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Limb ischemia

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https://www.readbyqxmd.com/read/29679687/a-novel-technique-indocyanine-green-angiography-to-prognosticate-healing-of-foot-ulcer-in-critical-limb-ischemia
#1
Hiten M Patel, Shahzad S Bulsara, Shubhabrata Banerjee, Tapish Sahu, Virender K Sheorain, Tarun Grover, Rajiv Parakh
BACKGROUND: To predict wound healing in patients with critical limb ischemia(CLI) is ongoing issue. Currents methods like ankle-brachial index (ABI), color doppler and transcutaneous oxygen pressure (TCPO2 ), CT angiography are lacking in demonstrating regional perfusion. Indocyanine green angiography (ICGA) has the potential to provide regional perfusion information lacking in other methods. To demonstrate successes of revascularization procedure in CLI patients based on ICGA data this study was conducted...
April 18, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29678653/continued-ultrasound-surveillance-required-after-hand-ischemia-associated-with-trauma-in-children
#2
Melissa L Kirkwood, Khalil H Chamseddin, Brianne Hanson, Carlos H Timaran, Mujtaba Ali, Alexis D Jacob, John E Rectenwald
BACKGROUND: Hand ischemia following trauma in children is rare and the natural history after upper extremity arterial bypass in children is unknown. We hypothesize children with brachial artery repair are at long term risk of developing aneurysmal degeneration or Thrombosis thus necessitating annual duplex ultrasonography and physical examination. STUDY DESIGN: A retrospective review of children who had brachial artery repair (bypass or vein patch) for hand ischemia secondary to trauma at a level I trauma pediatric hospital was performed...
April 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29678429/intercostal-entrapment-of-clavicle-fracture-causing-a-pulseless-flaccid-upper-extremity
#3
Chase Kluemper, Tyler Koestner, Justin Cowart, Matt Higgins
Limb-threatening vascular compromise from an isolated closed clavicle fracture is exceedingly rare. We report a case of a posteriorly angulated, closed clavicle fracture segment causing right upper-extremity ischemia, numbness, and paresis caused by entrapment of the clavicle between the first and second ribs.
April 17, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29678197/resuscitative-endovascular-balloon-occlusion-of-the-aorta-performed-by-emergency-physicians-for-traumatic-hemorrhagic-shock-a-case-series-from-japanese-emergency-rooms
#4
Ryota Sato, Akira Kuriyama, Rei Takaesu, Nobuhiro Miyamae, Wataru Iwanaga, Hayato Tokuda, Takehiro Umemura
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA), which has been increasingly used for the management of hemorrhagic shock, is a less invasive strategy for the management of patients with very severe hemorrhage. However, its effectiveness remains controversial. METHODS: This retrospective case series included trauma patients who underwent REBOA for hemorrhagic shock due to trauma in four Japanese tertiary care emergency centers from January 2013 to March 2017...
April 21, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29675441/acute-bilateral-lower-extremity-paralysis-secondary-to-acute-thrombosis-of-an-infrarenal-abdominal-aortic-aneurysm
#5
T Joseph Watson, W Kurtis Childers, Lindsey Haga, John Calaitges
We present the case of a 64-year-old male who presented to the emergency department with bilateral limb ischemia and paralysis for approximately 1 hour. Computed tomographic angiography demonstrated occlusion of the infrarenal aorta beginning just above the patient's known abdominal aortic aneurysm (AAA) and extending into both common iliac arteries. He was emergently treated via open repair of the AAA with a Gore-Tex tube graft, bilateral common iliac thrombectomies, and bilateral lower extremity four-compartment fasciotomies...
June 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/29674661/donor-dependent-variation-of-human-umbilical-cord-blood-mesenchymal-stem-cells-in-response-to-hypoxic-preconditioning-and-amelioration-of-limb-ischemia
#6
Insung Kang, Byung-Chul Lee, Soon Won Choi, Jin Young Lee, Jae-Jun Kim, Bo-Eun Kim, Da-Hyun Kim, Seung Eun Lee, Nari Shin, Yoojin Seo, Hyung-Sik Kim, Dong-Ik Kim, Kyung-Sun Kang
With the rapidly growing demand for mesenchymal stem cell (MSC) therapy, numerous strategies using MSCs for different diseases have been studied and reported. Because of their immunosuppressive properties, MSCs are commonly used as an allogeneic treatment. However, for the many donors who could potentially be used, it is important to understand the capacity for therapeutic usage with donor-to-donor heterogeneity. In this study, we aimed to investigate MSCs as a promising therapeutic strategy for critical limb ischemia...
April 20, 2018: Experimental & Molecular Medicine
https://www.readbyqxmd.com/read/29673298/initial-clinical-experience-using-the-low-profile-altura-endograft-system-with-double-d-shaped-proximal-stents-for-endovascular-aneurysm-repair
#7
Dainis Krievins, Albrecht Krämer, Janis Savlovskis, Georgij Oszkinis, E Sebastian Debus, Alexander Oberhuber, Christopher K Zarins
PURPOSE: To report the initial clinical results of endovascular aneurysm repair (EVAR) using the low-profile (14-F) Altura Endograft System, which features a double "D-shaped" stent design with suprarenal fixation and modular iliac components that are deployed from distal to proximal. METHODS: From 2011 to 2015, 90 patients (mean age 72.8±8.3 years; 79 men) with abdominal aortic aneurysm (AAA; mean diameter 53.8±5.7 mm) were treated at 10 clinical sites in 2 prospective, controlled clinical studies using the Altura endograft...
April 1, 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29672392/the-effect-of-hyperoxygenated-fatty-acids-in-preventing-skin-lesions-caused-by-surgical-pneumatic-tourniquets
#8
Beatriz Castillo Martín, Juan Ignacio Castillo Martín, Jesús Lago Oliver, Jorge Diz Gómez
OBJECTIVES: To determine whether hyperoxygenated fatty acids (HOFAs) provide safe and effective protection against lesions caused by surgical pneumatic tourniquets (SPTs). METHODS: This was a nonrandomized, single-blind, 2-arm, prospective, comparative study. The study was approved by the Ethics and Clinical Research Commission of the Hospital Universitario Gregorio Marañón, in Madrid, Spain. Subjects in the intervention group were treated topically with HOFAs (Linovera; B...
May 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29664057/remote-ischemic-postconditioning-for-ischemic-stroke-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#9
Jing-Jing Zhao, Hui Xiao, Wen-Bo Zhao, Xiao-Pei Zhang, Yu Xiang, Zeng-Jie Ye, Miao-Miao Mo, Xue-Ting Peng, Lin Wei
Background: Remote ischemic postconditioning (RIPostC) appears to protect distant organs from ischemia-reperfusion injury (IRI). However, cerebral protection results have remained inconclusive. In the present study, a meta-analysis was performed to compare stroke patients with and without RIPostC. Methods: CNKI, WanFang, VIP, CBM, PubMed, and Cochrane Library databases were searched up to July 2016. Data were analyzed using both fixed-effects and random-effects models by Review Manager...
April 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29663990/-expression-and-role-of-heat-shock-protein-70-and-apoptosis-related-proteins-in-muscle-tissue-of-pressure-injury
#10
Nan Zhang, Haiyan Liu, Yan Qu
OBJECTIVE: To observe the phenomenon of apoptosis and expression of related proteins in injured muscle tissue during the formation of pressure injury, and to explore its mechanism of action on the pressure injury. METHODS: Forty male Sprague-Dawley (SD) rats were divided into normal control group, 3, 5, 7 and 9 compression groups according to the random number table, with 8 rats in each group. The pressure injury models on the gracilis muscle of hind limbs were reproduced by using a way of cycle compression of ischemia/reperfusion (I/R) magnet...
April 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29661987/review-of-the-latest-percutaneous-devices-in-critical-limb-ischemia
#11
REVIEW
Leila Haghighat, Sophia Elissa Altin, Robert R Attaran, Carlos Mena-Hurtado, Christopher J Regan
Critical limb ischemia (CLI) is a terminal stage of peripheral arterial disease that, in the absence of intervention, may lead to lower extremity amputation or death. Endovascular interventions have become a first-line approach to the management of CLI and have advanced considerably within the past decade. This review summarizes the types of percutaneous devices and the techniques that are available for the management of CLI and the data supporting their use. These include devices that establish and maintain vessel patency, including percutaneous transluminal angioplasty, drug-coated balloons, bare metal stents, drug-eluting stents, bioresorbable vascular scaffolds, and atherectomy; devices that provide protection from embolization; and, cell-based therapies...
April 14, 2018: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/29661291/hemodialysis-patients-have-worse-outcomes-after-infrageniculate-revascularization-procedures
#12
Caitlin W Hicks, Joseph K Canner, Kevin Kirkland, Mahmoud B Malas, James H Black, Christopher J Abularrage
BACKGROUND: Hemodialysis (HD) has been shown to be an independent predictor of poor outcomes after femoropopliteal revascularization procedures in patients with chronic limb-threatening ischemia. However, HD patients tend to have isolated infrageniculate disease, an anatomic risk factor for inferior patency. We aimed to compare outcomes for HD versus non-HD patients after infrageniculate open lower extremity bypass (LEB) and endovascular peripheral vascular interventions (PVIs). METHODS: Data from the Society for Vascular Surgery Vascular Quality Initiative database (2008-2014) were analyzed...
June 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29659744/human-adipose-mesenchymal-stem-cells-overexpressing-dual-chemotactic-gene-showed-enhanced-angiogenic-capacity-in-ischemic-hindlimb-model
#13
Younggeul Min, Seongho Han, Hyun Aae Ryu, Sung-Whan Kim
Aims: In present study, we sought to characterize the angio-vasculogenic property of human adipose mesenchymal stem cells (ASCs) overexpressing dual chemokine GCP-2 and SDF-1α (ASC-G/S) and to determine the therapeutic potential of ASC-G/S in the context of experimental ischemia. Methods and results: We generated ASC-G/S line and performed flow cytometry, quantitative (q)-PCR, Matrigel tube formation, Matrigel plug assays and in vivo therapeutic assays using hind limb ischemia mouse model...
April 5, 2018: Cardiovascular Research
https://www.readbyqxmd.com/read/29658870/descending-thoracic-aortic-aneurysm-rupture-treated-with-thoracic-endovascular-aortic-repair-in-a-patient-with-peripheral-artery-disease
#14
Ovidiu Stiru, Roxana Carmen Geana, Platon Pavel, Marian Croitoru, Cristian Boros, Ion Iovu, Vlad Anton Iliescu
Descending thoracic aortic aneurysm rupture is a life-threatening disease associated with high rates of morbidity and mortality. Treatment in these cases is a surgical emergency. Less invasive therapies for the treatment of this pathology have been developed over time. For descending thoracic aneurysm rupture, endovascular stent grafting is less invasive, life-saving, and a unique alternative to open repair. However, this approach is subject to anatomical and logistic limitations. The purpose of the present study is to report a case of an emergency endovascular repair for a ruptured thoracic aortic aneurysm in a patient with peripheral arterial disease, and to discuss some important issues related to this approach...
March 20, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29656608/combined-therapy-for-critical-limb-ischemia-biomimetic-plga-microcarriers-potentiates-the-pro-angiogenic-effect-of-adipose-tissue-stromal-vascular-fraction-cells
#15
Laurence Hoareau, Florian Fouchet, Cynthia Planesse, Sophie Mirbeau, Laurence Sindji, Emmanuel Delay, Régis Roche, Claudia N Montero-Menei, Franck Festy
We propose a regenerative solution in the treatment of critical limb ischemia. Poly-lactic/glycolic acid (PLGA) microcarriers were prepared and coated with laminin to be sterilized through γ-irradiation of 25 kGy at low temperature. Stromal vascular fraction (SVF) cells were extracted through enzymatic digestion of adipose tissue. Streptozotocin-induced diabetic mice underwent arteriotomy and received an administration of SVF cells combined or not with biomimetic microcarriers. Functional evaluation of the ischemic limb was then reported and tissue reperfusion was evaluated through fluorescence molecular tomography (FMT)...
April 14, 2018: Journal of Tissue Engineering and Regenerative Medicine
https://www.readbyqxmd.com/read/29655809/acute-limb-ischemia-in-an-8-year-old-patient-case-report
#16
Young Erben, Samuel M Miller, Brandon J Sumpio, Brian J Dillon, Alfred I Lee, Peter Blume, Bauer E Sumpio, Carlos Mena-Hurtado
We report the case of an 8-year-old patient with a history of nephrotic syndrome (NS), who presented to the emergency department (ED) with right foot pain. The patient's mother described intermittent pain that woke her son from sleep and was accompanied by the foot turning purple and becoming cold to touch. Physical exam revealed capillary refill of over ten seconds in the right and less than two seconds in the left foot. Ankle-brachial indices (ABI) were 0.0 on the right and 0.96 on the left. The patient was admitted and started on therapeutic intravenous heparin...
April 12, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29651358/pilot-study-of-intra-aortic-balloon-occlusion-to-limit-morbidity-in-patients-with-adherent-placentation-undergoing-cesarean-hysterectomy
#17
Elizabeth Blumenthal, Rashmi Rao, Aisling Murphy, Jeffrey Gornbein, Richard Hong, John M Moriarty, Daniel A Kahn, Carla Janzen
Objective  We study whether using an intra-aortic balloon (IAB) during cesarean hysterectomy decreases delivery morbidity in patients with suspected morbidly adherent placentation. Study Design  This is a retrospective cohort study of deliveries complicated by suspected abnormal placentation between 2009 and 2016 comparing maternal and neonatal outcomes with an IAB placed prior to cesarean hysterectomy versus no IAB. The primary outcome included quantified blood loss (QBL). Results  Thirty-five cases were reviewed, 16 with IAB and 19 without IAB...
April 2018: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/29650705/outcomes-of-peripheral-vascular-interventions-in-select-patients-with-lower-extremity-acute-limb-ischemia
#18
Elica Inagaki, Alik Farber, Jeffrey A Kalish, Mohammad H Eslami, Jeffrey J Siracuse, Robert T Eberhardt, Denis V Rybin, Gheorghe Doros, Naomi M Hamburg
BACKGROUND: Contemporary data on patients presenting with acute limb ischemia (ALI), who are selected for treatment with endovascular peripheral vascular interventions (PVI), are limited. Our study examined outcomes following endovascular PVI in patients with ALI by comparing with patients treated for chronic critical limb ischemia using a regional quality improvement registry. METHODS AND RESULTS: Of the 11 035 patients in the Vascular Study Group of New England PVI database (2010-2014), we identified 365 patients treated for lower extremity ALI who were 5:1 frequency matched (by procedure year and arterial segments treated) to 1808 patients treated for critical limb ischemia...
April 12, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29644834/31p-mr-spectroscopy-of-patients-with-mild-and-serious-lower-limb-ischemia
#19
Petr Sedivy, Miloslav Drobny, Monika Dezortova, Vit Herynek, Karel Roztocil, Helena Cermakova, Andrea Nemcova, Michal Dubsky, Milan Hajek
BACKGROUND: 31P MR spectroscopy is a technique for undertaking a comprehensive evaluation of muscle metabolism. The goal of this study was to compare patients with mild and severe lower limb ischemia measured by 31P MR spectroscopy at rest and during exercise. METHODS: 16 nondiabetic mild peripheral arterial occlusive disease (PAOD) patients, 23 diabetic PAOD patients with severe ischemia and 19 healthy controls were examined by rest and dynamic 31P MR spectroscopy with a 3T MR system equipped with an MR-compatible home-made pedal ergometer...
April 11, 2018: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/29643698/real-world-comparison-of-drug-eluting-and-bare-metal-stents-in-superficial-femoral-artery-occlusive-disease-with-trans-atlantic-intersociety-consensus-b-lesions-a-2-year-single-institute-study
#20
Fan-Chieh Meng, Po-Lin Chen, Chiu-Yang Lee, Chun-Che Shih, I-Ming Chen
Background: Endovascular stenting has surpassed bypass surgery to become the first-line treatment for superficial femoral artery (SFA) occlusive disease, and various types of stents including bare-metal stents (BMSs), covered stents, and drug-eluting stents (DESs), have been approved for treatment. This retrospective, single-institute study compared the short-term, real-world outcomes of BMSs and DESs for treating SFA occlusive disease. Methods: A retrospective chart review was used to enroll 94 patients who received a DES (n = 24) or BMS (n = 70) between 2009 and 2014...
March 2018: Acta Cardiologica Sinica
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