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Lower limb ischemia

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https://www.readbyqxmd.com/read/28741197/axillobifemoral-bypasses-reappraisal-of-an-extra-anatomic-bypass-by-analysis-of-results-and-prognostic-factors
#1
D Dickas, F Verrel, J Kalff, A Koscielny
BACKGROUND: Axillobifemoral bypass (AFB) is method of second choice. It is reserved for patients at high operative risk or to bypass infected vessels or grafts. In this study, we analyzed prognostic factors for AFB patency and limb salvage rate to facilitate the choice of procedure. METHODS: Between Jan 2006 and Aug 2013, 45 patients underwent AFB surgery in our department, 24 for critical limb ischemia (CLI) and 23 for infection. Endpoints of study were graft occlusion, graft infection, amputation and patient's death...
July 24, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28740785/coronary-artery-disease-in-patients-with-critical-limb-ischemia-undergoing-major-amputation-or-not
#2
Akio Nishijima, Naoto Yamamoto, Ryuichi Yoshida, Koji Hozawa, Satoshi Yanagibayashi, Megumi Takikawa, Rie Hayasaka, Junko Nishijima, Masahiko Gosho, Haruo Nishijima
BACKGROUND: Due to the increase of elderly and diabetes patients, surgeons encounter patients requiring treatment of critical limb ischemia (CLI) in the presence of systemic arteriosclerotic diseases. In this study, we retrospectively investigated the prevalence of coronary artery disease (CAD) in patients with CLI who underwent major (above-the-ankle) amputation or nonmajor amputation (below-the-ankle amputation or debridement of wound). METHODS: We retrospectively investigated 129 consecutive patients surgically managed for CLI in our institution between January 2013 and December 2015...
June 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28739471/comparison-of-low-dose-catheter-directed-thrombolysis-with-and-without-pharmacomechanical-thrombectomy-for-acute-lower-extremity-ischemia
#3
Sagar S Gandhi, Joseph A Ewing, Emily Cooper, Jose Mauro Chaves, Bruce H Gray
INTRODUCTION: Catheter directed thrombolysis (CDT) and/or pharmacomechanical thrombectomy (PMT) can dissolve/remove thrombus; PMT alone, however, may require the adjunctive use of CDT. The aim of this study was to compare the use of CDT with and without PMT for the treatment of acute limb ischemia (ALI). METHODS: We retrospectively reviewed all patients with ALI who underwent CDT with or without PMT between January 2008 and April 2014 (N=99). Patients with incomplete medical charts were excluded (n=16)...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28739456/acute-type-b-dissection-causing-collapse-of-evar-endograft-and-iliac-limb-occlusion
#4
Nathan K Itoga, Tiffany Wu, Michael D Dake, Ronald L Dalman, Jason T Lee
We describe a rare case of acute type B dissection causing collapse of a previously placed infrarenal stent-graft, resulting in acute limb ischemia due to left iliac limb thrombosis in a 59-year-old male. The patient presented with acute back and abdominal discomfort radiating to his back, bilateral buttock stabbing discomfort, and left> right thigh and calf rest pain. CTA showed a spiral type B dissection with collapse of the proximal portion of the EVAR device and left limb occlusion. Urgent treatment with TEVAR distal to the left subclavian covered the entry tear and redirected the majority of the flow to the true lumen leading to near immediate expansion of the proximal portion of the EVAR device...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28721011/effect-of-picroside-ii-on-hind-limb-ischemia-reperfusion-injury-in-rats
#5
Yiğit Kılıç, Abdullah Özer, Tolga Tatar, Mustafa Hakan Zor, Mehmet Kirişçi, Hakan Kartal, Ali Doğan Dursun, Deniz Billur, Mustafa Arslan, Ayşegül Küçük
INTRODUCTION: Many structural and functional damages are observed in cells and tissues after reperfusion of previously viable ischemic tissues. Acute ischemia reperfusion (I/R) injury of lower extremities occurs especially when a temporary cross-clamp is applied to the abdominal aorta during aortic surgery. Research regarding the treatment of I/R injury has been increasing day-by-day. In this study, we aimed to investigate the effect of picroside II on skeletal muscle of rats experiencing simulated I/R...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28712733/long-term-outcomes-after-autogenous-versus-synthetic-lower-extremity-bypass-in-patients-on-hemodialysis
#6
Isibor Arhuidese, Caitlin W Hicks, Satinderjit Locham, Tammam Obeid, Besma Nejim, Mahmoud B Malas
BACKGROUND: Hemodialysis dependence confers unique physiologic conditions. Prior reports of outcomes after infrainguinal open bypass operations in patients on hemodialysis have been based on relatively small sample institutional series. In this study, we evaluate long-term outcomes after open bypass operations in a large contemporary population-based cohort of hemodialysis patients. We studied all hemodialysis patients who underwent infrainguinal open operation using autogenous versus prosthetic conduits in the United States Renal Data System between January 2007 and December 2011...
July 13, 2017: Surgery
https://www.readbyqxmd.com/read/28705403/symptomatic-lower-limb-giant-cell-arteritis-characteristics-management-and-long-term-outcome
#7
C Le Hello, L Auboire, L Berger, D Gouicem, M T Barrellier, S Duthois
OBJECTIVE: To describe characteristics and long-term outcomes of the rare symptomatic lower-limb giant-cell arteritis (LL-GCA). METHODS: Retrospective analysis of 8 patients (6 women; mean±SD age, 63.6±10.9 years; follow-up, 137.3±57.3 months). RESULTS: Four patients satisfied≥3 American College of Rheumatology (ACR) GCA-classification criteria; 4 had<3 criteria and histological LL-GCA proof or associated typical upper-limb involvement...
May 2017: J Med Vasc
https://www.readbyqxmd.com/read/28697938/outcomes-of-endovascular-recanalization-versus-autogenous-venous-bypass-for-thromboangiitis-obliterans-patients-with-critical-limb-ischemia-due-to-tibioperoneal-arterial-occlusion
#8
Kaichuang Ye, Huihua Shi, Jinbao Qin, Minyi Yin, Xiaobing Liu, Weimin Li, Mi'er Jiang, Xinwu Lu
OBJECTIVE: This study sought to compare the outcomes of endovascular recanalization (ER) vs autogenous venous bypass (AVB) for tibioperoneal arterial occlusion in thromboangiitis obliterans patients with critical lower limb ischemia. METHODS: A total of 90 limbs in 75 patients, successfully treated with ER (ER group, 35 patients, 43 limbs) and AVB (AVB group, 40 patients, 47 limbs) for tibioperoneal arterial occlusions from January 2009 to December 2015 in a single institution, were retrospectively analyzed...
July 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28689936/results-of-one-stage-or-staged-amputations-of-lower-limbs-consequent-to-critical-limb-ischemia-and-infection
#9
Leandro Ramos Silva, Giordano Masini Fernandes, Natacha Ueda Morales, Marcone Lima Sobreira, Regina Moura, Matheus Bertanha, Winston Bonetti Yoshida
BACKGROUND: Amputations of lower limbs can be conducted as one-stage (OSA) or staged procedures (SA). OBJECTIVE: To analyze technical success and mortality rates of both techniques, as well as factors that might influence outcomes in patients with critical limb ischemia (CLI). METHODS: Retrospective study of 185 consecutive patients with CLI who underwent amputations in the period 2004-2011. Primary endpoints were rates of technical success (healing without dehiscence or reintervention), and mortality...
July 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28687310/structural-and-functional-disorders-of-hippocampus-following-ischemia-reperfusion-in-lower-limbs-and-kidneys
#10
Narges Karimi, Masoud Haghani, Ali Noorafshan, Seyed Mostafa Shid Moosavi
Recent evidence suggests that ischemia/reperfusion (I/R) in an organ may have distance effect on the brain. In this study, the effects of renal I/R, limb I/R or both together on the structural and function of hippocampus were evaluated and compared. Hence, rats were subjected to 2-h bilateral lower limb ischemia, 45-min bilateral renal ischemia, or combined limb and renal ischemia followed by 1-day reperfusion. At 22-h reperfusion, each rat was fixed on a stereotaxic apparatus for performing electrophysiological study on the hippocampus...
July 4, 2017: Neuroscience
https://www.readbyqxmd.com/read/28674266/pilot-cohort-study-assessing-the-efficacy-of-endovascular-revascularization-in-the-restoration-of-peripheral-sensory-disturbance-in-patients-with-critical-limb-ischemia
#11
Kentaro Jujo, Katsumi Saito, Issei Ishida, Yuho Furuki, Eiji Shibahashi, Kensuke Shimazaki, Haruki Sekiguchi, Yuichiro Minami, Junichi Yamaguchi, Hiroshi Ogawa, Nobuhisa Hagiwara
BACKGROUND: Sensory disturbance (SD) is a common consequence of peripheral nerve damage associated with diabetes and severe ischemia. Progression of SD places patients at high risk for lower extremity ulcers and amputations. SD has been thought to be progressive and irreversible, and possibly caused by microvascular dysfunction. The aim of this study was to determine whether endovascular revascularization (EVR) induces quantifiable changes in SD in chronic critical limb ischemia (CLI) patients with neuropathy...
July 1, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28670395/factor-vii-activating-protease-fsap-influences-vascular-remodeling-in-the-mouse-hind-limb-ischemia-model
#12
Joerg Herold, Steven Nowak, Sawa Kostin, Jan-Marcus Daniel, Alexander Francke, Saravanan Subramaniam, Ruediger C Braun-Dullaeus, Sandip M Kanse
BACKGROUND: Investigations in factor VII activating protease (FSAP)(-/-) mice suggest a role for FSAP in stroke, thrombosis and neointima formation. Here, we analyzed the role of FSAP in vascular remodeling processes related to arteriogenesis and angiogenesis in the mouse hind limb ischemia model. METHODS AND RESULTS: Femoral artery ligation was performed in mice and exogenous FSAP was injected locally to examine its effect on arteriogenesis in the adductor and angiogenesis in the gastrocnemius muscle over 21 days...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/28662928/surveillance-after-endovascular-aortic-repair
#13
Feras Zaiem, Jehad Almasri, Mouaffaa Tello, Larry J Prokop, Elliot L Chaikof, Mohammad Hassan Murad
OBJECTIVE: The objective of this systematic review and meta-analysis was to evaluate the optimal modality and frequency of surveillance after endovascular aortic repair (EVAR) in adult patients with abdominal aortic aneurysms. METHODS: We searched for studies of post-EVAR surveillance in MEDLINE In-Process & Other Non-Indexed Citations, MEDLINE, Embase, Cochrane Database of Systematic Reviews, and Scopus through May 10, 2016. The outcomes of interest were endoleaks, mortality, limb ischemia, renal complications, late rupture, and aneurysm-related mortality...
June 26, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28655549/lower-extremity-bypass-for-critical-limb-ischemia-decreases-major-adverse-limb-events-with-equivalent-cardiac-risk-compared-with-endovascular-intervention
#14
J Hunter Mehaffey, Robert B Hawkins, Anna Fashandi, Kenneth J Cherry, John A Kern, Irving L Kron, Gilbert R Upchurch, William P Robinson
OBJECTIVE: Lower extremity bypass (LEB) has traditionally been the "gold standard" in the treatment of critical limb ischemia (CLI). Infrainguinal endovascular intervention (IEI) has become more commonly performed than LEB, but comparative outcomes are limited. We sought to compare rates of major adverse limb events (MALEs) and major adverse cardiovascular events (MACEs) after LEB and IEI in a propensity score-matched, national cohort of patients with CLI. METHODS: The National Surgical Quality Improvement Program (NSQIP) vascular targeted files (2011-2014) for LEB and IEI were merged...
June 24, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28654852/adductor-canal-compression-syndrome-in-an-18-year-old-female-patient-leading-to-acute-critical-limb-ischemia-a-case-report
#15
Yi Zhou, Evan J Ryer, Robert P Garvin, Jeremy L Irvan, James R Elmore
BACKGROUND: Adductor canal compression syndrome is a rare non-atherosclerotic cause of arterial occlusion and limb ischemia. PRESENTATION OF CASE: The patient is an 18-year-old healthy female who presented to the emergency department with acute left lower extremity ischemia. Her symptoms began as sudden onset mild foot pain approximately two months ago. Over the 72h prior to presentation, she developed severe pain, pallor, paralysis, loss of pedal pulses, paresthesia, and poikilothermia...
June 17, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28653784/massive-tumor-embolism-in-the-abdominal-aorta-from-pulmonary-squamous-cell-carcinoma-case-report-and-review-of-the-literature
#16
Kenji Ohshima, Yuri Tsujii, Kazuya Sakai, Hiroshi Oku, Eiichi Morii
Acute arterial tumor embolism is a rare complication in cancer patients. Most of the previously reported cases of arterial tumor embolism have been associated with pulmonary malignancies and occurred during the intraoperative and postoperative periods. Very few cases occurred spontaneously. To our knowledge, there is no previous report of spontaneous and massive tumor embolism occluding the abdominal aorta in patients suffering from primary pulmonary carcinoma. We describe the case of 64-year-old man who presented with left homonymous hemianopsia and backache...
June 27, 2017: Pathology International
https://www.readbyqxmd.com/read/28648651/the-impact-of-functional-status-on-the-outcomes-of-endovascular-lower-extremity-revascularization-for-critical-limb-ischemia-in-the-elderly
#17
Isidore Dinga Madou, Martin D Slade, Kristine C Orion, Timur Sarac, Cassius Iyad Ochoa Chaar
INTRODUCTION: Functional status is an important predictor of outcomes after infrainguinal bypass surgery. There is little data on the effect of functional status on the outcomes of endovascular LE interventions, especially in the elderly frail population. METHODS: This is a retrospective analysis of the American College of Surgeons - National Surgical Quality Improvement Program (ACS-NSQIP) files for the years 2011-2013 to assess the impact of functional status on outcome after endovascular intervention for critical limb ischemia...
June 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28648117/alteration-of-sarcoplasmic-reticulum-ca-2-atpase-expression-in-lower-limb-ischemia-caused-by-atherosclerosis-obliterans
#18
J Fodor, A Gomba-Tóth, T Oláh, E Zádor, Zs Cs Tóth, I Ioannis, B Molnár, I Kovács, L Csernoch
Atherosclerosis is a disease caused by a build-up of fatty plaques and cholesterol in the arteries. The lumen of the vessels is obliterated resulting in restricted blood supply to tissues. In ischemic conditions, the cytosolic Ca(2+) level of skeletal muscle may increase, indicating the alteration of Ca(2+) removal mechanisms. Ca(2+) is transported from cytosol into the sarcoplasmic reticulum by Ca(2+) ATPase (SERCA), with its 1a isoform expressed in adult, while its 1b isoform in neonatal and regenerating fast-twitch skeletal muscle...
June 26, 2017: Physiology International
https://www.readbyqxmd.com/read/28647640/bypass-surgery-after-endovascular-therapy-for-infrapopliteal-lesion-is-not-a-poor-outcome-compared-with-initial-bypass-surgery-by-vascular-surgeons
#19
Koichi Morisaki, Terutoshi Yamaoka, Kazuomi Iwasa, Takahiro Ohmine
PURPOSE: It is unclear whether prior endovascular therapy (EVT) adversely affects bypass surgery. The aim of this study is to investigate treatment outcomes between initial bypass (bypass-first) and bypass surgery after EVT (EVT-first). METHODS: We conducted a retrospective analysis of critical limb ischemia patients undergoing infrapopliteal bypass between November 2006 and December 2015. Graft patency, limb salvage (LS), amputation-free survival (AFS), and overall survival (OS) were examined between bypass-first and EVT-first groups...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28647197/characterizing-tissue-perfusion-after-lower-extremity-intervention-using-two-dimensional-color-coded-digital-subtraction-angiography
#20
Ann H Kim, Andrew J Shevitz, Katherine L Morrow, Daniel E Kendrick, Karem Harth, Henry Baele, Vikram S Kashyap
OBJECTIVE: Digital subtraction angiography (DSA) of the peripheral arterial vasculature provides lumenographic information but only a qualitative assessment of blood flow. The ability to quantify adequate tissue perfusion of the lower extremities would enable real-time perfusion assessment during DSA of patients with peripheral arterial disease (PAD). In this study, we used a novel real-time imaging software to delineate tissue perfusion parameters in the foot in PAD patients. METHODS: Between March 2015 and June 2016, patients (N = 31) underwent lower extremity angiography using a two-dimensional perfusion (2DP) imaging protocol (Philips Healthcare, Andover, Mass)...
June 21, 2017: Journal of Vascular Surgery
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