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Lower limb ischemia

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https://www.readbyqxmd.com/read/27908824/arteriographic-patterns-of-atherosclerosis-and-the-association-between-diabetes-mellitus-and-ethnicity-in-chronic-critical-limb-ischemia
#1
Jayer Chung, J Gregory Modrall, Martyn Knowles, Qun Xiang, Lawrence A Lavery, Carlos H Timaran, R James Valentine
BACKGROUND: Disparate outcomes in critical limb ischemia (CLI) persist between ethnicities. The contribution of modifiable factors versus intrinsic biologic differences remains unclear. Hence, we aimed to quantify the associations between ethnicity and anatomic patterns of arterial occlusive disease in CLI, adjusting for known atherosclerotic risk factors. METHODS: We performed a retrospective, single-center review of consecutive patients presenting to the vascular surgery service with CLI...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27905554/increased-plasma-vegf-levels-following-ischemic-preconditioning-are-associated-with-downregulation-of-mirna-762-and-mir-3072-5p
#2
Koji Ueno, Makoto Samura, Tamami Nakamura, Yuya Tanaka, Yuriko Takeuchi, Daichi Kawamura, Masaya Takahashi, Tohru Hosoyama, Noriyasu Morikage, Kimikazu Hamano
Ischemic preconditioning (IPC) has protective effects against ischemia-perfusion injury of organs. In the present study, we investigated the associated mechanisms after performing remote IPC (rIPC) of lower limbs by clamping abdominal aorta in mice. Subsequent experiments showed decreased damage and paralysis of lower limbs following spinal cord injury (SCI). Concomitantly, plasma vascular endothelial growth factor (VEGF) levels were increased 24 h after rIPC compared with those in sham-operated animals. In subsequent microRNA analyses, thirteen microRNAs were downregulated in exosomes 24 h after rIPC...
December 1, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27901322/risk-factors-analysis-of-thromboembolectomy-for-acute-thromboembolic-lower-extremity-ischemia-in-native-arteries
#3
Gabriele Piffaretti, Alessandro Angrisano, Marco Franchin, Massimo Ferrario, Nicola Rivolta, Alessandro Bacuzzi, Patrizio Castelli, Matteo Tozzi
BACKGROUND: Aim of this study is to report the results of thromboembolectomy (ThEmb) for acute thromboembolic lower limb ischemia (ATLI) in native arteries and to create a predictive score for amputation-free survival (AFS) at 30 days. METHODS: It is a single center, retrospective analysis of a four years period. All patients had ThEmb: adjunctive procedures included femoral and/or popliteal endarterectomy in 30 (18.3%) cases, PTA- stent in 24 (14.6%), and femoral endarterectomy plus PTA-stent in 12 (7...
November 30, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27896226/use-of-the-directional-atherectomy-for-the-treatment-of-femoro-popliteal-lesions-in-patients-with-critical-lower-limb-ischemia
#4
Umberto Marcello Bracale, Gaetano Vitale, Guido Bajardi, Donatella Narese, Ettore Dinoto, Anna Maria Giribono, Doriana Ferrara, Luca Del Guercio, Massimo Midiri, Felice Pecoraro
: Femoro-popliteal PTA for the treatment of critical limb ischemia is frequently associated with unsatisfactory procedural success rates while directional atherectomy (DCA) has improved success rate since claudicant patients undergoing percutaneous treatment of femoro-popliteal obstructive disease. The aim of this prospective study is to evaluate the safety, efficacy and procedural success of DCA, at one year, in the percutaneous treatment of femoro-popliteal obstructive disease in patients with critical limb ischemia...
November 2016: Translational Medicine @ UniSa
https://www.readbyqxmd.com/read/27890841/development-of-a-scoring-system-for-the-prediction-of-early-graft-failure-after-peripheral-arterial-bypass-surgery
#5
Andreas M Lazaris, Sotiria Mastoraki, Evangelos Kontopantelis, Konstantinos Seretis, Maria Karouki, Konstantinos Moulakakis, Miltiadis Matsagkas, Spyros N Vasdekis
OBJECTIVES: An occluded lower limb arterial bypass is associated with poor prognosis for the limb. Currently, no risk assessment method to estimate the risk of early graft failure exists. Aim of this study was to investigate the effect of various potential factors on early graft failure of infrainguinal bypass surgery and to develop a risk-scoring model to predict it. DESIGN AND METHODS: A prospective observational clinical study was performed. One hundred infrainguinal bypass procedures (60 autologous and 40 synthetic grafts), throughout a 3-year period were included...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27884944/ruptured-abdominal-aortic-aneurysm-after-endovascular-aortic-aneurysm-repair-thrombosis
#6
Jesse Victory, Syed Ali Rizvi, Enrico Ascher, Anil Hingorani
BACKGROUND: Complete thrombosis of an aortic endograft after an endovascular aortic aneurysm repair is a rare complication. The majority of thrombotic events occur in the iliac limbs. CASE PRESENTATION: We present the case of a patient who presented with acute limb ischemia as the result of a thrombosed infra-renal aortic endograft. After restoration of blood flow to the lower extremities with an axillary to bi-femoral artery bypass, the patient was lost to follow-up...
November 24, 2016: Vascular
https://www.readbyqxmd.com/read/27884329/saphenous-artery-based-flap-models-in-rats-new-flap-designs-for-experimental-studies
#7
Ersin Aksam, Berrak Aksam, Mustafa Erol Demirseren, Huban Sibel Orhun Yavuz
BACKGROUND: Experimental research using laboratory animals provides substantial data about reconstructive surgery. However, the literature does not include any experimental studies that have used flap models on the hind limbs of rats. To gain an understanding of the physiology of lower-extremity flaps and of flap failures, this study assessed the cutaneous perforators of the saphenous artery, and new flap models were designed for the hind limbs of rats. MATERIALS AND METHODS: The experiment was designed to include three stages and used 35 rats...
December 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27882913/persistent-sciatic-artery-aneurysm-a-potential-cause-of-acute-lower-limb-ischemia-in-young-patients
#8
Konstantinos Spanos, Sokol Xhepa, Athanasios D Giannoukas
No abstract text is available yet for this article.
November 24, 2016: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/27879958/evaluation-of-a-6-year-old-multicentric-standard-endovascular-treatment-of-critical-limb-ischemia-in-the-drug-eluting-era
#9
Vincenzo Brizzi, Caroline Caradu, Xavier Berard, Gerard Sassoust, Dominique Midy, Eric Ducasse
BACKGROUND: There has been increasing evidence to support the endovascular- first approach in the treatment of below the knee (BTK) lesions. Plain Old Balloon Angioplasty (POBA), with bailout bare-metal stent scaffolding in case of flow limiting dissection or recoil, have been considered the standard treatment of choice but industries are continually developing innovative equipment and dedicated technologies, such as drug-eluting platforms whose use is increasingly extended, despite significant costs and lack of high-quality evidence to support a well- established strategy...
November 23, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27876517/clinical-effects-of-single-or-double-tibial-artery-revascularization-in-critical-limb-ischemia-patients-with-tissue-loss
#10
Norihiro Kobayashi, Keisuke Hirano, Masahiro Yamawaki, Motoharu Araki, Hideyuki Takimura, Yasunari Sakamoto, Shinsuke Mori, Yoshiaki Ito
OBJECTIVE: The achievement of single vessel inflow to the wound is an acceptable end point of peripheral vascular intervention for patients with critical limb ischemia (CLI) with tissue loss. However, CLI patients often have multitibial artery lesions. We evaluated the clinical effects of single or double tibial artery revascularization for CLI patients. METHODS: This study was conducted retrospectively in a single center. Between April 2007 and January 2015, we treated 123 CLI patients (137 limbs) who had lesions in both the anterior tibial artery and the posterior tibial artery...
November 19, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27876411/disruption-of-mitochondrial-quality-control-in-peripheral-artery-disease-new-therapeutic-opportunities
#11
REVIEW
Cintia B Ueta, Katia S Gomes, Márcio A Ribeiro, Daria Mochly-Rosen, Julio C B Ferreira
Peripheral artery disease (PAD) is a multifactorial disease initially triggered by reduced blood supply to the lower extremities due to atherosclerotic obstructions. It is considered a major public health problem worldwide, affecting over 200 million people. Management of PAD includes smoking cessation, exercise, statin therapy, antiplatelet therapy, antihypertensive therapy and surgical intervention. Although these pharmacological and non-pharmacological interventions usually increases blood flow to the ischemic limb, morbidity and mortality associated with PAD continue to increase...
November 19, 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/27873171/prognostic-value-of-lower-limb-perfusion-single-photon-emission-computed-tomography-computed-tomography-in-patients-with-lower-limb-atherosclerotic-peripheral-artery-disease
#12
Hidenobu Hashimoto, Yoshimitsu Fukushima, Shin-Ichiro Kumita, Masaaki Miyamoto, Gen Takagi, Junichi Yamazaki, Takanori Ikeda
PURPOSE: The purpose of this study was to estimate the severity of the participants' lower limb ischemia by calculating the lower limb muscle-to-background ratio (LMBR) using lower limb perfusion single-photon emission computed tomography-computed tomography (SPECT/CT) and to evaluate the prognostic value of LMBR in peripheral artery disease (PAD) patients. MATERIALS AND METHODS: This retrospective study consists of 38 patients with PAD (70 ± 12 years) and observed over 1 year who were included in the analysis...
November 21, 2016: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/27871493/diabetes-does-not-worsen-outcomes-following-infrageniculate-bypass-or-endovascular-intervention-for-patients-with-critical-limb-ischemia
#13
Caitlin W Hicks, Alireza Najafian, Alik Farber, Matthew T Menard, Mahmoud B Malas, James H Black, Christopher J Abularrage
OBJECTIVE: Both open surgery and endovascular peripheral interventions have been shown to effectively improve outcomes in patients with peripheral arterial disease, but minimal data exist comparing outcomes performed at and below the knee among patients with diabetes (DM) specifically. The purpose of this study is to compare outcomes following open bypass (lower extremity bypass [LEB]) and peripheral vascular intervention (PVI) at and below the knee in patients with DM vs patients without DM (non-DM) with critical limb ischemia...
December 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27866700/angiopoietin-related-growth-factor-is-independently-associated-with-lower-extremity-peripheral-arterial-disease
#14
Hao Nie, Yue Liang, Hong-Xia Wang, Hua-Liang Ren, Yue-Wei Wang, Fang-Da Li, Yue-Hong Zheng
AIMS: The present study investigated the association of serum levels of angiopoietin-related growth factor (AGF) with lower extremity peripheral arterial disease (LEPAD). METHODS: The study group is comprised of 105 patients with lower extremity peripheral arterial disease. The control group consisted of 80 individuals without lower extremity peripheral arterial disease. Serum AGF concentrations were determined by enzyme-linked immunosorbent assay. The relationship between AGF and clinical and biochemical parameters was studied...
October 27, 2016: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/27863591/identifying-beliefs-about-smoking-in-patients-with-peripheral-vascular-disease
#15
Elizabeth Lopes-Costa, Elaine Amato-Vealey
Peripheral vascular disease (PVD) is a chronic disabling illness that frequently results in the occlusion of arteries in lower limbs and may cause ischemia, gangrene, or infection. The single most significant factor contributing to both the onset and progression of PVD is smoking, which has addictive properties. Once smoking becomes a habitual behavior, combined with the atherosclerotic process, a disastrous pathway ensues. The aim of this project was to gain an understanding of the beliefs of patients with PVD who smoked...
December 2016: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
https://www.readbyqxmd.com/read/27853042/polyarteritis-nodosa-presenting-as-peripheral-vascular-disease-and-acute-limb-ischemia
#16
A Shukla, A Aggarwal
Acute limb ischemia and peripheral vascular disease (PVD) are unusual presentations of polyarteritis nodosa (PAN). Here, we present a case with PVD of both lower limbs leading to foot claudication. Digital subtraction angiography showed narrowing, irregularity, and occlusion of both lower limb arteries with no involvement of the abdomen visceral arteries. Based on significant weight loss, diastolic blood pressure >90 mmHg, myalgia, testicular pain, and angiographic abnormalities in medium-sized arteries, he was diagnosed as having PAN...
November 16, 2016: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/27842952/-acute-arterial-thrombosis-in-a-context-of-hyperhomocysteinemia-case-report-and-literature-review
#17
G Raybaud, M Lambert, C Douillard, A F Dessein, S Morell-Dubois, M Guillou, S Haulon, P-Y Hatron
INTRODUCTION: Hyperhomocysteinemia is a biological marker that could be identified in the venous thrombotic events and rarely during acute arterial thrombotic events. The consequences can be serious. Effective diagnostic strategy is needed to optimize the management. CASE REPORT: Following bariatric surgery, a 40-year-old patient was admitted with an acute encephalopathy associated with peripheral lower limb arterial ischemia. The diagnostic work-up identified a major hyperhomocysteinemia whose causes were several...
November 11, 2016: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/27835656/the-association-of-peri-procedural-blood-transfusion-with-morbidity-and-mortality-in-patients-undergoing-percutaneous-lower-extremity-vascular-interventions-insights-from-bmc2-vic
#18
Peter K Henke, Yeo Jung Park, Sachinder Hans, Paul Bove, Robert Cuff, Andris Kazmers, Theodore Schreiber, Hitinder S Gurm, P Michael Grossman
OBJECTIVE: To determine the predictors of periprocedural blood transfusion and the association of transfusion on outcomes in high risk patients undergoing endoluminal percutaneous vascular interventions (PVI) for peripheral arterial disease. METHODS/RESULTS: Between 2010-2014 at 47 hospitals participating in a statewide quality registry, 4.2% (n = 985) of 23,273 patients received a periprocedural blood transfusion. Transfusion rates varied from 0 to 15% amongst the hospitals in the registry...
2016: PloS One
https://www.readbyqxmd.com/read/27834057/lower-limb-ischemia-caused-by-resuscitative-balloon-occlusion-of-aorta
#19
Yohei Okada, Hiromichi Narumiya, Wataru Ishi, Iiduka Ryoji
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emergency procedure to manage severe hemorrhagic shock from torso injury but can cause severe ischemia of the lower extremities. However, lower extremity ischemia occurring as a complication of REBOA has been rarely reported. We describe the severe lower extremity ischemia caused by REBOA with a 12-Fr sheath in a small-built patient. CASE REPRESENTATION: The patient was a 16-year-old male who developed severe hemorrhagic shock due to abdominal blunt trauma...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27826790/direct-stenting-in-patients-with-acute-lower-limb-arterial-occlusions-immediate-and-long-term-results
#20
Nikolaos Galanakis, Nikolaos Kontopodis, Ioannis Peteinarakis, Elias Kehagias, Christos V Ioannou, Dimitrios Tsetis
PURPOSE: The purpose of this study is to accentuate the efficacy of direct stenting (stent placement without predilatation of the lesion) in patients with acute lower limb arterial ischemia (ALLI). MATERIALS AND METHODS: Between January 2010 and September 2015, 16 patients (11 men and 5 women) underwent direct stenting of acute arterial occlusions. All patients had contraindication for surgical revascularization or catheter-directed thrombolysis. According to SVS/ISCVS Classification, six patients had IIa and ten patients IIb ALLI...
November 8, 2016: Cardiovascular and Interventional Radiology
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