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Lower limb ischemia

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https://www.readbyqxmd.com/read/28318856/balloon-aortic-valvuloplasty-in-the-transcatheter-aortic-valve-implantation-era-a-single-center-registry
#1
Ana Rita G Francisco, Miguel Nobre Menezes, Pedro Carrilho Ferreira, Cláudia Jorge, Doroteia Silva, Eduardo Infante de Oliveira, Fausto J Pinto, Pedro Canas da Silva
INTRODUCTION: Percutaneous balloon aortic valvuloplasty (BAV) has been limited by the risk of complications and restenosis. However, growing use of transcatheter aortic valve implantation (TAVI) has revived interest in this technique. We analyzed the current indications for BAV and outcomes in a single center. METHODS: Acute results and long-term outcomes were analyzed in a retrospective single-center registry of patients undergoing BAV between January 2013 and January 2016...
March 16, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28292886/optical-probing-of-gastrocnemius-in-patients-with-peripheral-artery-disease-characterizes-myopathic-biochemical-alterations-and-correlates-with-stage-of-disease
#2
Ryan A Becker, Kim Cluff, Nithyanandhi Duraisamy, Hootan Mehraein, Hussam Farhoud, Tracie Collins, George P Casale, Iraklis I Pipinos, Jeyamkondan Subbiah
Peripheral artery disease (PAD) is a condition caused by atherosclerotic blockages in the arteries supplying the lower limbs and is characterized by ischemia of the leg, progressive myopathy, and increased risk of limb loss. The affected leg muscles undergo significant changes of their biochemistry and metabolism including variations in the levels of many key proteins, lipids, and nucleotides. The mechanisms behind these changes are poorly understood. The objective of this study was to correlate the severity of the PAD disease stage and associated hemodynamic limitation (determined by the ankle brachial index, ABI) in the legs of the patients with alterations in the biochemistry of chronically ischemic leg muscle as determined by ATR-Fourier transform infrared micro-spectroscopy...
March 2017: Physiological Reports
https://www.readbyqxmd.com/read/28288884/the-profile-of-circulating-matrix-metalloproteinases-in-patients-undergoing-lower-limb-endovascular-interventions-for-peripheral-arterial-disease
#3
Ioakeim T Giagtzidis, Nikolaos P Kadoglou, George Mantas, Aris Spathis, Konstantinos O Papazoglou, Petros Karakitsos, Christos D Liapis, Christos D Karkos
BACKGROUND: Matrix metalloproteinases (MMPs) play a significant role in the development and progression of atherosclerotic vascular disease. We aimed to document the profile of circulating MMPs in peripheral arterial disease (PAD) patients undergoing lower limb endovascular revascularization. METHODS: A total of 46 patients (37 male; mean age 66±11 years) undergoing elective lower limb percutaneous revascularization (angioplasty/stent) for symptomatic PAD were recruited from two vascular centers...
March 10, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28279723/physiologic-cryoamputation-in-managing-critically-ill-patients-with-septic-advanced-acute-limb-ischemia
#4
Samuel L Chen, Isabella J Kuo, Nii-Kabu Kabutey, Roy M Fujitani
OBJECTIVES: Certain critically ill patients with advanced acute limb ischemia with a non-viable extremity may be unsuitable for transport to the operating room to undergo definitive amputation. In these unstable patients, rapid regional cryotherapy allows for prompt infectious source control and correction of hemodynamic and metabolic abnormalities, thereby lessening the risk associated with definitive surgical amputation. We describe our refined technique for lower extremity physiologic cryoamputation and review our institutional experience...
March 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28274753/results-for-primary-bypass-versus-primary-angioplasty-stent-for-lower-extremity-chronic-limb-threatening-ischemia
#5
Jeremy D Darling, John C McCallum, Peter A Soden, Lindsey Korepta, Raul J Guzman, Mark C Wyers, Allen D Hamdan, Marc L Schermerhorn
BACKGROUND: Long-term results comparing percutaneous transluminal angioplasty with or without stenting (PTA/S) and open surgical bypass for chronic limb-threatening ischemia (CLTI) in patients who have had no prior intervention are lacking. METHODS: All patients undergoing a first-time lower extremity revascularization for CLTI by vascular surgeons at our institution from 2005 to 2014 were retrospectively reviewed. Outcomes included perioperative complications, wound healing, restenosis, primary patency, reintervention, major amputation, RAS events (ie, reintervention, major amputation, or stenosis), and mortality...
March 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28273223/endovascular-therapeutic-options-for-the-treatment-of-aortoiliac-aneurysms
#6
Bernardo Massière, Arno VON-Ristow, Alberto Vescovi, Daniel Leal, Lea Mirian Barbosa Fonseca
About 20% of patients with abdominal aortic aneurysms have associated iliac aneurysms. Distal sealing during the endovascular treatment of aortic-iliac aneurysms is a challenge that has led to the emergence of several technical options to achieve this goal over the years. Internal iliac artery embolization is associated with the risk of ischemic complications, such as gluteal necrosis, lower limb neurological deficit, colonic ischemia, impotence and gluteal claudication. This article summarizes the technical options for endovascular treatment of aortoiliac aneurysms with different approaches to preserving the patency of internal iliac arteries...
December 2016: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28259572/vascular-surgery-an-essential-hospital-resource-in-modern-health-care
#7
Miguel F Manzur, Sung Wan Ham, Ramsey Elsayed, Sherwin Abdoli, Trevor Simcox, Sukgu Han, Vincent Rowe, Fred A Weaver
OBJECTIVE: In modern health care, vascular surgeons frequently serve as a unique resource to other surgical specialties for vascular exposure, repair, reconstruction, or control. These services occur both in planned and unplanned clinical settings. We analyzed the frequency, outcomes, and value of vascular services in this setting to other surgical specialties and the hospital. METHODS: Intraoperative planned and unplanned vascular surgery operative consultations were reviewed over a 3-year period (2013-2016)...
March 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28259571/preoperative-inflammatory-status-as-a-predictor-of-primary-patency-after-femoropopliteal-stent-implantation
#8
Kenneth R Nakazawa, Sean P Wengerter, John R Power, Robert A Lookstein, Rami O Tadros, Windsor Ting, Peter L Faries, Ageliki G Vouyouka
OBJECTIVE: The purpose of this study was to evaluate the impact of preoperative inflammatory status, as determined by complete blood count test parameters, on 12- and 24-month patency of femoropopliteal stenting for peripheral arterial disease. METHODS: We retrospectively analyzed baseline clinical and angiographic data among 138 patients (median age, 73 years; 46% female) from 2005 to 2014 at our institution with preoperative complete blood count test values and information of patency for at least 12 months after first-time femoropopliteal stenting...
March 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28259568/chloroquine-improves-the-response-to-ischemic-muscle-injury-and-increases-hmgb1-after-arterial-ligation
#9
Jun Xu, Xiangdong Cui, Jiehua Li, Panagiotis Koutakis, Iraklis Pipinos, Edith Tzeng, Alex Chen, Ulka Sachdev
OBJECTIVE: We have previously shown that exogenous administration of the nuclear protein high mobility group box 1 (HMGB1) improves angiogenesis after tissue ischemia. Antagonizing HMGB1 prolongs muscle necrosis and deters regeneration. In this study, we evaluated HMGB1 expression in peripheral arterial disease (PAD) and the mechanisms that promote its release in a murine model of hindlimb ischemia. Specifically, we investigated how chloroquine (CQ), a commonly employed disease-modifying antirheumatic drug, promotes HMGB1 release from muscle...
March 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28250690/aortoiliac-reconstruction-in-the-setting-of-in-stent-restenosis
#10
H S Natraj Setty, T R Raghu, B C Srinivas, C M Nagesh, Babu Reddy, Jayashree Kharge, B K Geetha, B N Krishnamurthy, Shivanand Patil, C N Manjunath
Complex iliac artery obstructions, particularly bilateral stenosis or total iliac artery occlusions, are usually treated with aortofemoral or aortobifemoral graft surgery. However, surgical treatment is associated with 3% mortality rate and significant morbidity such as intestinal ischemia, spinal cord injury, and ureteral damage. Percutaneous interventions of aortic bifurcation offer a promising alternative to surgery with potentially lower morbidity and mortality risk. We report a case of peripheral artery disease who had underwent right transfemoral iliac angioplasty with femoropopliteal bypass presented again with bilateral lower limb ischemia, who was successfully treated with stent implantation with the kissing balloon technique...
January 2017: Journal of Natural Science, Biology, and Medicine
https://www.readbyqxmd.com/read/28244825/therapeutic-potential-of-adipose-derived-stem-cells-and-macrophages-for-ischemic-skeletal-muscle-repair
#11
Viktoriya Rybalko, Pei-Ling Hsieh, Laura M Ricles, Eunna Chung, Roger P Farrar, Laura J Suggs
AIM: Progressive ischemia due to peripheral artery disease causes muscle damage and reduced strength of the lower extremities. Autologous cell therapy is an attractive treatment to restore perfusion and improve muscle function. Adipose-derived stem cells (ASCs) have therapeutic potential in tissue repair, including polarizing effects on macrophages (MPs). MATERIALS & METHODS: Co-culture systems of ASCs and MPs were analyzed for gene and protein expression modifications in ASC-conditioned MPs...
March 2017: Regenerative Medicine
https://www.readbyqxmd.com/read/28243607/treatment-with-sildenafil-and-donepezil-improves-angiogenesis-in-experimentally-induced-critical-limb-ischemia
#12
Ioana M Constantinescu, Pompei Bolfa, Dan Constantinescu, Aurel I Mironiuc, Claudia D Gherman
Objectives. In this study, we aimed to demonstrate the role of sildenafil (an antagonist of phosphodiesterase type 5 (PDE-5)) and donepezil (a specific and reversible inhibitor of acetylcholinesterase (Ach)) in increasing ischemia-induced angiogenesis. Method. Critical limb ischemia was induced by ligation of the common femoral artery followed by ligation of the common iliac artery. The operated animals were divided into 3 groups: receiving sildenafil, receiving donepezil, and surgery alone; the contralateral lower limb was used as a negative control...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28242402/hypoalbuminemia-predicts-perioperative-morbidity-and-mortality-after-infrainguinal-lower-extremity-bypass-for-critical-limb-ischemia
#13
Matthew R Peacock, Alik Farber, Mohammad H Eslami, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Nishant K Shah, Jeffrey J Siracuse
OBJECTIVES: Poor nutritional status has been associated with a higher risk of morbidity and mortality in general surgery patients, however outcomes in vascular surgery patients are unclear. Our goal was to determine the effect of poor nutritional status on perioperative morbidity and mortality after lower extremity bypass (LEB). METHODS: The 2005-2012 National Surgical Quality Improvement Program was analyzed to determine associated complications, mortality, length of stay (LOS), and readmissions for patients with hypoalbuminemia (serum albumin <3...
February 24, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28240525/infrapopliteal-calcification-patterns-in-critical-limb-ischemia-diagnostic-pathologic-and-therapeutic-implications-in-the-search-for-the-endovascular-holy-grail
#14
Jihad A Mustapha, Larry J Diaz-Sandoval, Fadi Saab
Critical limb ischemia (CLI) represents the terminal stage of peripheral arterial disease (PAD) and is characterized by multilevel and multivessel disease. Amongst patients with infrainguinal disease, approximately one third have predominantly isolated infrapopliteal disease and the remaining two thirds, a combination of femoropopliteal and infrapopliteal disease. Isolated infrapopliteal disease is mainly seen in the elderly, diabetic, or dialysis-dependent patients. These patients have higher risk of amputation and shorter amputation-free survival...
February 27, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28239949/temporal-trends-in-peripheral-arterial-interventions-observations-from-the-blue-cross-blue-shield-of-michigan-cardiovascular-consortium-bmc2-pvi
#15
Michael P Thomas, Yeo Jung Park, Scott Grey, Theodore L Schreiber, Hitinder S Gurm, Dale Leffler, Thomas P Davis, Peter Henke, Paul Michael Grossman
OBJECTIVES: The aim is to examine trends in procedural indication, arterial beds treated, and device usage in peripheral arterial interventions (PVIs). BACKGROUND: There is little data on indication, vascular beds treated and devices utilized for peripheral arterial interventions. METHODS: We used data from 43 hospitals participating in the BMC2 VIC registry. PVIs were separated by year and divided by arterial segment. Lower extremity PVIs were subclassified as having been performed for claudication or critical limb ischemia (CLI)...
February 27, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28236918/morbidity-and-mortality-after-emergency-lower-extremity-embolectomy
#16
Sergio Casillas-Berumen, Lili Sadri, Alik Farber, Mohammad H Eslami, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Jeffrey J Siracuse
OBJECTIVE: Emergency lower extremity embolectomy is a common vascular surgical procedure that has poorly defined outcomes. Our goal was to define the perioperative morbidity for emergency embolectomy and develop a risk prediction model for perioperative mortality. METHODS: The American College of Surgeons National Surgical Quality Improvement database was queried to identify patients undergoing emergency unilateral and lower extremity embolectomy. Patients with previous critical limb ischemia, bilateral embolectomy, nonemergency indication, and those undergoing concurrent bypass were excluded...
March 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28235425/therapeutic-strategies-for-cell-based-neovascularization-in-critical-limb-ischemia
#17
REVIEW
Makoto Samura, Tohru Hosoyama, Yuriko Takeuchi, Koji Ueno, Noriyasu Morikage, Kimikazu Hamano
Critical limb ischemia (CLI) causes severe ischemic rest pain, ulcer, and gangrene in the lower limbs. In spite of angioplasty and surgery, CLI patients without suitable artery inflow or enough vascular bed in the lesions are often forced to undergo amputation of a major limb. Cell-based therapeutic angiogenesis has the potential to treat ischemic lesions by promoting the formation of collateral vessel networks and the vascular bed. Peripheral blood mononuclear cells and bone marrow-derived mononuclear cells are the most frequently employed cell types in CLI clinical trials...
February 24, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28228977/transient-hemi-lower-limb-ischemia-in-the-newborn-arterial-thrombosis-or-persistent-sciatic-artery
#18
Makiko Kirino, Masayuki Ochiai, Masako Ichiyama, Hirosuke Inoue, Takeshi Kusuda, Tadamune Kinjo, Masataka Ishimura, Shouichi Ohga
Neonatal thromboembolism occurs with various predispositions and triggers. Early diagnosis of the thrombosis is challenging and essential for the therapeutic interventions. We herein report two newborns who presented with transient hemi-lower limb ischemia due to (1) arterial thrombosis or (2) a persistent sciatic artery (PSA). The patient with arterial thrombosis showed elevations of fibrin degradation product and D-dimer and received antithrombin and heparin intravenously. The patient with PSA was immediately assessed by a contrast-enhanced computed tomography because of a transient ischemic episode with no evidence of hypercoagulability...
January 2017: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/28222984/index-complications-predict-secondary-complications-after-infrainguinal-lower-extremity-bypass-for-critical-limb-ischemia
#19
Matthew R Peacock, Nishant K Shah, Alik Farber, Su Yeon Lee, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Jeffrey J Siracuse
OBJECTIVE: Patients undergoing lower extremity bypass (LEB) are at high risk of perioperative complications that can lead to a cascade of secondary complications. Our goal was to understand the association of index complications with secondary complications after LEB. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database from 2005 to 2012 was used to analyze secondary complications after five index complications after LEB: deep/organ space surgical site infection, urinary tract infection (UTI), myocardial infarction (MI), pneumonia, and acute renal failure (ARF)...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28217986/the-effects-of-remote-ischemic-conditioning-in-patients-with-st-segment-elevation-myocardial-infarction-treated-with-primary-percutaneous-coronary-intervention-a-meta-analysis
#20
Jing Gao, Qingjie Chen, Fen Liu, Qian Zhao, Bangdang Chen, Yun Zhou, Qiang Zhao, Yitong Ma, Yining Yang
INTRODUCTION: Timely and successful reperfusion is effective at improving outcome in patients presenting with STEMI. However, abrupt restoration of blood flow may cause detrimental myocardial repercussion injury. Remote ischemic conditioning (RIC) is a potent activator of innate protection against ischemia-reperfusion injury. This study assessed remote ischemic conditioning in patients presenting with STEMI treated with primary PCI. EVIDENCE ACQUISITION: Relevant studies were identified through electronic literature search from PubMed, Medline, EMBASE, CNKI, WANFANG, and VIP...
February 17, 2017: Minerva Medica
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