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Lower limb ischemia

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https://www.readbyqxmd.com/read/28421855/midterm-outcomes-after-infrapopliteal-interventions-in-patients-with-critical-limb-ischemia-based-on-the-tasc-ii-classification-of-below-the-knee-arteries
#1
Gagan D Singh, Ellen K Brinza, Justin Hildebrand, Stephen W Waldo, T Raymond Foley, John R Laird, Ehrin J Armstrong
PURPOSE: To analyze the relationship between the new TransAtlantic Inter-Society Consensus (TASC II) infrapopliteal classification and limb outcomes among patients with critical limb ischemia (CLI). METHODS: A single-center retrospective study was performed on 166 consecutive CLI patients (mean age 71 years; 113 men) undergoing endovascular treatment of 244 infrapopliteal lesions from 2006 to 2013. Patient, procedural, angiographic, and limb outcomes were compared for the new TASC A/B vs C/D classification for infrapopliteal lesions...
April 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28412011/-nicolau-livedoid-dermatitis-with-severe-neurological-involvement-in-a-child
#2
F-Z Elfatoiki, A Ennajdi, W Gueddari, S Chiheb
BACKGROUND: Nicolau syndrome is a rare condition consisting in tissue ischemia and necrosis following intramuscular, intra-articular or subcutaneous injection. PATIENTS AND METHODS: Immediately after gluteal intramuscular injection of benzathine-penicillin, a 10-year-old male child presented an extensive painful violaceous lesion on the left buttock associated with urinary incontinence and left lower-limb paresis. Additional underlying muscular damage was supported by high serum levels of creatine kinase and lactate dehydrogenase...
April 12, 2017: Annales de Dermatologie et de Vénéréologie
https://www.readbyqxmd.com/read/28411244/long-term-follow-up-of-the-padi-trial-percutaneous-transluminal-angioplasty-versus-drug-eluting-stents-for-infrapopliteal-lesions-in-critical-limb-ischemia
#3
Marlon I Spreen, Jasper M Martens, Bob Knippenberg, Lukas C van Dijk, Jean-Paul P M de Vries, Jan Albert Vos, Gert Jan de Borst, Evert-Jan P A Vonken, Okker D Bijlstra, Jan J Wever, Randolph G Statius van Eps, Willem P Th M Mali, Hendrik van Overhagen
BACKGROUND: Clinical outcomes reported after treatment of infrapopliteal lesions with drug-eluting stents (DESs) have been more favorable compared with percutaneous transluminal angioplasty with a bailout bare metal stent (PTA-BMS) through midterm follow-up in patients with critical limb ischemia. In the present study, long-term results of treatment of infrapopliteal lesions with DESs are presented. METHODS AND RESULTS: Adults with critical limb ischemia (Rutherford category ≥4) and infrapopliteal lesions were randomized to receive PTA-BMS or DESs with paclitaxel...
April 14, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28410939/acute-hand-ischemia-following-elective-venous-sclerotherapy-for-dorsal-hand-varicose-veins
#4
Steven M Andelman, Amanda L Walsh, Todd A Rubin, Michael R Hausman
Venous sclerotherapy is an emerging cosmetic treatment option for dorsal hand varicose veins. Although venous sclerotherapy is considered a safe and effective procedure for treatment of venous malformations and varicosities in both the upper and lower extremities, inadvertent injection of the sclerosing agent into the arterial system has led to reported instances of acute ischemic events and distal limb necrosis. This is a rare but well-documented complication of lower-extremity venous sclerotherapy. Only 2 cases have been reported in upper-extremity venous sclerotherapy, both of which occurred during treatment of complex vascular malformations...
April 12, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28410924/society-for-vascular-surgery-wound-ischemia-foot-infection-wifi-score-correlates-with-the-intensity-of-multimodal-limb-treatment-and-patient-centered-outcomes-in-patients-with-threatened-limbs-managed-in-a-limb-preservation-center
#5
William P Robinson, Lorraine Loretz, Colleen Hanesian, Julie Flahive, John Bostrom, Nicholas Lunig, Andres Schanzer, Louis Messina
OBJECTIVE: The Society for Vascular Surgery Wound, Ischemia, foot Infection (WIfI) system aims to stratify threatened limbs according to their anticipated natural history and estimate the likelihood of benefit from revascularization, but whether it accurately stratifies outcomes in limbs undergoing aggressive treatment for limb salvage is unknown. We investigated whether the WIfI stage correlated with the intensity of limb treatment required and patient-centered outcomes. METHODS: We stratified limbs from a prospectively maintained database of consecutive patients referred to a limb preservation center according to WIfI stage (October 2013-May 2015)...
April 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28408154/outcomes-for-critical-limb-ischemia-are-driven-by-lower-extremity-revascularization-volume-not-distance-to-hospital
#6
Ankit N Medhekar, Doran S Mix, Christopher T Aquina, Lauren E Trakimas, Katia Noyes, Fergal J Fleming, Roan J Glocker, Michael C Stoner
OBJECTIVE: The objective of this study was to identify relationships among geographic access to care, vascular procedure volume, limb preservation, and survival in patients diagnosed with critical limb ischemia (CLI). METHODS: Using New York State administrative data from 2000 to 2013, we identified a patient's first presentation with CLI defined by International Classification of Diseases, Ninth Revision diagnosis and procedure codes. Distance from the patient's home to the index hospital was calculated using the centroids of the respective ZIP codes...
April 10, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28407473/trimodal-rescue-of-hind-limb-ischemia-with-growth-factors-cells-and-nanocarriers-fundamentals-to-clinical-trials
#7
Rajesh Laksmanan, Gopi Ukani, Muhammad Tipu Rishi, Nilanjana Maulik
Peripheral Artery Disease is a severe medical condition commonly characterized by critical or acute limb ischemia. Gradual accumulation of thrombotic plaques in peripheral arteries of the lower limb may lead to intermittent claudication or ischemia in muscle tissue. Ischemic muscle tissue with lesions may become infected, resulting in a non-healing wound. Stable progression of the non-healing wound associated with severe ischemia might lead to functional deterioration of the limb, which, depending on the severity, can result in amputation...
April 13, 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28406877/scapulothoracic-dissociation-evaluation-and-management
#8
Andrew M Choo, Patrick C Schottel, Andrew R Burgess
Scapulothoracic dissociation is a rare, potentially limb- and life-threatening injury of the shoulder girdle. The injury is characterized by lateral displacement of the scapula resulting from traumatic disruption of the scapulothoracic articulation. The typical physical examination findings consist of substantial swelling of the shoulder girdle, along with weakness, numbness, and pulselessness in the ipsilateral upper extremity. Radiographic evaluation includes measurement of the scapular index on a nonrotated chest radiograph and assessment for either a distracted clavicle fracture or a disrupted acromioclavicular or sternoclavicular joint...
May 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28405996/ebstein-s-anomaly-with-paradoxical-embolism-to-lower-limb
#9
Gouranga Santra, Shinjan Patra
Ebstein's anomaly (EA) is a rare congenital heart disease. Paradoxical embolism (PDE) may occur in EA due to associated atrial septal defect (ASD). An 18 year old male with EA presented with left lower limb ischemia due to PDE to the limb. No features of cerebral embolism was present. PDE is a potential complication of EA. High level of awareness is needed for early diagnosis of PDE in EA to save a limb in case of embolism to the extremity.
December 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28400218/outcomes-of-the-japanese-multicenter-viabahn-trial-of-endovascular-stent-grafting-for-superficial-femoral-artery-lesions
#10
Takao Ohki, Kimihiko Kichikawa, Hiroyoshi Yokoi, Masaaki Uematsu, Terutoshi Yamaoka, Koji Maeda, Yuji Kanaoka
OBJECTIVE: The objective of this study was to assess 1-year safety, efficacy, and invasiveness outcomes of endovascular stent grafting of symptomatic long lesions (≥10 cm) in the superficial femoral artery (SFA) as a substitute for above-knee open bypass surgery. METHODS: This prospective, multicenter (15 hospitals) study assessed heparin-coated stent grafts for the treatment of long SFA lesions in Japanese subjects with peripheral arterial disease. Inclusion criteria were Rutherford category 2 to 5 symptoms (grade 5 without active infection), ankle-brachial index ≤0...
April 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28400063/first-case-of-ischemic-stroke-which-happened-during-continuous-intravenous-infusion-of-rt-pa
#11
Anna Zurawska, Jaroslaw Czeczotka, Jacek J Rozniecki
Catheter-directed thrombolysis (CDT) is one of the methods in the treatment of patients with acute lower limb ischemia. It is based on intrathrombus infusion of one of the thrombolytic agents. The most common complication of CDT is bleeding. We present a patient with left lower limb ischemia, treated by CDT, in which symptoms of stroke, proved to have ischemic etiology, started during continuous intra-arterial infusion of rt-PA. As the patient presented with the history of atrial fibrillation, the most probable mechanism of stroke was related to detachment of possible intra-atrial thrombus...
March 18, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28393971/-mechanical-and-pharmacomechanical-trombolysis-in-deep-venous-thrombosis-with-no-clinical-response-to-conventional-treatment
#12
Leopoldo Marine, Jesús Urbina, Michel Bergoeing, Francisco Valdés, Renato Mertens, Albrecht Kramer
BACKGROUND: Conventional treatment of deep vein thrombosis (DVT) is anticoagulation, bed rest and limb elevation. Proximal DVT patients with persisting edema, pain and cyanosis of extremities despite of conventional therapy may develop ischemia. Direct treatment of thrombosis becomes necessary. AIM: To report our experience with mechanical trombolysis of proximal lower extremity DVT. MATERIAL AND METHODS: Retrospective review of medical records of proximal DVT patients treated with thrombolysis between March 2012 and August 2015...
January 2017: Revista Médica de Chile
https://www.readbyqxmd.com/read/28392250/unusual-clinical-complication-acute-lower-limb-ischemia-caused-by-a-tibial-osteochondroma
#13
Noelia Alonso-Gómez, Miguel Cuesta-de Diego, Antonio Martínez-Izquierdo, Felipe Sáinz-González
No abstract text is available yet for this article.
April 6, 2017: Reumatología Clinica
https://www.readbyqxmd.com/read/28390911/critical-limb-ischemia-secondary-to-antiphospholipid-syndrome-in-a-pediatric-patient-case-report-and-review
#14
Andrew J Soo Hoo, Joseph M White, Paul W White
A pediatric patient with critical limb ischemia secondary to antiphospholipid syndrome (APS) is reported. A 14-year-old male underwent extensive evaluation for worsening right lower extremity pain and ulcerative lesions of his right foot. He was discovered to have proximal occlusion of the superficial femoral artery (SFA), the distal popliteal artery, the anterior tibial artery at the mid-calf, and the posterior tibial artery at the ankle. Laboratory analysis revealed a diagnosis of APS, and he underwent a common femoral artery to above-knee-popliteal artery bypass with reversed greater saphenous graft...
April 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28390771/contemporary-outcomes-of-surgical-revascularization-of-the-lower-extremity-in-patients-on-dialysis
#15
Ajit Rao, Melissa Baldwin, James Cornwall, Michael Marin, Peter Faries, Ageliki Vouyouka
OBJECTIVE: Peripheral arterial disease is a common comorbidity found in up to 38% of patients with end-stage renal disease (ESRD). With an increase in the survival rate of patients with ESRD by >25%, there is a lack of contemporary data on the safety of open surgical revascularization of the lower extremity (OSRLE) in this population of patients. We sought to identify the perioperative morbidity and mortality and independent risk factors of mortality in dialysis patients undergoing OSRLE...
April 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28389290/symptomatic-intragraft-thrombus-following-endovascular-repair-of-blunt-thoracic-aortic-injury
#16
Sherwin Abdoli, Sung Wan Ham, Alison G Wilcox, Fernando Fleischman, Lydia Lam
INTRODUCTION: Thoracic endovascular aortic repair (TEVAR) can be complicated by graft collapse, endoleaks, and stent migration. The incidence of these complications and other outcomes is poorly understood in young trauma victims who receive endovascular aortic repair of blunt thoracic aortic injury. REPORT: A 29 year-old pedestrian was struck by a vehicle resulting in polytrauma including blunt thoracic aortic injury (BTAI) with transection distal to the left subclavian artery origin...
April 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28378609/antegrade-vs-crossover-femoral-artery-access-in-the-endovascular-treatment-of-isolated-below-the-knee-lesions-in-patients-with-critical-limb-ischemia
#17
Yukun Li, Ali Esmail, Konstantinos P Donas, Georgios Pitoulias, Giovanni Torsello, Theodosios Bisdas, Stefano Michelagnoli, Nicola Troisi
PURPOSE: To evaluate the safety and effectiveness of antegrade vs crossover femoral artery access in the endovascular treatment of isolated below-the-knee (BTK) lesions in patients with critical limb ischemia (CLI). METHODS: Between January 2014 and December 2015, 224 high-risk patients (mean age 75.8±9.8 years; 151 men) with CLI underwent infragenicular interventions on 292 crural vessels in 3 European vascular centers. All patients had isolated TransAtlantic Inter-Society Consensus (TASC) C (n=26) or D (n=198) BTK lesions...
April 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28376797/impact-of-diabetes-on-outcome-in-critical-limb-ischemia-with-tissue-loss-a-large-scaled-routine-data-analysis
#18
Eva Freisinger, Nasser M Malyar, Holger Reinecke, Holger Lawall
BACKGROUND: Patients with diabetes concomitant to critical limb ischemia (CLI) represent a sub-group at particular risk. Objective of this analysis is to evaluate the actual impact of diabetes on treatment, outcome, and costs in a real-world scenario in Germany. METHODS: We obtained routine-data on 15,332 patients with CLI with tissue loss from the largest German health insurance, BARMER GEK from 2009 to 2011, including a follow-up until 2013. Patient data were analyzed regarding co-diagnosis with diabetes with respect to risk profiles, treatment strategy, in-hospital and long-term outcome including costs...
April 4, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28376704/management-of-isolated-atherosclerotic-stenosis-of-the-common-femoral-artery-a-review-of-the-literature
#19
David Halpin, Young Erben, Sasanka Jayasuriya, Bennett Cua, Sunny Jhamnani, Carlos Mena-Hurtado
OBJECTIVE: Common femoral endarterectomy (CFE) remains the standard of care for treatment of atherosclerotic stenosis of the common femoral artery (CFA). Endovascular interventions have become the first-line therapy for atherosclerotic disease of the aortoiliac and femoropopliteal systems. Recent reports have documented high rates of technical success and low rates of complications with endovascular management of CFA stenosis. This study is a contemporary review of the surgical and endovascular literature on the management CFA stenosis and compares the results of these methods...
May 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28370223/novel-assessment-tool-based-on-laser-speckle-contrast-imaging-to-diagnose-severe-ischemia-in-the-lower-limb-for-patients-with-peripheral-arterial-disease
#20
Sotaro Katsui, Yoshinori Inoue, Kimihiro Igari, Takahiro Toyofuku, Toshifumi Kudo, Hiroyuki Uetake
OBJECTIVE: We propose a new assessment tool to diagnose severe ischemia of the lower limb in peripheral arterial disease, using laser speckle contrast imaging to evaluate heating-induced microcirculatory fluctuations in the proximal and distal sites of the dorsal foot. STUDY DESIGN: A cross-sectional study. METHODS: We recorded the slope describing the behavior of perfusion values (decrease or plateau) following the initial, heating-induced increase in perfusion in 63 feet of patients with clinical signs of peripheral arterial disease...
April 2, 2017: Lasers in Surgery and Medicine
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