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Limb ischemia

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https://www.readbyqxmd.com/read/29240587/reclaiming-autologous-amputated-tissue-for-limb-salvage-of-a-diabetic-foot-burn-with-underlying-critical-limb-ischemia
#1
Catherine N Tchanque-Fossuo, Andrew M Wishy, Kaitlyn I M West, David L Dawson, Sara E Dahle, John G Carson
BACKGROUND: Diabetes mellitus is a worldwide pandemic that impacts more than 387 million people, with 29 million individuals affected in the United States alone. Diabetic patients have a 25% lifetime risk of developing a diabetic foot ulcer (DFU). Having a DFU is associated with a risk of recurrence approaching 70%. In addition, 1 in 6 patients with DFU will have a lower-limb amputation, with an associated increase in mortality ranging from 47% to 70%. Therefore, limb salvage is critical in patients with DFU...
January 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29237360/endovascular-treatment-of-thromboangiitis-obliterans-buerger-s-disease
#2
Mohammad-Hadi S Modaghegh, Shahab Hafezi
PURPOSE: When critical limb ischemia (CLI) occurs in patients with thromboangiitis obliterans (TAO) or Buerger's disease, smoking cessation alone may be insufficient to relieve rest pain and promote wound healing. Accordingly, adjunctive measures are warranted to restore adequate blood flow required for limb salvage. This study aimed to evaluate the feasibility and efficacy of percutaneous transluminal angioplasty (PTA) for the treatment of patients with TAO and CLI. In addition, a review of the literature on endovascular management of TAO is included...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29232398/remote-ischemic-preconditioning-attenuates-cardiopulmonary-bypass-induced-lung-injury
#3
Xiaona Zhou, Runzhu Jiang, Yucai Dong, Lifeng Wang
The use of cardiopulmonary bypass (CPB) in cardiac surgeries is known to induce pathological changes in vital organs such as lungs. Remote ischemic preconditioning (RIPC) is a protective strategy that has shown to be able to reduce tissue damage related to ischemia-reperfusion injury (IRI). The current study seeks to evaluate the beneficial effects of limb RIPC on lung tissues and function in a rat CPB model. RIPC, which consisted of three cycles of 5-min ischemia and subsequently 5-min reperfusion, was induced in the hind limbs of the animals via a tourniquet...
2017: PloS One
https://www.readbyqxmd.com/read/29232293/pressure-and-flow-characteristics-of-a-novel-bidirectional-cannula-for-cardiopulmonary-bypass
#4
Yi Chen, Elli Tutungi, James McMillan, Sara M Tayeh, Jess K Underwood, Adam C Wells, Julian A Smith, Randall A Moshinsky
OBJECTIVE: Femoral arterial cannulation is associated with a significant risk of lower limb ischemia. The aim of the study was to assess the pressure and flow in the femoral artery using a novel bidirectional femoral cannula in a sheep model of peripheral cardiopulmonary bypass. METHODS: Peripheral cardiopulmonary bypass was established using a multistage venous cannula inserted into the internal jugular vein and the bidirectional or a conventional arterial cannula into the femoral artery in seven adult ewes...
December 7, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29232210/response-percutaneous-vascular-interventions-versus-bypass-surgeries-in-patients-with-critical-limb-ischemia
#5
Chi Shu, Jiarong Wang, Yazhou He, Jichun Zhao
No abstract text is available yet for this article.
December 11, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29228603/elevating-vegf-a-and-pdgf-bb-secretion-by-salidroside-enhances-neoangiogenesis-in-diabetic-hind-limb-ischemia
#6
Agnes Dwi Ariyanti, Julita Sisjayawan, Jing Zhang, Jian-Qi Zhang, Gui-Xue Wang, Makoto Miyagishi, Shou-Rong Wu, Vivi Kasim
Hind-limb ischemia (HLI) is one of the major complication of diabetic patients. Angiogenesis potential in diabetic patients is severely disrupted, and the mechanism underlying it has not been fully elucidated, making it an obstacle for developing an efficient therapeutic angiogenesis strategy. Skeletal muscle cells, through their paracrine function, had been known to be critical for neoangiogenesis. Here we found that hyperglycemia upregulates the expression of skeletal muscle cells prolyl hydroxylase domain 3 (PHD3), which resulted in the decrease of the secretion of angiogenic factors, especially VEGF-A and PDGF-BB...
November 14, 2017: Oncotarget
https://www.readbyqxmd.com/read/29227899/cardiac-troponins-and-nt-probnp-in-the-forensic-setting-overview-of-sampling-site-postmortem-interval-cardiopulmonary-resuscitation-and-review-of-the-literature
#7
Cristian Palmiere, Camilla Tettamanti, Alessandro Bonsignore, Francesco De Stefano, Jessica Vanhaebost, Guillaume Rousseau, Maria Pia Scarpelli, Daniel Bardy
The possible use of biochemical markers in the postmortem diagnosis of myocardial ischemia is well known in the forensic setting, though several issues have limited its widespread adoption. The study presented herein focuses of N-terminal pro-B-type natriuretic peptide, troponin T, and troponin I, and the possible influence due to sampling site chosen, postmortem interval elapsed, and cardiopulmonary resuscitation attempts. Comparisons were performed between antemortem serum levels of these markers and postmortem levels measured in pericardial fluid and postmortem serum samples obtained from different sampling sites (n=16)...
November 27, 2017: Forensic Science International
https://www.readbyqxmd.com/read/29227345/response-percutaneous-vascular-interventions-versus-bypass-surgeries-in-patients-with-critical-limb-ischemia
#8
Sharath C V Paravastu, Shannon D Thomas, Ramon L Varcoe
No abstract text is available yet for this article.
December 7, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29226477/cell-therapy-for-critical-limb-ischemia-an-integrated-review-of-pre-clinical-and-clinical-studies
#9
REVIEW
Mohammad Qadura, Daniella C Terenzi, Subodh Verma, Mohammed Al-Omran, David A Hess
Critical limb ischemia (CLI), the most severe form of peripheral artery disease, is characterized by pain at rest and non-healing ulcers in the lower extremities. For patients with CLI, where the extent of atherosclerotic artery occlusion is too severe for surgical bypass or percutaneous interventions, limb amputation remains the only treatment option. Thus, cell-based therapy to restore perfusion and promote wound healing in patients with CLI is under intense investigation. Despite promising preclinical studies in animal models, transplantation of bone marrow (BM) derived cell populations in patients with CLI has shown limited benefit preventing limb amputation...
December 11, 2017: Stem Cells
https://www.readbyqxmd.com/read/29224944/use-of-the-wound-ischemia-foot-infection-classification-system-in-hemodialysis-patients-after-endovascular-treatment-for-critical-limb-ischemia
#10
Takahiro Tokuda, Keisuke Hirano, Yasunari Sakamoto, Shisuke Mori, Norihiro Kobayashi, Motoharu Araki, Masahiro Yamawaki, Yoshiaki Ito
OBJECTIVE: The Wound, Ischemia, foot Infection (WIfI) classification system is used to predict the amputation risk in patients with critical limb ischemia (CLI). The validity of the WIfI classification system for hemodialysis (HD) patients with CLI is still unknown. This single-center study evaluated the prognostic value of WIfI stages in HD patients with CLI who had been treated with endovascular therapy (EVT). METHODS: A retrospective analysis was performed of collected data on CLI patients treated with EVT between April 2007 and December 2015...
December 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29224940/results-of-nonoperative-management-of-acute-limb-ischemia-in-infants
#11
S Keisin Wang, Gary W Lemmon, Natalie A Drucker, Raghu L Motaganahalli, Michael C Dalsing, Ashley R Gutwein, Brian W Gray, Michael P Murphy
OBJECTIVE: Acute limb ischemia (ALI) in infants poses a challenge to the clinician secondary to poor operative outcomes, limb loss risk, and lifelong morbidity. This retrospective study reviewed a 10-year institutional experience with the nonoperative management of ALI in infants. METHODS: Infants (aged ≤12 months) diagnosed with ALI by duplex ultrasound and treated with initial nonoperative management at a tertiary care children's hospital were identified through vascular laboratory arterial duplex ultrasound records and International Classification of Diseases and Current Procedural Terminology codes associated with ALI...
December 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29224939/the-association-of-statin-therapy-with-the-primary-patency-of-femoral-and-popliteal-artery-stents
#12
Derek de Grijs, Pedro Teixeira, Steven Katz
OBJECTIVE: It has long been known that hydroxymethylglutaryl-coenzyme A reductase inhibitors (statins) broadly reduce cardiovascular events in patients with peripheral vascular disease. It was the goal of this study to determine whether there is an association between statin therapy and primary patency after stenting of superficial femoral and popliteal arteries. METHODS: The records of all patients undergoing primary nitinol stenting of the femoral and popliteal arteries at a single institution and by a single surgeon during a 10-year period were reviewed...
December 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29224661/acute-limb-ischemia
#13
Charles Gilliland, Jay Shah, Jonathan G Martin, Michael J Miller
Acute limb ischemia is technically defined as ischemia of the lower extremities lasting 14 days or less. The condition affects between 15 and 26 persons per 100,000 each year in the United States. The associated morbidity and mortality is extremely high, with 1-year mortality rates reported at over 40%. Acute limb ischemia is 20 times more common in the lower extremities than the upper extremities. Both interventional radiologists and vascular surgeons bring unique skills to the table in caring for these patients, and therefore should approach the care of these patients in a multidisciplinary manner to ensure the best outcomes for each patient...
December 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29221961/prevalence-of-high-on-treatment-aspirin-and-clopidogrel-platelet-reactivity-in-patients-with-critical-limb-ischemia
#14
Leonardo C Clavijo, Noor Al-Asady, Ashwat Dhillon, Ray V Matthews, Jorge Caro, Han Tun, Vincent Rowe, David M Shavelle
OBJECTIVES: The goal of this study is to establish the prevalence of high on-treatment platelet reactivity to aspirin (HPRA) and clopidogrel (HPRC) in patients with critical limb ischemia (CLI). BACKGROUND: CLI is associated with an increased risk of death and cardiovascular events. Unlike other patient populations with atherosclerotic cardiovascular disease, previous studies failed to demonstrate a benefit of antiplatelet therapy in patients with CLI. METHODS: From June 2014 to November 2016, we performed platelet reactivity studies for P2Y12 and thromboxane A2 (TXA2) inhibition in 100 CLI patients receiving daily treatment with aspirin and clopidogrel...
October 28, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29221836/efficacy-versus-complications-in-arterial-thrombolysis
#15
H P Ebben, M V van Burink, V Jongkind, D E Mouwen, J Udding, W Wisselink, J K Kievit, A M Wiersema, K K Yeung
BACKGROUND: Acute peripheral arterial occlusions threaten life and limb. Thrombolysis is an established, minimally invasive alternative treatment for surgical thromboembolectomy. Yet, there is no consensus regarding an optimal thrombolysis protocol and current knowledge is largely based on studies from the 1990's. This study reviews a contemporary cohort of patients treated with thrombolysis and aims to evaluate the treatment results and to identify possible predictors for outcome and (bleeding) complications...
December 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29219030/laser-atherectomy-combined-with-drug-coated-balloon-angioplasty-is-associated-with-improved-1-year-outcomes-for-treatment-of-femoropopliteal-in-stent-restenosis
#16
Damianos G Kokkinidis, Prio Hossain, Omar Jawaid, Bejan Alvandi, T Raymond Foley, Gagan D Singh, Stephen W Waldo, John R Laird, Ehrin J Armstrong
PURPOSE: To examine whether laser atherectomy combined with drug-coated balloons (laser + DCB) can improve the outcomes of femoropopliteal (FP) in-stent restenosis (ISR). METHODS: A dual-center retrospective study was conducted of 112 consecutive patients (mean age 70.3±10.6 years; 86 men) with Tosaka class II (n=29; diffuse stenosis) or III (n=83; occlusion) FP-ISR lesions. Sixty-two patients (mean age 68.5±10 years; 51 men) underwent laser + DCB while the other 50 patients (mean age 72...
December 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29218290/critical-upper-limb-ischemia-due-to-brachial-tourniquet-in-misdiagnosed-thoracic-outlet-syndrome-after-carpal-tunnel-decompression-a-case-report
#17
Cesare Tiengo, Andrea Monticelli, Stefano Bonvini, Valentina Wassermann, Erica Dalla Venezia, Franco Bassetto
We present the case of a 68-year-old woman, referred to our department for critical upper limb ischemia, which had occurred a few days after homolateral surgical ligamentotomy for carpal tunnel syndrome, diagnosed and confirmed by electromyography, and performed with a brachial tourniquet. The patient was later admitted for subsequent progressive necrosis of the first three fingers of the left hand, accompanied by signs of upper limb ischemia. An accessory cervical rib was identified, completely obliterating the subclavian artery distally at the origin of the suprascapular artery...
September 2017: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29217449/role-of-brachial-artery-ligation-bal-in-management-of-prosthetic-arterio-venous-graft-infections
#18
A R Chandrashekar, Chetan R Hoskatti, Sanjay C Desai, Rajendra B Prasad
CONTEXT: Arterio-Venous Graft (AVG) infections can present as major life-threatening hemorrhage or sepsis in a chronic kidney disease patient. Frequently all these patients present in critical condition which need prompt and expeditious management. Various procedures are described for management of infected grafts and its bleeding complications. However these procedures are associated with postop-operative bleeding and persistent infection. AIM: To study brachial artery ligation near the elbow joint in the management of an infected AV graft...
December 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29217446/the-use-of-the-profunda-femoral-artery-as-the-sole-target-vessel-to-bypass-aorto-iliac-disease-in-patients-with-critical-limb-ischemia-and-concomitant-unreconstructable-infra-inguinal-disease
#19
Nikolaos Kontopodis, Stella Lioudaki, Christos Chronis, Paris Kalogerakos, George Lazopoulos, Alexandra Papaioannou, Christos V Ioannou
BACKGROUND: Critical limb ischemia (CLI) often results from multilevel occlusive disease. There are occasions where a patent profunda femoral artery (PFA) is the only target artery that can be used as outflow during reconstruction to bypass aorto-iliac disease (AOID), with no further option for infra-inguinal revascularization. We aim to report results of the use of PFA as the sole target vessel for the treatment of these patients. METHODS: This is a retrospective, single-center study including CLI patients treated during 36-months...
December 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29217439/in-patients-with-severe-peripheral-arterial-disease-revascularization-induced-improvement-in-lower-extremity-ischemia-can-be-detected-by-laser-speckle-contrast-imaging-of-the-fluctuation-in-blood-perfusion-after-local-heating
#20
Sotaro Katsui, Yoshinori Inoue, Yohei Yamamoto, Kimihiro Igari, Toshifumi Kudo, Hiroyuki Uetake
BACKGROUND: We previously reported the utility of the perfusion value fluctuation slope for detecting severe ischemia in the lower limb. Our approach was based on a thermal load test mimicking the well-known physiological reaction termed "cold-induced vasodilation," which is known to occur as a three-phase phenomenon. The slope parameter quantifies the decrease in perfusion values accompanying the relative cooling (third phase) following the transient increase in blood flow (second phase) induced by the applied thermal load...
December 4, 2017: Annals of Vascular Surgery
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