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Limb ischemia

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https://www.readbyqxmd.com/read/28822661/preoperative-anemia-associated-with-adverse-outcomes-after-infrainguinal-bypass-surgery-in-patients-with-chronic-limb-threatening-ischemia
#1
Thomas C F Bodewes, Alexander B Pothof, Jeremy D Darling, Sarah E Deery, Douglas W Jones, Peter A Soden, Frans L Moll, Marc L Schermerhorn
OBJECTIVE: Preoperative anemia in elderly patients undergoing surgery is prevalent and associated with adverse events; however, the interaction with other risk factors in patients with chronic limb-threatening ischemia (CLTI) is not well described. The purpose of this study was to assess the association between lower hematocrit (HCT) levels on admission and postoperative outcomes after infrainguinal bypass surgery. METHODS: Patients with CLTI undergoing nonemergent infrainguinal bypass were identified in the targeted vascular module of National Surgical Quality Improvement Program (NSQIP; 2011-2014)...
August 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28822457/-meta-analysis-of-clinical-safety-and-efficacy-evaluation-of-peripheral-arterial-disease-patients-with-critical-limb-ischemia-who-accepted-bypass-surgery-or-endovascular-therapy
#2
S K Shen, D M Wu, C G Wang, L K Zhang, Q W Gang
Objective: To evaluate the safety and efficacy of peripheral arterial disease patients with critical limb ischemia who accepted BSX or EVT. Methods: According to the requirements of systematic review, we searched MEDLINE (1980-2014), Emabse (1980-2014), Journals @ Ovid Full Text (1980-2014) databases, selected literature and extracted data, meta-analysis was performed through STATA11.2. Results: A total of 17 studies (3 RCTs, 14 non-randomized studies) and 5 515 patients (BSX group: 2 454, EVT group: 2 769) were deemed eligible...
August 8, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28819879/lower-extremity-bypass-using-bovine-carotid-artery-graft-artegraft-an-analysis-of-124-cases-with-long-term-results
#3
Philip Lindsey, Angela Echeverria, Mathew Cheung, Elias Kfoury, Carlos F Bechara, Peter H Lin
INTRODUCTION: Although biological grafts have been utilized as a vascular conduit in leg bypass for many years, reports of a bovine carotid artery graft (BCAG) in lower extremity revascularization have been scarce. This study analyzed the outcome of lower leg bypass using BCAG. METHODS: A retrospective review of a prospectively collected database of all patients undergoing lower extremity bypass using BCAG from 2002 to 2017 was performed. Clinical outcomes including graft patency and limb salvage were evaluated...
August 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28819822/endovascular-aneurysm-repair-with-balloon-thrombectomy-for-acute-thrombosis-of-abdominal-aortic-aneurysm
#4
Kensuke Uotani, Akihiro Hamanaka, Keigo Matsushiro, Erika Idaka, Kiyo Ito, Yuko Yamasaki, Takeyuki Kushima, Takaki Sugimoto, Koji Sugimoto
Acute occlusion of abdominal aortic aneurysm (AAA) is a rare complication and is usually treated with surgical reconstruction. We present a case of acute AAA occlusion that was successfully treated by endovascular aneurysm repair (EVAR) with Fogarty balloon thrombectomy. A 77-year-old man with a history of acute myocardial ischemia presented with limb weakness and coldness. Contrast-enhanced computed tomography showed a 42-mm-diameter infrarenal AAA that was completely thrombosed in the distal portion. The proximal neck of the aneurysm was patent, and its shape was suitable for EVAR...
August 17, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28816093/vascular-complications-following-intra-aortic-balloon-pump-implantation-an-updated-review
#5
Monique M de Jong, Roberto Lorusso, Fatima Al Awami, Francesco Matteuci, Orlando Parise, Pieter Lozekoot, Massimo Bonacchi, Jos G Maessen, Daniel M Johnson, Sandro Gelsomino
BACKGROUND: The use of the intra-aortic balloon pump (IABP) as a support device remains controversial due to the fact that a number of studies have shown no benefit in end mortality whilst using this device. One of the reasons for this could be the increase in vascular complications when using the pump. Therefore, the aim of the present review was to assess the current literature available with regards to IABP vascular complications during the clinical situation. METHODS: A literature search was performed, searching for IABP complications in adult human studies between 1990 and 2016...
August 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28811566/injectable-phosphorescence-based-oxygen-biosensors-identify-post-ischemic-reactive-hyperoxia
#6
Jennifer S Chien, Mahmoud Mohammed, Hysem Eldik, Mohamed M Ibrahim, Jeremy Martinez, Scott P Nichols, Natalie Wisniewski, Bruce Klitzman
Novel injectable biosensors were used to measure interstitial oxygenation before, during, and after transient ischemia. It is well known that reactive hyperemia occurs following a period of ischemia. However, increased blood flow does not necessarily mean increased oxygen tension in the tissue. Therefore, the purpose of this study was to test the hypothesis that tissue reactive hyperoxia occurs following release of hind-limb tourniquet occlusions. Rats were injected with bilateral hind-limb biosensors and were simultaneously subjected to a unilateral femoral vessel ligation...
August 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28811546/serum-derived-extracellular-vesicles-evs-impact-on-vascular-remodeling-and-prevent-muscle-damage-in-acute-hind-limb-ischemia
#7
Claudia Cavallari, Andrea Ranghino, Marta Tapparo, Massimo Cedrino, Federico Figliolini, Cristina Grange, Valentina Giannachi, Paolo Garneri, Maria Chiara Deregibus, Federica Collino, Pietro Rispoli, Giovanni Camussi, Maria Felice Brizzi
Serum is an abundant and accessible source of circulating extracellular vesicles (EVs). Serum-EV (sEV) pro-angiogenic capability and mechanisms are herein analyzed using an in vitro assay which predicts sEV angiogenic potential in vivo. Effective sEVs (e-sEVs) also improved vascular remodeling and prevented muscle damage in a mouse model of acute hind limb ischemia. e-sEV angiogenic proteomic and transcriptomic analyses show a positive correlation with matrix-metalloproteinase activation and extracellular matrix organization, cytokine and chemokine signaling pathways, Insulin-like Growth Factor and platelet pathways, and Vascular Endothelial Growth Factor signaling...
August 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28810647/limb-graft-occlusion-following-endovascular-aortic-repair-incidence-causes-treatment-and-prevention-in-a-study-cohort
#8
Guoquan Wang, Shuiting Zhai, Tianxiao Li, Xuan Li, Danghui Lu, Bo Wang, Dongbin Zhang, Shuaitao Shi, Zhidong Zhang, Kai Liang, Kewei Zhang, Xiaoyang Fu, Kun Li, Weixiao Li
The present study investigated the incidence, causes, treatment and prevention of limb graft occlusion following endovascular aortic repair (EVAR). A total of 66 cases of abdominal aortic aneurysm receiving EVAR at our department from January 2005 to December 2013 were enrolled. After EVAR, patients received routine antiplatelet therapy of 75 mg PLAVIX for 6 months and then 100 mg Aspirin for another 6 months by oral administration. According to previous clinical experiences, antiplatelet therapy is able to effectively reduce the incidence of iliac occlusion after EVAR...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28810573/warfarin-induced-life-threatening-bleeding-associated-with-a-cyp3a4-loss-of-function-mutation-in-an-acute-limb-ischemia-patient-case-report-and-review-of-the-literature
#9
Xiao-Wei Ma, Chang-Ning Hao, Zhi-Chun Gu, Meng Ye, Min Li, Lan Zhang
Patients with acute limb ischemia, deep venous thrombosis and pulmonary artery embolism may be treated with warfarin. The dose-response interaction of warfarin is associated with numerous factors, depending on which an uncommon life-threatening bleeding may occur. The present case study reported on a patient with acute limb ischemia and a history of warfarin-induced bleeding ten years previously and who again developed life threatening bleeding associated with warfarin treatment and received vascular surgery...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28807382/association-between-statin-therapy-and-amputation-free-survival-in-patients-with-critical-limb-ischemia-in-the-critisch-registry
#10
Konstantinos Stavroulakis, Matthias Borowski, Giovanni Torsello, Theodosios Bisdas
OBJECTIVE: Secondary prevention in patients with critical limb ischemia (CLI) is crucial for the reduction of cardiovascular morbidity and mortality. Nonetheless, current recommendations are extrapolated from other high-risk populations because of the lack of CLI-dedicated trials. The aim of this explorative study was to evaluate the association of statin therapy with the outcomes of CLI patients. METHODS: The First-Line Treatments in Patients With Critical Limb Ischemia (CRITISCH) registry is a prospective multicenter registry analyzing the effectiveness of all available treatment strategies in 1200 CLI patients...
August 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28807201/overexpression-of-thioredoxin1-enhances-functional-recovery-in-a-mouse-model-of-hind-limb-ischemia
#11
Inam A Shaikh, Muhammad Tipu Rishi, Mark Youssef, Vaithinathan Selvaraju, Mahesh Thirunavukkarasu, Gopi Ukani, Rajesh Lakshmanan, J Alexander Palesty, Nilanjana Maulik
BACKGROUND: There is keen interest in finding nonsurgical treatments for peripheral vascular disease (PVD). Previously, we demonstrated that selective activation of Thioredoxin1 (Trx1), a 12-kDa cytosolic protein, initiates redox-dependent signaling and promotes neovascularization after ischemic heart disease. Therefore, Trx1 might possess immense potential to not only treat murine hind limb ischemia (HLI) through effective angiogenesis but also provide PVD patients with nonsurgical therapy to enhance neovascularization and improve blood perfusion...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28806175/point-of-care-ultrasound-facilitated-detection-of-femoral-occlusive-septic-emboli-during-mitral-valve-surgery-a-case-report
#12
Melissa L Bellomy, Susan Eagle, Mias Pretorius, Ben R Barton, Yafen Liang
Acute lower extremity ischemia from septic emboli is a surgical emergency. Timely diagnosis and management are critical to improve patient outcome. However, traditional diagnostic modalities such as intraoperative angiogram are time-consuming, require special equipment and personnel, and introduce contrast exposure for critically ill patients. There are limited reports of utilization of point-of-care ultrasound to detect peripheral septic emboli. We present a case where femoral occlusive septic emboli were identified by point-of-care ultrasound after mitral valve replacement...
August 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28804223/the-effect-of-transcutaneous-electrical-acupoint-stimulation-on-inflammatory-response-in-patients-undergoing-limb-ischemia-reperfusion
#13
Yunchang Mo, Sijia Chen, Lili Yang, Ledan Huang, Dan Jin, Zhi Yu, Leilei Wang, Liangrong Wang, Shan Luo, Junlu Wang
Reperfusion after tourniquet use can induce inflammation and cause remote organ injury. We evaluated the therapeutic effect of transcutaneous electrical acupoint stimulation (TEAS) on inflammatory mediators and lung function in patients receiving lower limb tourniquets. Forty patients undergoing unilateral lower extremity surgery with tourniquet were randomly assigned to two groups: the TEAS group and ischemia-reperfusion (I/R) group. The C-C motif chemokine ligand 2 (CCL2), C-X-C motif chemokine ligand 8 (CXCL8), interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α), and arterial blood gas analysis were measured preoperatively and 6 h after tourniquet removal...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28802661/efficacy-of-isolated-limb-perfusion-ilp-in-patients-with-merkel-cell-carcinoma-mcc-a-multicenter-experience
#14
L M van Veenendaal, M F Madu, M E T Tesselaar, C Verhoef, D J Grünhagen, A C J van Akkooi
BACKGROUND: Merkel cell carcinoma (MCC) is a rare and potentially aggressive neuroendocrine tumor of the skin, with a propensity for locoregional metastases. In two expert referral centers, isolated limb perfusion (ILP) is used to obtain locoregional control in selected locoregionally advanced MCC patients. This study describes our experience. METHOD: Patients who underwent ILP for MCC were analyzed. ILP was performed with melphalan and tumor necrosis factor (TNF) combination therapy...
August 3, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28802596/effects-of-differential-phase-remote-ischemic-preconditioning-intervention-in-laparoscopic-partial-nephrectomy-a-single-blinded-randomized-controlled-trial-in-a-parallel-group-design
#15
Yuan-Yuan Hou, Yun Li, Shu-Fang He, Jie Song, De-Xin Yu, Gordon T C Wong, Ye Zhang
STUDY OBJECTIVE: There are two windows of protection for remote ischemic preconditioning (RIPC), an early (ERIPC) and a late-phase (LRIPC). While ERIPC has been well studied, works on LRIPC are relatively scarce, especially for the kidneys. We aimed to compare the effects of early-phase versus late-phase RIPC in patients with laparoscopic partial nephrectomy (LPN). DESIGN: A randomized controlled study SETTING: The Second Affiliated Hospital of Anhui Medical University, 1 May 2012 to 30 October 2013 PATIENTS: Sixty-five ASA 1 to 2 patients scheduled for LPN were located randomly to ERIPC group, LRIPC group and CON group (control)...
September 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28799724/characteristics-and-clinical-outcomes-of-repeat-endovascular-therapy-after-infrapopliteal-balloon-angioplasty-in-patients-with-critical-limb-ischemia
#16
Norihiro Kobayashi, Keisuke Hirano, Masahiro Yamawaki, Motoharu Araki, Tsuyoshi Sakai, Yasunari Sakamoto, Shinsuke Mori, Masakazu Tsutsumi, Yohsuke Honda, Takahiro Tokuda, Kenji Makino, Shigemitsu Shirai, Yoshiaki Ito
OBJECTIVES: We clarified characteristics and clinical outcomes of critical limb ischemia (CLI) patients who underwent repeat endovascular therapy (EVT) for infrapopliteal lesions. BACKGROUND: High restenosis rate after infrapopliteal EVT remains a major concern. METHODS: Patients with CLI who underwent EVT between April 2007 and February 2014, were divided into the following three groups according to how often EVT was repeated: Group A, no repeat of EVT; Group B, EVT repeated once/twice; and Group C, EVT repeated ≥3 times...
August 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28798201/remote-ischemic-preconditioning-does-not-prevent-acute-mountain-sickness-after-rapid-ascent-to-3450-m
#17
Marc M Berger, Franziska Macholz, Lukas Lehmann, Daniel Dankl, Marcel Hochreiter, Bernhard Bacher, Peter Bärtsch, Heimo Mairbäurl
Remote ischemic preconditioning (RIPC) has been shown to protect remote organs, such as the brain and the lung, from damage induced by subsequent hypoxia or ischemia. Acute mountain sickness (AMS) is a syndrome of non-specific neurologic symptoms and in high altitude pulmonary edema excessive hypoxic pulmonary vasoconstriction (HPV) plays a pivotal role. We hypothesized that RIPC protects the brain from AMS and attenuates the magnitude of HPV after rapid ascent to 3450 m. Forty non-acclimatized volunteers were randomized into 2 groups...
August 10, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28796258/loss-of-phd3-in-myeloid-cells-dampens-the-inflammatory-response-and-fibrosis-after-hind-limb-ischemia
#18
Angelika Beneke, Annemarie Guentsch, Annette Hillemann, Anke Zieseniss, Lija Swain, Dörthe M Katschinski
Macrophages are essential for the inflammatory response after an ischemic insult and thereby influence tissue recovery. For the oxygen sensing prolyl-4-hydroxylase domain enzyme (PHD) 2 a clear impact on the macrophage-mediated arteriogenic response after hind-limb ischemia has been demonstrated previously, which involves fine tuning a M2-like macrophage population. To analyze the role of PHD3 in macrophages, we performed hind-limb ischemia (ligation and excision of the femoral artery) in myeloid-specific PHD3 knockout mice (PHD3(-/-)) and analyzed the inflammatory cell invasion, reperfusion recovery and fibrosis in the ischemic muscle post-surgery...
August 10, 2017: Cell Death & Disease
https://www.readbyqxmd.com/read/28794502/proteomics-phosphoproteomics-of-left-ventricular-biopsies-from-patients-with-surgical-coronary-revascularization-and-pigs-with-coronary-occlusion-reperfusion-remote-ischemic-preconditioning
#19
Nilgün Gedik, Marcus Krüger, Matthias Thielmann, Eva Kottenberg, Andreas Skyschally, Ulrich H Frey, Elke Cario, Jürgen Peters, Heinz Jakob, Gerd Heusch, Petra Kleinbongard
Remote ischemic preconditioning (RIPC) by repeated brief cycles of limb ischemia/reperfusion reduces myocardial ischemia/reperfusion injury. In left ventricular (LV) biopsies from patients undergoing coronary artery bypass grafting (CABG), only the activation of signal transducer and activator of transcription 5 was associated with RIPC's cardioprotection. We have now used an unbiased, non-hypothesis-driven proteomics and phosphoproteomics approach to analyze LV biopsies from patients undergoing CABG and from pigs undergoing coronary occlusion/reperfusion without (sham) and with RIPC...
August 9, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28793823/role-of-atp-sensitive-potassium-channels-in-remote-ischemic-preconditioning-induced-tissue-protection
#20
Sapna Aggarwal, Puneet Kaur Randhawa, Nirmal Singh, Amteshwar Singh Jaggi
Remote ischemic preconditioning (RIPC) is an innovative treatment strategy that alleviates ischemia-reperfusion injury, whereby short episodes of regional ischemia and reperfusion delivered to remote organs including hind limb, kidney and intestine, and so on provide protection to the heart. The RIPC is known to reduce infarct size, serum levels of cardiac enzymes, and myocardial dysfunction in various animal species as well as in patients. There have been a large number of studies suggesting that the ATP-sensitive potassium channels (KATP channel) play a significant role as a mediator or end effector in RIPC...
September 2017: Journal of Cardiovascular Pharmacology and Therapeutics
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