, Gavin R Norton
AIM: Although chronic kidney disease (CKD) as determined from estimated glomerular filtration rate (eGFR) is recommended for risk prediction by current hypertension guidelines, the equations to derive eGFR may not perform well in black Africans. We compared whether across the adult lifespan, eGFR or CKD are as closely associated with noncardiac arterial vascular events, as carotid intima-media thickness (IMT), in Africa. METHODS: In 1152 black South Africans [480 with noncardiac arterial events (294 with critical lower limb ischemia, 186 with stroke) of which 37% were premature] and 672 age, sex and ethnicity-matched controls from a randomly selected community sample, we assessed relations between eGFR, CKD or carotid IMT (B-mode ultrasound) and arterial events...
September 17, 2018: Journal of Hypertension
Julian Vitse, Huidi Tchero, Sylvie Meaume, Anne Dompmartin, Julie Malloizel-Delaunay, Chloé Géri, Christine Faure, Christian Herlin, Luc Teot
Flammacerium is a topical treatment composed of silver sulfadiazine and cerium nitrate initially used in burns. The objective was to assess the effectiveness of silver sulfadiazine and cerium nitrate on ischemic necrosis wounds of the lower limb as an alternative to amputation for a period of 12 weeks. Patients were prospectively randomized to receive silver sulfadiazine and cerium nitrate or standard care. Patients included adults with an ischemic wound of the lower limb, with necrosis covering over at least 50%...
September 2018: International Journal of Lower Extremity Wounds
Monica S O'Brien-Irr, Maciej L Dryjski, H Hasan Dosluoglu, Sherif Shalaby, Gregory Cherr, Mariel Rivero, Dimitrios Kuoduomas, Linda M Harris
OBJECTIVE: To evaluate outcomes following lower extremity revascularization for critical limb ischemia with tissue loss in patients with chronic immune mediated inflammatory disease. METHODS: A retrospective medical record review of all lower extremity revascularization for critical limb ischemia with tissue loss at a University affiliated hospital over a 3 year period was completed for demographics, co-morbidities, lower extremity revascularization indication, angiogram results, complications, mortality, limb salvage and re-intervention...
September 11, 2018: Annals of Vascular Surgery
Jordan R Stern, Danielle E Cafasso, Peter H Connolly, Sharif H Ellozy, Darren B Schneider, Andrew J Meltzer
INTRODUCTION: and Objectives: Retrograde arterial access (RA) of the popliteal, tibial or pedal arteries may facilitate endovascular treatment of complex infrainguinal lesions in patients with critical limb ischemia (CLI). Here, we assess the safety and efficacy of this technique. METHODS: A retrospective review of prospectively collected institutional data (consecutive M2S entries) was performed to identify patients with CLI undergoing peripheral vascular intervention from February, 2012 through December, 2017...
September 11, 2018: Annals of Vascular Surgery
Thanavel Rajangam, Kyoung-Sik Moon, Dokyun Kim, Jungmi Kang, Sunyeong Lee, Seung Ja Oh, Sang-Heon Kim
This study developed a xeno-free (XF) spherical cell cluster of adipose-derived stem cells (hASCs) for the treatment of severe ischemic diseases. hASCs are an attractive cell source for therapeutic angiogenesis. Herein, we describe an innovative method of culturing a three-dimensional stem cell mass (3DCM) in the XF condition and demonstrate the therapeutic potential and safety of XF-3DCMs in ischemic mice and in SCID/ BALB/c Slc-nu/nu nude mice, respectively. XF-3DCMs were generated by culturing hASCs on a maltose-binding protein-linked basic fibroblast growth factor-immobilized polystyrene surface...
September 14, 2018: Tissue Engineering. Part A
Zdenek Tauber, Katerina Cizkova, Maria Janikova, Jana Jurcikova, Katerina Vitkova, Lubomir Pavliska, Ludmila Porubova, Agata Krauze, Carlos Fernandez, Frantisek Jaluvka, Iveta Spackova, Ivo Lochman, Martin Prochazka, Brian H Johnstone, Vaclav Prochazka
AIM: The therapeutic potential of adipose-derived stem cell conditioned medium (ASC-CM) was studied in the rabbit model of critical limb ischemia (CLI). METHODS: Rabbits received treatment with ASC-CM or placebo. Gastrocnemius muscle tissue was collected 35 days after ischemia induction. Ischemic changes were evaluated in hematoxylin-eosin stained tissues for early (necrotic lesions/granulation tissue) and late (fibrous scars) phases of tissue repair. The expression of proangiogenic miR-126 was also evaluated using in situ hybridization...
September 7, 2018: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
Valentina Izzo, Marco Meloni, Laura Giurato, Luigi Uccioli
PURPOSE: The aim of this study is to evaluate the role of Iloprost as an early predictor of successful revascularization in patients affected by ischemic diabetic foot ulcers (DFUs). METHODS: Consecutive patients with ischemic DFUs with persistent low TcPO2 (<30mmHg) one day after a technical successful Percutaneous Transluminal Angioplasty (PTA) have been included. All patients underwent Iloprost infusion and TcPO2 has been recorded at days 3, 14 and 30. According to the TcPO2 reported at day 3, patients were divided into two groups: group A (patients with TcPO2 ≥30mmHg) and group B (patients with TcPO2 <30mmHg)...
August 31, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Vivian Capilla-González, Javier López-Beas, Natalia Escacena, Yolanda Aguilera, Antonio de la Cuesta, Rafael Ruiz-Salmerón, Franz Martín, Abdelkrim Hmadcha, Bernat Soria
Diabetes is a chronic metabolic disorder that affects 415 million people worldwide. This pathology is often associated with long-term complications, such as critical limb ischemia (CLI), which increases the risk of limb loss and mortality. Mesenchymal stromal cells (MSCs) represent a promising option for the treatment of diabetes complications. Although MSCs are widely used in autologous cell-based therapy, their effects may be influenced by the constant crosstalk between the graft and the host, which could affect the MSC fate potential...
August 16, 2018: Molecular Therapy: the Journal of the American Society of Gene Therapy
Tadashi Furuyama, Toshihiro Onohara, Ryosuke Yoshiga, Keiji Yoshiya, Yutaka Matsubara, Kentaro Inoue, Daisuke Matsuda, Koichi Morisaki, Takuya Matsumoto, Yoshihiko Maehara
Objective Patients with critical limb ischemia have serious systemic comorbidities and are at high risk of impairment of limb function. In this study, we assessed the prognostic factors of limbs after revascularization. Methods In this retrospective single-center cohort study, from April 2008 to December 2012, we treated 154 limbs of 121 patients with critical limb ischemia by the endovascular therapy-first approach based on the patients' characteristics. The primary end point was amputation-free survival. Secondary end points were patency of a revascularized artery, major adverse limb events, or death...
September 7, 2018: Vascular
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