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Lower limb ischemia

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https://www.readbyqxmd.com/read/28210050/a-study-of-the-relationships-of-changes-in-pain-and-gait-after-tourniquet-induced-ischemia-reperfusion-in-rats
#1
Kazuki Aihara, Takeya Ono, Namiko Umei, Wakako Tsumiyama, Atsushi Tasaka, Hideki Ishikura, Yuta Sato, Tomohiro Matsumoto, Sadaaki Oki
[Purpose] The purpose of this study was to determine the relationships of changes in pain and gait after ischemia reperfusion was induced by tourniquet in rats. [Subjects and Methods] The subjects were six ten-week-old male Wistar rats. Ischemia was induced in the left lower limbs of the experimental rats at a pressure of 300 mmHg for 90 minutes. Pain behavior evaluations were measured using the von Frey test in all the rats' hind limbs. A consistently increasing plantar stimulus was applied until the rats exhibited an escape behavior...
January 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28203578/supersized-atheroma-causing-acquired-coarctation-of-aorta-leading-to-heart-failure
#2
Sajin Karakattu, Ghulam Murtaza, Sharma Dinesh, Kamesh Sivagnanam, Jeffrey Schoondyke, Timir Paul
Calcified atheromatous aortic lesion causing significant narrowing of the aorta is an uncommon clinical entity. This calcified atheroma leads to obstruction of the lumen of the aorta simulating acquired coarctation of aorta causing impaired perfusion of lower limbs, visceral ischemia, and hypertension. We report a case of 58-year-old patient who presented with dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea, 25-lb weight gain, lower extremity edema, and chest pain. Extensive workup including computed tomography and magnetic resonance imaging revealed a large calcific mass in the aortic arch causing his presenting symptoms...
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28194186/safety-and-effectiveness-of-bone-marrow-cell-concentrate-in-the-treatment-of-chronic-critical-limb-ischemia-utilizing-a-rapid-point-of-care-system
#3
Venkatesh Ponemone, Saniya Gupta, Dalip Sethi, Manish Suthar, Monika Sharma, Richard J Powell, Kenneth Lee Harris, Nungshi Jungla, Priyadarshini Arambam, Upendra Kaul, Ashok Seth, Suhail Bukhari
Critical limb ischemia (CLI) is the end stage of lower extremity peripheral vascular disease (PVD) in which severe obstruction of blood flow results in ischemic rest pain, ulcers and/or gangrene, and a significant risk of limb loss. This open-label, single-arm feasibility study evaluated the safety and therapeutic effectiveness of autologous bone marrow cell (aBMC) concentrate in revascularization of CLI patients utilizing a rapid point-of-care device. Seventeen (17) no-option CLI patients with ischemic rest pain were enrolled in the study...
2017: Stem Cells International
https://www.readbyqxmd.com/read/28193783/remote-ischemic-preconditioning-triggers-changes-in-autonomic-nervous-system-activity-implications-for-cardioprotection
#4
Safa Abdul-Ghani, Arnold N Fleishman, Igor Khaliulin, Marco Meloni, Gianni D Angelini, M-Saadeh Suleiman
Cardioprotective efficacy of remote ischemic preconditioning (RIPC) remains controversial. Experimental studies investigating RIPC have largely monitored cardiovascular changes during index ischemia and reperfusion with little work investigating changes during RIPC application. This work aims to identify cardiovascular changes associated with autonomic nervous system (ANS) activity during RIPC and prior to index ischemia. RIPC was induced in anesthetized male C57/Bl6 mice by four cycles of 5 min of hindlimb ischemia using inflated cuff (200 mmHg) followed by 5 min reperfusion...
February 2017: Physiological Reports
https://www.readbyqxmd.com/read/28191744/endovascular-therapy-for-angio-seal-tm-related-acute-limb-ischemia-perioperative-and-long-term-results
#5
Hui Dong, Meng Peng, Xiongjing Jiang, Wuqiang Che, Yubao Zou, Bo Xu, Yuejin Yang, Runlin Gao
OBJECTIVES: To investigate the perioperative and long-term outcomes of endovascular therapy for Angio-seal(TM) -related acute limb ischemia. BACKGROUND: Currently, limited data are available on the optimal treatment strategy for Angio-seal(TM) -related acute lower limb ischemia. METHODS: The prospectively maintained patient database of our institution was retrospectively searched to identify all patients who developed acute lower limb ischemia after use of the Angio-Seal(TM) and received endovascular treatment from January 2010 to February 2016...
February 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28184959/endovascular-treatment-strategy-using-catheter-directed-thrombolysis-percutaneous-aspiration-thromboembolectomy-and-angioplasty-for-acute-upper-limb-ischemia
#6
Tatsuo Ueda, Satoru Murata, Izumi Miki, Daisuke Yasui, Fumie Sugihara, Hiroyuki Tajima, Tetsuro Morota, Shin-Ichiro Kumita
PURPOSE: To evaluate the usefulness and safety of endovascular treatments for acute upper limb ischemia (AULI) by using multiple techniques, and to compare catheter-directed thrombolysis (CDT) and percutaneous aspiration thromboembolectomy (PAT) as initial procedures. MATERIALS AND METHODS: The study included 18 patients (4 men and 14 women) with AULI, who underwent a total of 20 sessions of endovascular treatment using various endovascular techniques between January 2005 and April 2016...
February 9, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28182087/pretreatment-with-fish-oil-based-lipid-emulsion-modulates-muscle-leukocyte-chemotaxis-in-murine-model-of-sublethal-lower-limb-ischemia
#7
Yao-Ming Shih, Juey-Ming Shih, Yu-Chen Hou, Chiu-Li Yeh, Cheng-Che Li, Sung-Ling Yeh
This study investigated the effects of a fish oil- (FO-) based lipid emulsion on muscle leukocyte chemotaxis and inflammatory responses in a murine model of limb ischemia-reperfusion (IR) injury. Mice were assigned randomly to 1 sham (sham) group, 2 ischemic groups, and 2 IR groups. The sham group did not undergo the ischemic procedure. The mice assigned to the ischemic or IR groups were pretreated intraperitoneally with either saline or FO-based lipid emulsion for 3 consecutive days. The IR procedure was induced by applying a 4...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28170200/glyoxalase-1-overexpression-reverses-defective-proangiogenic-function-of-diabetic-adipose-derived-stem-cells-in-streptozotocin-induced-diabetic-mice-model-of-critical-limb-ischemia
#8
Zhiyou Peng, Xinrui Yang, Jinbao Qin, Kaichuang Ye, Xin Wang, Huihua Shi, Mier Jiang, Xiaobing Liu, Xinwu Lu
Adipose-derived stem cell (ADSC)-based therapy is promising for critical limb ischemia (CLI) treatment, especially in patients with diabetes. However, the therapeutic effects of diabetic ADSCs (D-ADSCs) are impaired by the diabetes, possibly through intracellular reactive oxygen species (ROS) accumulation. The objective of the present study was to detect whether overexpression of methylglyoxal-metabolizing enzyme glyoxalase-1 (GLO1), which reduces ROS in D-ADSCs, can restore their proangiogenic function in a streptozotocin-induced diabetic mice model of CLI...
January 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28166662/-ischemic-origin-of-diabetic-foot-disease-epidemiology-difficulties-of-diagnosis-options-for-prevention-and-revascularization
#9
Endre Kolossváry, Zoltán Bánsághi, Gábor Viktor Szabó, Zoltán Járai, Katalin Farkas
"Diabetic foot" as definition covers a multifactorial clinical condition. According to the recent epidemiological data, the role of lower limb ischemia is getting more influential over other pathological causes, like neuropathy, infections and bone or soft tissue deformity. In diabetes, vascular disease leads to increased risk for leg ulcers and minor or major amputations. The traditional diagnostic tools for recognition of peripheral arterial disease have limited value because of diabetes specific clinical manifestations...
February 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28165556/complicated-thoraco-abdominal-aortic-dissection-presenting-with-lower-limb-ischemia-in-a-patient-with-bovine-arch-and-arteria-lusoria
#10
G-R Joliat, C Dubuis, S Déglise
We report the case of a 58-year-old man who presented with thoraco-abdominal pain and right lower limb ischemia due to type B aortic dissection. Moreover, the patient was discovered to have several concomitant aortic arch anomalies (bovine arch, arteria lusoria, and left vertebral artery arising from the aortic arch). Taking into account this complex anatomy, emergent femoral exploration with fenestration and thrombectomy was performed. The blood flow to the right lower limb was restored. A few days later the aortic dissection spread proximally, and the aortic arch dilatation enlarged...
January 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28161267/-lower-limb-arterial-thrombosis-in-a-nephrotic-syndrome
#11
Raja Arrab, Aicha Bourrahouate, Mohamed Sbihi, Imane Ait Sab
Thromboembolic complications are frequent in the nephrotic syndrome. Arterial localizations have been rarely reported. There is no consensus on their management; it depends on the location and hypercoagulable state. We report a case of acute lower limb ischemia occurring in children with a history of nephrotic syndrome, complicated by toes necrosis. The diagnosis was made by Doppler ultrasonography. Thrombectomy was performed and the patient received an anticoagulant treatment. Local cares have improved the local state, avoiding surgical necrosectomy...
February 1, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28151868/impact-of-betablockers-on-general-and-local-outcome-in-patients-hospitalized-for-lower-extremity-peripheral-artery-disease-the-copart-registry
#12
Tristan Mirault, Alexandre Galloula, Jean-Pierre Cambou, Philippe Lacroix, Victor Aboyans, Carine Boulon, Joel Constans, Alessandra Bura-Riviere, Emmanuel Messas
Lower extremity peripheral artery disease (PAD) is one manifestation of atherosclerosis. Patients with PAD have an increased rate of mortality due to concurrent coronary artery disease and hypertension. Betablockers (BB) may, therefore, be prescribed, especially in case of heart failure. However, BB safety in PAD is controversial, because of presumed peripheral hemodynamic consequences of BB that could lead to worsening of symptoms in patients with PAD. In this context, we aimed to determine the impact of BB on all-cause and cardiovascular mortality and amputation rate at 1 year after hospitalization for PAD from the COPART Registry population...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28128542/management-of-ambulatory-day-case-endovascular-procedures-for-peripheral-arterial-disease
#13
Alexandra Hauguel, Blandine Maurel, Nicolas Bague, Flora Vulcain-Gouailler, Alain Costargent, Philippe Chaillou, Yann Gouëffic
BACKGROUND: Thanks to exceptional improvements in technological developments and vascular teams' expertise, endovascular repair of peripheral arterial disease (PAD) has drastically increased these past decades. Incidence of PAD rising, pressure to reduce costs and patient's empowerment make outpatient endovascular procedures for PAD an attractive alternative to conventional hospitalization. This review describes outpatient endovascular procedures for PAD in the literature. METHODS: We used PRISMA guidelines and Medline to conduct this systematic review...
January 27, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28126175/risk-factors-for-30-day-unplanned-readmission-following-infrainguinal-endovascular-interventions
#14
Thomas C F Bodewes, Peter A Soden, Klaas H J Ultee, Sara L Zettervall, Alexander B Pothof, Sarah E Deery, Frans L Moll, Marc L Schermerhorn
OBJECTIVE: Unplanned hospital readmissions following surgical interventions are associated with adverse events and contribute to increasing health care costs. Despite numerous studies defining risk factors following lower extremity bypass surgery, evidence regarding readmission after endovascular interventions is limited. This study aimed to identify predictors of 30-day unplanned readmission following infrainguinal endovascular interventions. METHODS: We identified all patients undergoing an infrainguinal endovascular intervention in the targeted vascular module of the American College of Surgeons National Surgical Quality Improvement Program between 2012 and 2014...
February 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28123169/pathophysiology-of-intermittent-claudication-in-peripheral-artery-disease
#15
Naomi M Hamburg, Mark A Creager
Peripheral artery disease (PAD) affects more than 200 million adults worldwide. Patients with lower extremity PAD have a heightened risk for cardiovascular events because of the systemic nature of atherosclerosis, and benefit from treatment with risk factor-modifying therapies. Limb symptoms in PAD include intermittent claudication and diminished walking ability. Arterial obstruction from atherosclerotic lesions initiates limb ischemia; however, decreased perfusion incompletely determines the clinical expression of PAD and its response to therapy...
January 26, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28121366/the-use-of-vascularised-bone-capping-to-prevent-and-treat-amputation-stump-spiking-in-the-paediatric-population
#16
Adrian D Murphy, Sara E Atkins, Damon J Thomas, David McCombe, Chris J Coombs
BACKGROUND: Overgrowth of the stump skeleton is a major complication seen in children after an amputation. In advanced cases, perforation of the bone spike through the skin can occur. Many surgical treatments have been employed to treat and prevent this, with best results seen when non-vascularised osteo-chondral bone grafts are placed to try to mimic a trans-articular amputation. We reviewed our outcomes using vascularized bone flaps to prevent and treat spiking. PATIENTS AND METHODS: Between 2000 and 2016 we carried out six vascularised osteo-cartilaginous bone capping procedures...
January 25, 2017: Microsurgery
https://www.readbyqxmd.com/read/28116273/primary-total-hip-replacement-for-a-femoral-neck-fracture-in-a-below-knee-amputee
#17
Karim Masmoudi, Hédi Rbai, Ayman Ben Fradj, Jecem Saâdena, Anouar Boughattas
INTRODUCTION: Femoral neck fracture on amputated limb is an uncommon lesion and challenging to manage. CASE REPORT: We report a case of a displaced neck fracture of the left femur in a 57-year-old female. She underwent at the age of the three a below-knee amputation of the ipsilateral limb for post traumatic ischemia. The fracture was managed by a total hip arthroplasty (THA), as a primary procedure. In this article we describe our experience of this unusual entity...
July 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28095625/potentiation-of-biological-effects-of-mesenchymal-stem-cells-in-ischemic-conditions-by-melatonin-via-upregulation-of-cellular-prion-protein-expression
#18
Jun Hee Lee, Yong-Seok Han, Sang Hun Lee
Mesenchymal stem cells (MSCs) are promising candidates for stem cell-based therapy in ischemic diseases. However, ischemic injury induces pathophysiological conditions, such as oxidative stress and inflammation, which diminish therapeutic efficacy of MSC-based therapy by reducing survival and functionality of transplanted MSCs. To overcome this problem, we explored the effects of melatonin on the proliferation, resistance to oxidative stress, and immunomodulatory properties of MSCs. Treatment with melatonin enhanced MSC proliferation and self-renewal via upregulation of cellular prion protein (PrP(C) ) expression...
January 17, 2017: Journal of Pineal Research
https://www.readbyqxmd.com/read/28093811/routine-use-of-distal-arterial-perfusion-in-pediatric-femoral-venoarterial-extracorporeal-membrane-oxygenation
#19
Christine A Schad, Brian P Fallon, Julie Monteagudo, Shunpei Okochi, Eva W Cheung, Nicholas J Morrissey, Angela V Kadenhe-Chiweshe, Gudrun Aspelund, Steven Stylianos, William Middlesworth
Lower-extremity ischemia is a significant complication in children on femoral venoarterial extracorporeal membrane oxygenation (VA ECMO). Our institution currently routinely uses distal perfusion catheters (DPCs) in all femoral arterial cannulations in attempts to reduce ischemia. We performed a single-center, retrospective review of pediatric patients supported with femoral VA ECMO from January 2005 to November 2015. The outcomes of patients with prophylactic DPC placement at cannulation (prophylactic DPC) were compared to a historical group with DPCs placed in response only to clinically evident ischemic changes (reactive DPC)...
January 2017: Artificial Organs
https://www.readbyqxmd.com/read/28075499/long-term-outcome-following-remote-ischemic-postconditioning-during-percutaneous-coronary-interventions-the-rip-pci-trial-long-term-follow-up
#20
Shahar Lavi, Nour Abu-Romeh, Sabrina Wall, Mistre Alemayehu, Ronit Lavi
The clinical value of ischemic conditioning during percutaneous coronary intervention (PCI) and mode of administration is controversial. Our aim was to assess the long-term effect of remote ischemic postconditioning among patients undergoing PCI. We randomized 360 patients undergoing PCI who presented with a negative troponin T at baseline into 3 groups: 2 groups received remote ischemic postconditioning (with ischemia applied to the arm in 1 group and to the thigh in the other group), and the third group acted as a control group...
January 11, 2017: Clinical Cardiology
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