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Limb ischemia

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https://www.readbyqxmd.com/read/28318856/balloon-aortic-valvuloplasty-in-the-transcatheter-aortic-valve-implantation-era-a-single-center-registry
#1
Ana Rita G Francisco, Miguel Nobre Menezes, Pedro Carrilho Ferreira, Cláudia Jorge, Doroteia Silva, Eduardo Infante de Oliveira, Fausto J Pinto, Pedro Canas da Silva
INTRODUCTION: Percutaneous balloon aortic valvuloplasty (BAV) has been limited by the risk of complications and restenosis. However, growing use of transcatheter aortic valve implantation (TAVI) has revived interest in this technique. We analyzed the current indications for BAV and outcomes in a single center. METHODS: Acute results and long-term outcomes were analyzed in a retrospective single-center registry of patients undergoing BAV between January 2013 and January 2016...
March 16, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28318517/-intracardiac-myxoma-complicated-by-acute-aortic-occlusion-case-report
#2
O Zizi, B Benfor, H Jiber, A Bouarhroum, S Benlamkaddem, N Kanjaa
We report the case for a 44-year-old patient without medical history, admitted in our department for bilateral acute limb ischemia (H6). The patient was hemodynamically stable and the physical examination shows limb sever ischemia (no femoral arterial pulses, coldness, cyanosis and paralysis). Abdominal CT angiography showed a complete occlusion of the infra renal abdominal aorta compatible with embolus. An embolectomy with Fogarty catheters was performed. Echocardiography showed a mass in the left atrium. Pathological examination of the material embolic confirmed the diagnosis of the cardiac myxoma...
March 16, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28303468/human-very-small-embryonic-like-cells-support-vascular-maturation-and-therapeutic-revascularization-induced-by-endothelial-progenitor-cells
#3
Coralie L Guerin, Elisa Rossi, Bruno Saubamea, Audrey Cras, Virginie Mignon, Jean-Sébastien Silvestre, David M Smadja
Very small embryonic-like stem cells (VSELs) are major pluripotent stem cells defined as cells of small size being Lineage- negative, CD133-positive, and CD45-negative. We previously described that human bone marrow VSELs were able to differentiate into endothelial cells and promoted post-ischemic revascularization in mice with surgically induced critical limb ischemia. In the present work, we isolated bone marrow VSELs from patients with critical limb ischemia and studied their ability to support endothelial progenitor cells therapeutic capacity and revascularization potential...
March 16, 2017: Stem Cell Reviews
https://www.readbyqxmd.com/read/28302707/neuropeptide-y3-36-incorporated-into-pvax-nanoparticle-improves-functional-blood-flow-in-a-murine-model-of-hind-limb-ischemia
#4
Derek Eshun, Rabya Saraf, Soochan Bae, Jelliffe Jeganathan, Feroze Mahmood, Serkan Dilmen, Qingen Ke, Dongwon Lee, Peter M Kang, Robina Matyal
We generated a novel nanoparticle called PVAX, which has intrinsic anti-apoptotic and anti-inflammatory properties. This nanoparticle was loaded with Neuropeptide Y3-36, an angiogenic neuro-hormone that plays a central role in angiogenesis. Subsequently, we investigated whether PVAX-NPY3-36 could act as a therapeutic agent and induce angiogenesis and vascular remodeling in a murine model of hind limb ischemia. Adult C57BL/J6 mice (n=40) were assigned to treatment groups: Control, Ischemia PBS, Ischemia PVAX, Ischemia NPY3-36, and Ischemia PVAX-NPY3-36 Ischemia was induced by ligation of the femoral artery in all groups except Control and given relevant treatments (PBS, PVAX, NPY3-36, and PVAX-NPY3-36)...
March 16, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28300357/pilot-randomized-controlled-trial-on-early-and-late-remote-ischemic-preconditioning-prior-to-complex-cardiac-surgery-in-young-infants
#5
Gonzalo Garcia Guerra, Ari R Joffe, Rob Seal, Ernest Phillipos, Maggie Wong, Elham Khodayari Moez, Irina A Dinu, Jonathan P Duff, David Ross, Ivan Rebeyka, Charlene M T Robertson
BACKGROUND: Remote ischemic preconditioning involves providing a brief ischemia-reperfusion event to a tissue to create subsequent protection from a more severe ischemia-reperfusion event to a different tissue/organ. The few pediatric remote ischemic preconditioning studies in the literature show conflicting results. AIM: We conducted a pilot randomized controlled trial to determine the feasibility of conducting a larger trial and to gather provisional data on the effect of early and late remote ischemic preconditioning on outcomes of infants after surgery for congenital heart disease...
April 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28298297/angiogenic-mechanisms-of-human-cd34-stem-cell-exosomes-in-the-repair-of-ischemic-hindlimb
#6
Prabhu Mathiyalagan, Yaxuan Liang, David Kim, Sol Misener, Tina Thorne, Christine Kamide, Ekaterina Klyachko, Douglas W Losordo, Roger J Hajjar, Susmita Sahoo
Rationale: Paracrine secretions appear to mediate therapeutic effects of human CD34(+) stem cells locally transplanted in patients with myocardial and critical limb ischemia as well as in animal models. Earlier, we had discovered that paracrine secretion from human CD34(+) cells contains pro-angiogenic, membrane-bound nano-vesicles called exosomes (CD34Exo). Objective: Here, we investigated the mechanisms of CD34Exo-mediated ischemic tissue repair and therapeutic angiogenesis by studying their miRNA content and uptake...
March 15, 2017: Circulation Research
https://www.readbyqxmd.com/read/28297569/administration-of-adult-human-bone-marrow-derived-cultured-pooled-allogeneic-mesenchymal-stromal-cells-in-critical-limb-ischemia-due-to-buerger-s-disease-phase-ii-study-report-suggests-clinical-efficacy
#7
Pawan K Gupta, Murali Krishna, Anoop Chullikana, Sanjay Desai, Rajkumar Murugesan, Santanu Dutta, Uday Sarkar, Radhakrishnan Raju, Anita Dhar, Rajiv Parakh, Lakshmanan Jeyaseelan, Pachaiyappan Viswanathan, Prasanth Kulapurathu Vellotare, Raviraja N Seetharam, Charan Thej, Mathiyazhagan Rengasamy, Sudha Balasubramanian, Anish S Majumdar
Critical limb ischemia (CLI) due to Buerger's disease is a major unmet medical need with a high incidence of morbidity. This phase II, prospective, nonrandomized, open-label, multicentric, dose-ranging study was conducted to assess the efficacy and safety of i.m. injection of adult human bone marrow-derived, cultured, pooled, allogeneic mesenchymal stromal cells (BMMSC) in CLI due to Buerger's disease. Patients were allocated to three groups: 1 and 2 million cells/kg body weight (36 patients each) and standard of care (SOC) (18 patients)...
March 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28295971/mid-term-outcomes-of-orbital-atherectomy-combined-with-drug-coated-balloon-angioplasty-for-treatment-of-femoropopliteal-disease
#8
T Raymond Foley, Ryan P Cotter, Damianos G Kokkinidis, Daniel D Nguyen, Stephen W Waldo, Ehrin J Armstrong
PURPOSE: To assess the intraprocedural and mid-term outcomes of orbital atherectomy (OA) combined with drug-coated balloon (DCB) angioplasty for the treatment of calcified femoropopliteal disease. METHODS: In this single-center cohort, 89 patients (139 lesions) were treated with DCB angioplasty for claudication or critical limb ischemia (CLI). Angiographic characteristics and procedural outcomes were reviewed for patients treated with or without adjunctive OA. Lesion calcification was graded using two previously published scoring systems, the angiographic calcium score (ACS) and the peripheral artery calcification scoring system (PACSS)...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28292886/optical-probing-of-gastrocnemius-in-patients-with-peripheral-artery-disease-characterizes-myopathic-biochemical-alterations-and-correlates-with-stage-of-disease
#9
Ryan A Becker, Kim Cluff, Nithyanandhi Duraisamy, Hootan Mehraein, Hussam Farhoud, Tracie Collins, George P Casale, Iraklis I Pipinos, Jeyamkondan Subbiah
Peripheral artery disease (PAD) is a condition caused by atherosclerotic blockages in the arteries supplying the lower limbs and is characterized by ischemia of the leg, progressive myopathy, and increased risk of limb loss. The affected leg muscles undergo significant changes of their biochemistry and metabolism including variations in the levels of many key proteins, lipids, and nucleotides. The mechanisms behind these changes are poorly understood. The objective of this study was to correlate the severity of the PAD disease stage and associated hemodynamic limitation (determined by the ankle brachial index, ABI) in the legs of the patients with alterations in the biochemistry of chronically ischemic leg muscle as determined by ATR-Fourier transform infrared micro-spectroscopy...
March 2017: Physiological Reports
https://www.readbyqxmd.com/read/28288884/the-profile-of-circulating-matrix-metalloproteinases-in-patients-undergoing-lower-limb-endovascular-interventions-for-peripheral-arterial-disease
#10
Ioakeim T Giagtzidis, Nikolaos P Kadoglou, George Mantas, Aris Spathis, Konstantinos O Papazoglou, Petros Karakitsos, Christos D Liapis, Christos D Karkos
BACKGROUND: Matrix metalloproteinases (MMPs) play a significant role in the development and progression of atherosclerotic vascular disease. We aimed to document the profile of circulating MMPs in peripheral arterial disease (PAD) patients undergoing lower limb endovascular revascularization. METHODS: A total of 46 patients (37 male; mean age 66±11 years) undergoing elective lower limb percutaneous revascularization (angioplasty/stent) for symptomatic PAD were recruited from two vascular centers...
March 10, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28288436/cell-therapy-of-critical-limb-ischemia-in-diabetic-patients-state-of-art
#11
REVIEW
Michal Dubský, Alexandra Jirkovská, Robert Bem, Andrea Nemcová, Vladimira Fejfarová, Edward B Jude
In this review we report on the state of cell therapy of critical limb ischemia (CLI) with respect to differences between diabetic and non-diabetic patients mainly from the clinical point of view. CLI is the most severe form of peripheral arterial disease and its diagnosis and treatment in diabetic patients is very difficult. The therapeutic effect of standard methods of CLI treatment is only partial - more than one third of diabetic patients are not eligible for standard revascularization; therefore, new therapeutic techniques such as cell therapy have been studied in clinical trials...
February 27, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28287292/-long-term-results-after-invasive-treatment-of-critical-limb-ischemia
#12
Zoltán Ruzsa, Ferenc Kuti, Balázs Berta, Károly Tóth, Zoltán Bánsághi, Zoltán Vámosi, Kálmán Hüttl
INTRODUCTION AND AIM: Surgical tibial bypass for critical limb ischemia is associated with significant morbidity, mortality, and graft failure, whereas percutaneous angioplasty and stenting has promising results. The objective of this study was the investigation of the long term results of below-knee percutaneous angioplasty for restoring straight inline arterial flow in patients with critical limb ischemia. METHOD: The clinical and angiographic data of 281 consecutive patients with critical limb ischemia treated by PTA between 2008 and 2011 was evaluated in a prospective register...
March 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28287126/pet-cell-tracking-using-18-f-flt-is-not-limited-by-local-reuptake-of-free-radiotracer
#13
Mark G MacAskill, Adriana S Tavares, Junxi Wu, Christophe Lucatelli, Joanne C Mountford, Andrew H Baker, David E Newby, Patrick W F Hadoke
Assessing the retention of cell therapies following implantation is vital and often achieved by labelling cells with 2'-[(18)F]-fluoro-2'-deoxy-D-glucose ((18)F-FDG). However, this approach is limited by local retention of cell-effluxed radiotracer. Here, in a preclinical model of critical limb ischemia, we assessed a novel method of cell tracking using 3'-deoxy-3'-L-[(18)F]-fluorothymidine ((18)F-FLT); a clinically available radiotracer which we hypothesise will result in minimal local radiotracer reuptake and allow a more accurate estimation of cell retention...
March 13, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28286751/new-delivery-systems-of-stem-cells-for-vascular-regeneration-in-ischemia
#14
REVIEW
Adegbenro Omotuyi John Fakoya
The finances of patients and countries are increasingly overwhelmed with the plague of cardiovascular diseases as a result of having to chronically manage the associated complications of ischemia such as heart failures, neurological deficits, chronic limb ulcers, gangrenes, and amputations. Hence, scientific research has sought for alternate therapies since pharmacological and surgical treatments have fallen below expectations in providing the desired quality of life. The advent of stem cells research has raised expectations with respect to vascular regeneration and tissue remodeling, hence assuring the patients of the possibility of an improved quality of life...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28279748/burden-of-readmissions-among-patients-with-critical-limb-ischemia
#15
Shikhar Agarwal, James M Pitcavage, Karan Sud, Badal Thakkar
BACKGROUND: Readmissions constitute a major healthcare burden among critical limb ischemia (CLI) patients. We aimed to study the incidence of readmission and factors affecting readmission in CLI patients. METHODS: All adult hospitalizations with a diagnosis code for CLI were included from State Inpatient Databases from Florida (2009-2013), New York (2010-2013) and California (2009-2011). Data were merged with the directory available from the American Hospital Association to obtain detailed information on hospital related characteristics...
March 3, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28279747/readmissions-for-critical-limb-ischemia-hear-no-evil
#16
EDITORIAL
Mehdi H Shishehbor, Herbert D Aronow
No abstract text is available yet for this article.
March 2, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28279723/physiologic-cryoamputation-in-managing-critically-ill-patients-with-septic-advanced-acute-limb-ischemia
#17
Samuel L Chen, Isabella J Kuo, Nii-Kabu Kabutey, Roy M Fujitani
OBJECTIVES: Certain critically ill patients with advanced acute limb ischemia with a non-viable extremity may be unsuitable for transport to the operating room to undergo definitive amputation. In these unstable patients, rapid regional cryotherapy allows for prompt infectious source control and correction of hemodynamic and metabolic abnormalities, thereby lessening the risk associated with definitive surgical amputation. We describe our refined technique for lower extremity physiologic cryoamputation and review our institutional experience...
March 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28274753/results-for-primary-bypass-versus-primary-angioplasty-stent-for-lower-extremity-chronic-limb-threatening-ischemia
#18
Jeremy D Darling, John C McCallum, Peter A Soden, Lindsey Korepta, Raul J Guzman, Mark C Wyers, Allen D Hamdan, Marc L Schermerhorn
BACKGROUND: Long-term results comparing percutaneous transluminal angioplasty with or without stenting (PTA/S) and open surgical bypass for chronic limb-threatening ischemia (CLTI) in patients who have had no prior intervention are lacking. METHODS: All patients undergoing a first-time lower extremity revascularization for CLTI by vascular surgeons at our institution from 2005 to 2014 were retrospectively reviewed. Outcomes included perioperative complications, wound healing, restenosis, primary patency, reintervention, major amputation, RAS events (ie, reintervention, major amputation, or stenosis), and mortality...
March 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28274750/the-society-for-vascular-surgery-wound-ischemia-and-foot-infection-wifi-classification-system-predicts-wound-healing-but-not-major-amputation-in-patients-with-diabetic-foot-ulcers-treated-in-a-multidisciplinary-setting
#19
Nestoras Mathioudakis, Caitlin W Hicks, Joseph K Canner, Ronald L Sherman, Kathryn F Hines, Ying W Lum, Bruce A Perler, Christopher J Abularrage
OBJECTIVE: The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) threatened limb classification has been shown to correlate well with risk of major amputation and time to wound healing in heterogeneous diabetic and nondiabetic populations. Major amputation continues to plague the most severe stage 4 WIfI patients, with 1-year amputation rates of 20% to 64%. Our aim was to determine the association between WIfI stage and wound healing and major amputation among patients with diabetic foot ulcers (DFUs) treated in a multidisciplinary setting...
March 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28273223/endovascular-therapeutic-options-for-the-treatment-of-aortoiliac-aneurysms
#20
Bernardo Massière, Arno VON-Ristow, Alberto Vescovi, Daniel Leal, Lea Mirian Barbosa Fonseca
About 20% of patients with abdominal aortic aneurysms have associated iliac aneurysms. Distal sealing during the endovascular treatment of aortic-iliac aneurysms is a challenge that has led to the emergence of several technical options to achieve this goal over the years. Internal iliac artery embolization is associated with the risk of ischemic complications, such as gluteal necrosis, lower limb neurological deficit, colonic ischemia, impotence and gluteal claudication. This article summarizes the technical options for endovascular treatment of aortoiliac aneurysms with different approaches to preserving the patency of internal iliac arteries...
December 2016: Revista do Colégio Brasileiro de Cirurgiões
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