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Lower limb ischemia

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https://www.readbyqxmd.com/read/29772334/quality-of-life-and-mortality-after-endovascular-surgical-or-conservative-treatment-of-elderly-patients-suffering-from-critical-limb-ischemia
#1
Stijn L Steunenberg, Jolanda de Vries, Jelle W Raats, Willem J Thijsse, Nathalie Verbogt, Paul Lodder, Geert-Jan van Eijck, Eelco J Veen, Hans G W de Groot, Gwan H Ho, Lijckle van der Laan
INTRODUCTION: Revascularisation to relieve ischemic pain and prevent limb loss is the cornerstone of critical limb ischemia (CLI) treatment, however not all elderly patients are deemed fit for revascularisation. Patient related outcome measurements are important in these patients. Quality of Life (QoL) results regarding the effect of endovascular, surgical, and conservative treatment on the quality of life (QoL) in the elderly are scarce in current literature. Goal of this study is to explore the outcome of the different treatment modalities in elderly patients suffering from CLI, with a specific focus on QoL...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29772326/thrombolysis-in-acute-lower-limb-ischemia-review-of-the-current-literature
#2
REVIEW
Panagiotis G Theodoridis, Constantinos H Davos, Ilias Dodos, Nikolaos Iatrou, Anastasios Potouridis, Georgios M Pappas, Dimitrios Staramos, Paul Antoniadis, Vasilios Argitis, Konstantinos Dervisis
INTRODUCTION: Catheter directed thrombolysis (CDT) is a therapeutic option with acceptable results in patients with acute limb ischaemia (ALI) but with severe systemic or intracranial bleeding being the most significant clinical complication. The aim of the study is to collect and present direct results of CDT in patients treated for ALI. MATERIALS AND METHODS: Reports on CDT treatment in ALI until December 2016 searched in PubMed using the key words catheter direct thrombolysis, acute lower limb ischemia and any combination of these...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29756521/cost-analysis-of-initial-treatment-with-endovascular-revascularization-open-surgery-or-primary-major-amputation-in-patients-with-peripheral-artery-disease
#3
Linda Tang, Sharath C V Paravastu, Shannon D Thomas, Elaine Tan, Eric Farmer, Ramon L Varcoe
PURPOSE: To compare the total initial treatment costs for open surgery, endovascular revascularization, and primary major amputation within a single-payer healthcare system. METHODS: A multicenter, retrospective analysis was undertaken to evaluate 1138 patients with symptomatic peripheral artery disease (PAD) who underwent 1017 endovascular procedures, 86 open surgeries, and 35 major amputations between 2013 and 2016. A cost-mix analysis was performed on individual patient data generated for selected diagnosis-related groups...
May 1, 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29754671/rationale-and-design-for-the-vascular-outcomes-study-of-asa-along-with-rivaroxaban-in-endovascular-or-surgical-limb-revascularization-for-peripheral-artery-disease-voyager-pad
#4
Warren H Capell, Marc P Bonaca, Mark R Nehler, Edmond Chen, John M Kittelson, Sonia S Anand, Scott D Berkowitz, Eike Sebastian Debus, Fabrizio Fanelli, Lloyd Haskell, Manesh R Patel, Rupert Bauersachs, William R Hiatt
BACKGROUND: Patients with peripheral artery disease (PAD) undergoing a lower-extremity revascularization are at heightened risk for ischemic cardiac and limb events. Although intensification of antithrombotic therapy after revascularization has demonstrated benefit in coronary disease populations, this approach has not been well studied or shown consistent benefit in PAD. Recent trial evidence demonstrated that a treatment strategy of rivaroxaban added to background antiplatelet therapy reduced ischemic risk in patients following recent acute coronary syndromes, as well as in patients with stable atherosclerotic vascular disease...
May 2018: American Heart Journal
https://www.readbyqxmd.com/read/29750927/frozen-elephant-trunk-for-acute-type-b-dissection-involving-the-distal-arch-in-the-hybrid-repair-era
#5
Rui-Dong Qi, Jun-Ming Zhu, Yong-Min Liu, Lei Chen, Cheng-Nan Li, Xiao-Yan Xing, Nan Zhang, Li-Zhong Sun
BACKGROUND: Hybrid repair of complicated acute type B aortic dissection(ATBAD) with aortic arch involvement is associated with a high rate of endoleak, stroke, and retrograde aortic dissection. Optimal management of this lesion remains uncertain. In this hybrid repair era, surgical results of ATBAD with distal aortic arch involvement using a frozen elephant trunk(FET) procedure with left subclavian artery(LSCA)-left common carotid artery(LCCA) transposition is reported. METHODS: From April 2011 to April 2016, 53 patients with complicated ATBAD with distal aortic arch involvement underwent a FET procedure with LSCA-LCCA transposition...
May 8, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29750878/perfusion-scintigraphy-in-the-assessment-of-autologous-cell-therapy-in-diabetic-patients-with-critical-limb-ischemia
#6
A Nemcova, A Jirkovska, M Dubsky, R Bem, V Fejfarova, V Woskova, A Pysna, M Buncova
Perfusion scintigraphy with technetium-99-methoxy-isobutyl-isonitrile ((99m)Tc-MIBI) is often used for assessing myocardial function but the number of studies concerning lower limb perfusion is limited. The aim of our study was to assess whether (99m)Tc-MIBI was an eligible method for evaluation of the effect of cell therapy on critical limb ischemia (CLI) in diabetic patients. (99m)Tc-MIBI of calf muscles was performed before and 3 months after autologous cell therapy (ACT) in 24 diabetic patients with CLI...
May 10, 2018: Physiological Research
https://www.readbyqxmd.com/read/29748311/radiotracer-imaging-allows-for-noninvasive-detection-and-quantification-of-abnormalities-in-angiosome-foot-perfusion-in-diabetic-patients-with-critical-limb-ischemia-and-nonhealing-wounds
#7
Jessica L Alvelo, Xenophon Papademetris, Carlos Mena-Hurtado, Sangchoon Jeon, Bauer E Sumpio, Albert J Sinusas, Mitchel R Stacy
BACKGROUND: Single photon emission computed tomography (SPECT)/computed tomography (CT) imaging allows for assessment of skeletal muscle microvascular perfusion but has not been quantitatively assessed in angiosomes, or 3-dimensional vascular territories, of the foot. This study assessed and compared resting angiosome foot perfusion between healthy subjects and diabetic patients with critical limb ischemia (CLI). Additionally, the relationship between SPECT/CT imaging and the ankle-brachial index-a standard tool for evaluating peripheral artery disease-was assessed...
May 2018: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29736948/chest-lead-st-j-amplitudes-using-arm-electrodes-as-reference-instead-of-the-wilson-central-terminal-in-smartphone-ecg-applications-influence-on-st-elevation-myocardial-infarction-criteria-fulfillment
#8
Thomas Lindow, Henrik Engblom, Ardavan Khoshnood, Ulf Ekelund, Marcus Carlsson, Olle Pahlm
BACKGROUND: "Smartphone 12-lead ECG" for the assessment of acute myocardial ischemia has recently been introduced. In the smartphone 12-lead ECG either the right or the left arm can be used as reference for the chest electrodes instead of the Wilson central terminal. These leads are labeled "CR leads" or "CL leads." We aimed to compare chest-lead ST-J amplitudes, using either CR or CL leads, to those present in the conventional 12-lead ECG, and to determine sensitivity and specificity for the diagnosis of STEMI for CR and CL leads...
May 7, 2018: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/29734259/ec-vad-combined-use-of-extracorporeal-membrane-oxygenation-and-percutaneous-microaxial-pump-left-ventricular-assist-device
#9
Olutosin J Akanni, Koji Takeda, Lauren K Truby, Paul A Kurlansky, Codruta Chiuzan, Jiho Han, Veli K Topkara, Melana Yuzefpolskaya, Paolo C Colombo, Dimitrios Karmpaliotis, Jeffery W Moses, Yoshifumi Naka, A Reshad Garan, Ajay J Kirtane, Hiroo Takayama
Combination of venoarterial extracorporeal membrane oxygenation (VA-ECMO) and a percutaneous microaxial left ventricular assist device (pLVAD), or "EC-VAD," has been reported in cases of left ventricular decompression with mixed results. We conducted a retrospective review of patients who received EC-VAD (n = 29) or isolated VA-ECMO therapy (ECMO-only; n = 196) for refractory cardiogenic shock between February 2011 and October 2014. Fourteen patients received VA-ECMO and then Impella pLVAD (E→EC-VAD), and 15 received the Impella pump then VA-ECMO (I→EC-VAD)...
April 19, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29730375/twelve-month-results-from-the-first-in-human-randomized-study-of-the-ranger-paclitaxel-coated-balloon-for-femoropopliteal-treatment
#10
Sabine Steiner, Andrea Willfort-Ehringer, Horst Sievert, Volker Geist, Michael Lichtenberg, Costantino Del Giudice, Antoine Sauguet, Juan Diaz-Cartelle, Claudia Marx, Armin Ströbel, Ingolf Schult, Dierk Scheinert
OBJECTIVES: The authors sought to evaluate the performance of the Ranger paclitaxel-coated balloon versus uncoated balloon angioplasty for femoropopliteal lesions at 12 months. BACKGROUND: Drug-coated balloons (DCBs) are a promising endovascular treatment option for peripheral artery disease of the femoropopliteal segment, and each unique device requires dedicated clinical study. METHODS: The prospective, randomized RANGER SFA (Comparison of the Ranger™ Paclitaxel-Coated PTA Balloon Catheter and Uncoated PTA Balloons in Femoropopliteal Arteries) study (NCT02013193) enrolled 105 patients with symptomatic lower limb ischemia (Rutherford category 2 to 4) and stenotic lesions in the nonstented femoropopliteal segment at 10 European centers...
April 27, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29726013/effect-of-comprehensive-remote-ischemic-conditioning-in-anterior-st-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention-design-and-rationale-of-the-coric-mi-randomized-trial
#11
Li Song, Hongbing Yan, Peng Zhou, Hanjun Zhao, Chen Liu, Zhaoxue Sheng, Yu Tan, Yi Chen, Jiannan Li, Jinying Zhou
BACKGROUND: Remote ischemic conditioning (RIC) applied during or after an ST-segment elevation myocardial infarction (STEMI) is currently the most promising adjuvant therapy to reduce reperfusion injury. Recent animal studies showed that RIC may help the myocardium recover if applied daily during the month after an STEMI. METHODS: The CORIC-MI trial is a single-center, randomized controlled study. 200 patients undergoing primary percutaneous coronary intervention (PPCI) for anterior STEMI will be randomized in a 1:1 ratio into comprehensive RIC (CORIC) or no intervention (control)...
May 3, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29721632/acute-lower-limb-ischemia-and-intestinal-necrosis-due-to-arterial-tumor-embolism-from-advanced-lung-cancer-a-case-report-and-literature-review
#12
Sayuri Togo, Terutoshi Yamaoka, Kazutoyo Morita, Kazuomi Iwasa, Yukihiko Aoyagi, Yumi Oshiro, Takatoshi Fujishita, Hideki Yokoyama, Takashi Matsui, Takashi Nishizaki
BACKGROUND: Arterial tumor embolism (ATE) is a rare but life-threating complication. PRESENTATION OF CASE: A 55-year-old man with acute lower-limb ischemia was referred to our hospital after endovascular intervention failed and underwent above-the-knee amputation for severe limb necrosis. On postoperative day 8, he developed small bowel necrosis and underwent resection. Histopathological examination of the resected bowel revealed that the submucosal arterial emboli were positive for the markers of squamous cells...
May 2, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29716475/contemporary-management-and-outcome-after-lower-extremity-fasciotomy-in-non-trauma-related-vascular-surgery
#13
Charlotte Wesslén, Carl-Magnus Wahlgren
INTRODUCTION: Acute compartment syndrome (ACS) is a challenging and recognized complication to vascular surgery revascularization. The aim of this study was to investigate the current epidemiology, management, and early outcomes of fasciotomy in vascular surgery. METHODS: Retrospective cohort study of all patients undergoing lower extremity fasciotomy at a single university center between January 2008 and December 2014. Patient demographics, operative techniques, and outcomes were analyzed...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29703251/allogeneic-transplantation-of-programmable-cells-of-monocytic-origin-pcmo-improves-angiogenesis-and-tissue-recovery-in-critical-limb-ischemia-cli-a-translational-approach
#14
Rouven Berndt, Lars Hummitzsch, Katharina Heß, Martin Albrecht, Karina Zitta, Rene Rusch, Beke Sarras, Andreas Bayer, Jochen Cremer, Fred Faendrich, Justus Groß
BACKROUND: Employing growth factor-induced partial reprogramming in vitro, peripheral human blood monocytes can acquire a state of plasticity along with expression of various markers of pluripotency. These so-called programmable cells of monocytic origin (PCMO) hold great promise in regenerative therapies. The aim of this translational study was to explore and exploit the functional properties of PCMO for allogeneic cell transplantation therapy in critical limb ischemia (CLI). METHODS: Using our previously described differentiation protocol, murine and human monocytes were differentiated into PCMO...
April 27, 2018: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/29701415/antiphospholipid-syndrome-and-acute-postpartum-limb-ischemia
#15
Inês Antunes, Carlos Pereira, Rui Machado, Duarte Rego, Vitor Ferreira, João Gonçalves, Gabriela Teixeira, Carlos Veiga, Daniel Mendes, Rui Almeida
INTRODUCTION: The diagnosis of Antiphospholipid syndrome (APS) implies the identification of antiphospoholipid antibodies and arterial/venous thrombosis or pregnancy loss. During pregnancy, there is an increased risk of thrombotic complications. METHODS: Present a case of acute lower limb ischemia in a patient with APS during postpartum period Materials/ Methods: review of a clinical case and available literature Results: Patient diagnosed with APS (triple antibody positive and antecedent of 3 previous abortions) underwent cesarean at 29 weeks of gestation...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701412/functional-popliteal-artery-entrapment-syndrome
#16
Luis Gamas, João Rocha Neves, Luís Machado, Ricardo Ferreira, Pedro Paz Dias, José Teixeira
INTRODUCTION: Popliteal artery entrapment is an uncommon syndrome, caused by extrinsic compression of the popliteal artery by muscular or tendinous structures. It occurs mainly in young individuals, with no atherosclerostic risk factors, and a mean age of presentation of 20 to 40 years, and has higher prevalence in males (83% of patients). Clinical presentation depends on the degree of arterial lesion, the most common being intermittent claudication, with critical ischemia being frequent...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29701340/comparaison-between-endovascular-approach-and-aorto-bifemoral-bypass-for-tasc-d-aorto-iliac-disease-patients-treated-between-2011-2017
#17
Joel Sousa, João Neves, André Ferreira, José Vidoedo, José Teixeira
INTRODUCTION: In the last few years, endovascular approaches have been demonstrating remarkable results on the treatment of aortoiliac TASC D lesions. However, the results remain conflictuous and proper evidence regarding the best treatment option for this group of patients is still lacking. Through this work, we aim to compare patency, cost-effectiveness and quality of life in patients successfully treated by these two approaches. METHODS: Patients with TASC D aorto-iliac disease, from two independent Vascular Surgery Centers, treated either by open surgery and endovascular intervention between 2011- 2017, were retrospectively analyzed and consecutively included (n=59)...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29699865/color-coded-digital-subtraction-angiography-for-assessing-acute-skeletal-muscle-ischemia-reperfusion-injury-in-a-rabbit-model
#18
Yan Zhang, Chengzhi Li, Hong Zhang, Wanghai Li, Jinwei Li, Xiaobai Wang
RATIONALE AND OBJECTIVES: This paper describes an ongoing investigation of imaging and characterization of ischemia-reperfusion (IR) and investigated the use of color-coded digital subtraction angiography (DSA) to assess reperfusion injury or potential injury. METHODS: New Zealand white rabbits were subjected to right hindlimb ischemia (IR, n = 24) or sham operation (control, n = 6). After 3 hours, the IR rabbits underwent reperfusion and were assessed at 0, 6, 12, or 24 hours (n = 6 each)...
April 23, 2018: Academic Radiology
https://www.readbyqxmd.com/read/29697685/-ruptures-of-popliteal-artery-aneurysms
#19
I P Mikhaylov, V N Lavrenov, G A Isaev, L S Kokov, E Yu Trofimova
AIM: To improve diagnosis and surgical outcomes in patients with ruptured popliteal artery aneurysm. MATERIAL AND METHODS: Eight patients with ruptured popliteal artery aneurysm have undergone surgery for the period from 1999 to 2015 at the Vascular Surgery Department of Sklifosovsky Research Institute for Emergency Care. Incidence of rupture was 2.9% from total number of popliteal artery aneurysm. 7 patients with rupture had signs of lower limb ischemia (acute form grade I in 2 (25%) cases, grade IIA in 1 (12...
2018: Khirurgiia
https://www.readbyqxmd.com/read/29697598/a-phase-1-study-of-a-novel-bidirectional-perfusion-cannula-in-patients-undergoing-femoral-cannulation-for-cardiac-surgery
#20
Silvana F Marasco, Elli Tutungi, Shirley A Vallance, Andrew A Udy, Justin C Negri, Adam D Zimmet, David C McGiffin, Vincent A Pellegrino, Randall A Moshinsky
OBJECTIVE: Leg ischemia is a serious complication of femoral artery cannulation. The primary aim of this study was to assess the safety and efficacy of a novel bidirectional femoral arterial cannula (Sorin Group USA, a wholly owned subsidiary of LivaNova PLC, Arvada, CO USA) that provides both antegrade and retrograde flow, in patients undergoing peripheral cannulation for cardiopulmonary bypass during cardiac surgery. METHODS: Patients undergoing routine cardiac surgery requiring femoral artery cannulation for cardiopulmonary bypass were identified preoperatively...
April 24, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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