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Lower limb ischemia

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https://www.readbyqxmd.com/read/29147167/validation-of-the-risk-score-of-the-mortality-and-lower-limb-loss-considering-ambulatory-status-after-surgical-revascularization-in-maintaining-patients-with-dialysis
#1
Haruto Yamazaki, Hisae Hayashi, Morio Kawamura, Ayana Sasaki, Eriko Kondo, Shinya Ito, Kenji Wakai
Surgical revascularization is performed to preserve limb and to maintain functional status of patients with critical limb ischemia (CLI). The PREVENT III risk score helps to predict the postoperative course of CLI. However, this score is not available to estimate the risk of amputation or death properly in patients with hemodialysis (HD) and tissue loss (HD: 4 points, Tissue loss: 3 points), because they are classified as a high-risk group. Therefore, we investigated 213 patients with revascularized HD for CLI and proposed prognosis amputation or death for patients with HD risk score (PAD for HD risk score)...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29145340/open-repair-of-intraoperative-popliteal-artery-injury-during-total-knee-arthroplasty-in-a-patient-with-severe-hemophilia-a-a-case-report-and-literature-review
#2
Bin Feng, Ke Xiao, Jiang Shao, Yu Fan, Xisheng Weng
RATIONALE: Arterial injuries during total knee arthroplasty (TKA) though rare may occur. Hemophilia may further challenge the management of such injury. PATIENT CONCERNS: A 48-year-old male patient with severe hemophilia type A and stiff knee arthropathy underwent bilateral TKAs. Left popliteal artery injury was detected at the end of the left TKA. DIAGNOSES: Urgent angiography confirmed the diagnosis of the left popliteal artery transection...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29133605/low-density-lipoprotein-cholesterol-lowering-with-evolocumab-and-outcomes-in-patients-with-peripheral-artery-disease-insights-from-the-fourier-trial-further-cardiovascular-outcomes-research-with-pcsk9-inhibition-in-subjects-with-elevated-risk
#3
Marc P Bonaca, Patrice Nault, Robert P Giugliano, Anthony C Keech, Armando Lira Pineda, Estella Kanevsky, Julia Kuder, Sabina A Murphy, J Wouter Jukema, Basil S Lewis, Lale Tokgozoglu, Ransi Somaratne, Peter S Sever, Terje R Pedersen, Marc S Sabatine
BACKGROUND : The PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitor evolocumab reduced low-density lipoprotein cholesterol and cardiovascular events in the FOURIER trial (Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk). We investigated the efficacy and safety of evolocumab in patients with peripheral artery disease (PAD) as well as the effect on major adverse limb events. METHODS : FOURIER was a randomized trial of evolocumab versus placebo in 27 564 patients with atherosclerotic disease on statin therapy followed for a median of 2...
November 13, 2017: Circulation
https://www.readbyqxmd.com/read/29126895/extracorporeal-membrane-oxygenation-in-circulatory-and-respiratory-failure-a-single-center-experience
#4
Marisa Passos Silva, Daniel Caeiro, Paula Fernandes, Cláudio Guerreiro, Eduardo Vilela, Marta Ponte, Adelaide Dias, Fernando Alves, Jorge Morais, Andreza Mello, Lino Santos, Paula Castelões, Vasco Gama
INTRODUCTION: Extracorporeal membrane oxygenation (ECMO) provides mechanical pulmonary and circulatory support for patients with shock refractory to conventional medical therapy. In this study we aim to describe the indications, clinical characteristics, complications and mortality associated with use of ECMO in a single tertiary hospital. METHODS: We conducted a retrospective observational cohort study of all patients supported with ECMO in two different intensive care units (general and cardiac), from the first patient cannulated in April 2011 up to October 2016...
November 7, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29122516/placenta-derived-plx-pad-mesenchymal-like-stromal-cells-are-efficacious-in-rescuing-blood-flow-in-hind-limb-ischemia-mouse-model-by-a-dose-and-site-dependent-mechanism-of-action
#5
Efrat Zahavi-Goldstein, Michal Blumenfeld, Dana Fuchs-Telem, Lena Pinzur, Shy Rubin, Zami Aberman, Noa Sher, Racheli Ofir
BACKGROUND: In peripheral artery disease (PAD), blockage of the blood supply to the limbs, most frequently the legs, leads to impaired blood flow and tissue ischemia. Pluristem's PLX-PAD cells are placenta-derived mesenchymal stromal-like cells currently in clinical trials for the treatment of peripheral artery diseases. METHODS: In this work, the hind limb ischemia (HLI) mouse model was utilized to study the efficacy and mechanism of action of PLX-PAD cells. ELISA assays were performed to characterize and quantitate PLX-PAD secretions in vitro...
November 6, 2017: Cytotherapy
https://www.readbyqxmd.com/read/29088925/predictive-value-of-underweight-status-for-patients-with-peripheral-artery-disease-with-claudication
#6
Keisuke Senda, Takashi Miura, Masatoshi Minamisawa, Yasushi Ueki, Tomoaki Mochidome, Hidetomo Nomi, Wataru Shoin, Satoko Higuchi, Yasutaka Oguchi, Hitoshi Nishimura, Tatsuya Saigusa, Soichiro Ebisawa, Hirohiko Motoki, Atsushi Izawa, Jun Koyama, Uichi Ikeda, Koichiro Kuwahara
We evaluated whether underweight status is associated with poor prognosis in patients with peripheral artery disease (PAD) with claudication, excluding critical limb ischemia. We identified 441 claudicants hospitalized for cardiovascular disease between 2005 and 2012. Patients were divided into 4 groups according to body mass index (BMI): an underweight group (BMI < 18.5 kg/m(2); n = 48), a normal group (BMI = 18.5-25.0 kg/m(2); n = 286), an overweight group (BMI = 25.0-30.0 kg/m(2); n = 92), and an obese group (BMI ≥ 30...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/29079009/long-term-mortality-benefit-of-renin-angiotensin-system-inhibitors-in-patients-with-chronic-limb-threatening-ischemia-undergoing-vascular-intervention
#7
Thomas C F Bodewes, Jeremy D Darling, Thomas F X O'Donnell, Sarah E Deery, Katie E Shean, Murray A Mittleman, Frans L Moll, Marc L Schermerhorn
OBJECTIVE: The beneficial effect of renin-angiotensin system (RAS) inhibitors has been well-established in patients with cardiovascular disease; however, their effectiveness in patients with chronic limb-threatening ischemia (CLTI), a selected disease-burdened population, is largely unknown. The purpose of this study was to evaluate long-term outcomes of RAS inhibitor use in patients with CLTI undergoing a vascular intervention. METHODS: For this study, all patients with CLTI undergoing a first-time revascularization (bypass or endovascular) were analyzed at our institution between 2005 and 2014...
October 24, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29074815/hyperbaric-oxygen-therapy-in-the-treatment-of-ischemic-lower-extremity-ulcers-in-patients-with-diabetes-results-of-the-damo2cles-multicenter-randomized-clinical-trial
#8
Katrien T B Santema, Robert M Stoekenbroek, Mark J W Koelemay, Jim A Reekers, Laura M C van Dortmont, Arno Oomen, Luuk Smeets, Jan J Wever, Dink A Legemate, Dirk T Ubbink
OBJECTIVE: Conflicting evidence exists on the effects of hyperbaric oxygen therapy (HBOT) in the treatment of chronic ischemic leg ulcers. The aim of this trial was to investigate whether additional HBOT would benefit patients with diabetes and ischemic leg ulcers. RESEARCH DESIGN AND METHODS: Patients with diabetes with an ischemic wound (n = 120) were randomized to standard care (SC) without or with HBOT (SC+HBOT). Primary outcomes were limb salvage and wound healing after 12 months, as well as time to wound healing...
October 26, 2017: Diabetes Care
https://www.readbyqxmd.com/read/29072090/hospital-cost-impact-of-orbital-atherectomy-with-angioplasty-for-critical-limb-ischemia-treatment-a-modeling-approach
#9
Nicolas W Shammas, Christopher W Boyes, Swetha R Palli, John A Rizzo, Brad J Martinsen, Harry Kotlarz, J A Mustapha
AIM: The incremental cost of peripheral orbital atherectomy system (OAS) plus balloon angioplasty (BA) versus BA-only for critical limb ischemia was estimated. MATERIALS & METHODS: A deterministic simulation model used clinical and healthcare utilization data from the CALCIUM 360° trial and current cost data. Incremental cost of OAS + BA versus BA-only included differential utilization during the procedure and adverse-event costs at 3, 6 and 12-months. RESULTS: For every 100 procedures, incremental annual costs to the hospital were USD$350,930 lower with OAS + BA compared with BA-only...
October 26, 2017: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/29062634/septic-shock-following-prostate-biopsy-aggressive-limb-salvage-for-extremities-after-pressor-induced-ischemic-gangrene
#10
Jocelyn Lu, Tammer Elmarsafi, Chrisovalantis Lakhiani, Sarah R Sher, Christopher Attinger, Karen K Evans
Vasopressors used to treat patients with septic shock can cause ischemic necrosis of appendages such as the ears and nose, as well as the extremities. Cases of quadruple-extremity necrosis have high morbidity and mortality, and a profound negative impact on quality of life. This case report details the successful limb salvage and return to function using free tissue transfer as a means to salvage bilateral lower extremities in a patient who suffered vasopressor-induced ischemia of upper and lower extremities after prostate biopsy-induced septic shock...
September 2017: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29054842/acute-biventricular-mechanical-circulatory-support-for-cardiogenic-shock
#11
Sudeep Kuchibhotla, Michele L Esposito, Catalina Breton, Robert Pedicini, Andrew Mullin, Ryan O'Kelly, Mark Anderson, Dennis L Morris, George Batsides, Danny Ramzy, Mark Grise, Duc Thinh Pham, Navin K Kapur
BACKGROUND: Biventricular failure is associated with high in-hospital mortality. Limited data regarding the efficacy of biventricular Impella axial flow catheters (BiPella) support for biventricular failure exist. The aim of this study was to explore the clinical utility of percutaneously delivered BiPella as a novel acute mechanical support strategy for patients with cardiogenic shock complicated by biventricular failure. METHODS AND RESULTS: We retrospectively analyzed data from 20 patients receiving BiPella for biventricular failure from 5 tertiary-care hospitals in the United States...
October 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29036797/effects-of-venotonic-drugs-on-the%C3%A2-microcirculation-comparison-between-ruscus-extract-and-micronized-diosmine1
#12
Fatima Zely Garcia de Almeida Cyrino, Daniela Signorelli Balthazar, Fernando Lencastre Sicuro, Eliete Bouskela
BACKGROUND: Chronic venous disease of the lower limbs is a common public health problem worldwide with negative impact on quality of life and results with drugs used to treat it are sparse, probably due to lack of good experimental models. OBJECTIVE: In this investigation we have tested the effects of two commonly used venotonic substances, Ruscus extract and micronized diosmine, on the microcirculation in vivo. METHODS: These substances were given orally, by gavage, during two weeks, twice daily and observations were made using the hamster cheek pouch preparation...
October 7, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/29034023/retrograde-ascending-aortic-dissection-after-stent-grafting-for-stanford-type-b-aortic-dissection-with-severe-limb-ischemia
#13
Yoshiro Higuchi, Masato Tochii, Yoshiyuki Takami, Akihiro Kobayashi, Tsutomu Yanagisawa, Kentaro Amano, Yusuke Sakurai, Michiko Ishida, Hiroshi Ishikawa, Koji Hattori, Yasushi Takagi
We report a rare case of retrograde Stanford type A aortic dissection after endovascular repair for complicated Stanford type B aortic dissection. A 45-year-old man presented with a sudden onset of back pain and was transferred to our hospital. Computed tomography demonstrated acute Stanford type B aortic dissection with lower limb ischemia. Emergency endovascular surgery was planned for repair of the Stanford type B aortic dissection. The patient suddenly developed recurrent chest pain 10 days after the initial procedure...
March 24, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29034020/persistent-sciatic-artery-aneurysm-with-limb-ischemia-a-report-of-two-cases
#14
Koichi Morisaki, Terutoshi Yamaoka, Kazuomi Iwasa, Sosei Kuma, Jin Okazaki
We report two cases of persistent sciatic artery (PSA) aneurysm with limb ischemia. Physicians who treat peripheral artery disease should be aware that PSA is a very rare congenital malformation of the lower extremities that is potentially hazardous, and that revascularization should be performed when a PSA aneurysm is treated.
March 24, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29032905/analysis-of-wound-healing-time-and-wound-free-period-as-outcomes-after-surgical-and-endovascular-revascularization-for-critical-lower-limb-ischemia
#15
Jin Okazaki, Daisuke Matsuda, Kiyoshi Tanaka, Masaru Ishida, Sosei Kuma, Koichi Morisaki, Tadashi Furuyama, Yoshihiko Maehara
BACKGROUND: Traditional end points, such as amputation-free survival, used to assess the clinical effectiveness of lower limb revascularization have shortcomings because they do not account independently for wound nonhealing and recurrence or patient survival. Wound healing process and maintenance of a wound-free state after revascularization were not well-studied. The aim of this study was to elucidate the long-term clinical course of ischemic wounds after revascularization. We focused on initial wound healing process as well as the maintenance of a wound-free state after achievement of wound healing...
October 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29019592/the-influence-of-allopurinol-and-post-conditioning-on-lung-injuries-induced-by-lower-limb-ischemia-and-reperfusion-in-wistar-rats
#16
Hugo Genki Kagawa Akahane, Ricardo Zanetti Gomes, Katia Sabrina Paludo, Filipe Linhares, Luana Lopes
PURPOSE: To analyze the effects of allopurinol and of post-conditioning on lung injuries induced by lower-limb ischemia and reperfusion. METHODS: Thirty rats were used. They were divided in 5 groups: (1) group A: abdominal aortic dissection only, (2) group B: ischemia and reperfusion, (3) group C: administered allopurinol (100mg/Kg) a few hours before procedure, (4) group D: post-conditioned and (5) group E: administered allopurinol and post-conditioned. With the exception of group A, all groups were submitted to infrarenal aortic ischemia for 2 hours, and reperfusion for 72 hours...
September 2017: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/29017514/impact-of-type-2-diabetes-mellitus-on-in-hospital-mortality-after-major-cardiovascular-events-in-spain-2002-2014
#17
José M de Miguel-Yanes, Rodrigo Jiménez-García, Valentín Hernández-Barrera, Manuel Méndez-Bailón, Javier de Miguel-Díez, Ana Lopez-de-Andrés
BACKGROUND: Diabetes mellitus has long been associated with cardiovascular events. Nevertheless, the higher burden of traditional cardiovascular risk factors reported in high-income countries is offset by a more widespread use of preventive measures and revascularization or other invasive procedures. The aim of this investigation is to describe trends in number of cases and outcomes, in-hospital mortality (IHM) and length of hospital stay (LHS), of hospital admissions for major cardiovascular events between type 2 diabetes (T2DM) and matched non-diabetes patients...
October 10, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28990512/fighting-type-2-diabetes-present-and-future-perspectives
#18
Cai-Guo Yu, Ying Fu, Yuan Fang, Ning Zhang, Rong-Xin Sun, Dong Zhao, Ying-Mei Feng, Bao-Yu Zhang
BACKGROUND: Type-2 diabetes mellitus accounts for 80-90% of diabetic patients. So far, the treatment of diabetes mainly aims at elevating insulin level and lowering glucose level in the peripheral blood and mitigating insulin resistance. Physiologically, insulin secretion from pancreatic β cells is delicately regulated. Thus, how insulin-related therapies could titrate blood glucose appropriately and avoid the occurrence of hypoglycemia remains an important issue for decades. Similar question is addressed on how to attenuate vascular complication in diabetic subjects...
October 9, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28988529/effect-of-anesthetics-on-efficiency-of-remote-ischemic-preconditioning
#19
D N Silachev, E A Usatikova, I B Pevzner, L D Zorova, V A Babenko, M V Gulyaev, Yu A Pirogov, E Yu Plotnikov, D B Zorov
Remote ischemic preconditioning of hind limbs (RIPC) is an effective method for preventing brain injury resulting from ischemia. However, in numerous studies RIPC has been used on the background of administered anesthetics, which also could exhibit neuroprotective properties. Therefore, investigation of the signaling pathways triggered by RIPC and the effect of anesthetics is important. In this study, we explored the effect of anesthetics (chloral hydrate and Zoletil) on the ability of RIPC to protect the brain from injury caused by ischemia and reperfusion...
September 2017: Biochemistry. Biokhimii︠a︡
https://www.readbyqxmd.com/read/28985707/simultaneous-pain-intensity-rating-and-quantification-of-ischemia-throughout-exercise-and-recovery-in-proximal-versus-distal-arterial-claudication
#20
Alban Fouasson-Chailloux, Pierre Abraham, Christophe Colas-Ribas, Mathieu Feuilloy, Bruno Vielle, Samir Henni
Data on simultaneous hemodynamic changes and pain rating estimation in arterial claudication while walking are lacking. This study was conducted to determine if a difference in transcutaneous oxygen pressure (tc pO2) exists between proximal and distal localization at pain appearance (PAINapp), maximal pain (PAINmax) and pain relief (PAINrel) in proximal or distal claudication and if a relationship exists between tc pO2 changes and pain intensity. We analyzed the pain rating (Visual Analog Scale (VAS)) to lower limb ischemia, measured with the decrease from rest of oxygen pressure (DROP) tc pO2 index during constant-load treadmill tests in patients with calf ( n = 41) or buttock ( n = 19) claudication...
October 1, 2017: Vascular Medicine
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