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Limb ischemia

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https://www.readbyqxmd.com/read/28647640/bypass-surgery-after-endovascular-therapy-for-infrapopliteal-lesion-is-not-a-poor-outcome-compared-with-initial-bypass-surgery-by-vascular-surgeons
#1
Koichi Morisaki, Terutoshi Yamaoka, Kazuomi Iwasa, Takahiro Ohmine
PURPOSE: It is unclear whether prior endovascular therapy (EVT) adversely affects bypass surgery. The aim of this study is to investigate treatment outcomes between initial bypass (bypass-first) and bypass surgery after EVT (EVT-first). METHODS: We conducted a retrospective analysis of critical limb ischemia patients undergoing infrapopliteal bypass between November 2006 and December 2015. Graft patency, limb salvage (LS), amputation-free survival (AFS), and overall survival (OS) were examined between bypass-first and EVT-first groups...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28647629/histological-analysis-of-a-new-route-after-subintimal-crural-angioplasty
#2
Daijirou Akamatsu, Fumiyoshi Fujisima, Hitoshi Goto, Munetaka Hashimoto, Ken Tsuchida, Keiichirou Kawamura, Yuta Tajima, Michihisa Umetsu, Syunya Suzuki, Takashi Kamei
BACKGROUND: Subintimal angioplasty is an alternative approach in treating critical limb ischemia with crural artery disease. However, route or location of the newly created channel is not understood. CASE PRESENTATION: A 68-year-old man was referred to our hospital with ischemic gangrene of the right big toe. We performed endovascular treatment because he was a poor candidate for bypass surgery. The posterior tibial artery was treated using subintimal angioplasty, though it resulted in early occlusion...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28647199/influence-of-frailty-on-treatment-outcomes-after-revascularization-in-patients-with-critical-limb-ischemia
#3
Koichi Morisaki, Terutoshi Yamaoka, Kazuomi Iwasa, Takahiro Ohmine
OBJECTIVE: It is unclear whether frailty adversely affects treatment outcomes in patients with critical limb ischemia (CLI). The aim of this study was to investigate the influence of frailty on CLI patients after revascularization. METHODS: Patients undergoing infrapopliteal revascularization between 2007 and 2015 were retrospectively analyzed. The patient was defined as CLI frail when two or more of the following were present: low Geriatric Nutritional Risk Index, low skeletal muscle mass index, or nonambulatory status...
June 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28647197/characterizing-tissue-perfusion-after-lower-extremity-intervention-using-two-dimensional-color-coded-digital-subtraction-angiography
#4
Ann H Kim, Andrew J Shevitz, Katherine L Morrow, Daniel E Kendrick, Karem Harth, Henry Baele, Vikram S Kashyap
OBJECTIVE: Digital subtraction angiography (DSA) of the peripheral arterial vasculature provides lumenographic information but only a qualitative assessment of blood flow. The ability to quantify adequate tissue perfusion of the lower extremities would enable real-time perfusion assessment during DSA of patients with peripheral arterial disease (PAD). In this study, we used a novel real-time imaging software to delineate tissue perfusion parameters in the foot in PAD patients. METHODS: Between March 2015 and June 2016, patients (N = 31) underwent lower extremity angiography using a two-dimensional perfusion (2DP) imaging protocol (Philips Healthcare, Andover, Mass)...
June 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28646446/innovations-in-the-endovascular-management-of-critical-limb-ischemia-retrograde-tibiopedal-access-and-advanced-percutaneous-techniques
#5
REVIEW
Jihad A Mustapha, Larry J Diaz-Sandoval, Fadi Saab
PURPOSE OF REVIEW: Retrograde tibiopedal access and interventions have contributed to advance of endovascular techniques to treat critical limb ischemia (CLI) patients. This review encompasses the spectrum from advanced diagnostic imaging and technical therapeutic approaches for infrapopliteal occlusions, to a discussion of current standards and future directions. RECENT FINDINGS: Contemporary studies of infrapopliteal angioplasty show suboptimal short-term and 1-year clinical outcomes...
August 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28641140/effect-of-c1-inh-on-ischemia-reperfusion-injury-in-a-porcine-limb-ex-vivo-perfusion-model
#6
Mai M Abdelhafez, Jane Shaw, Damian Sutter, Jonas Schnider, Yara Banz, Hansjörg Jenni, Esther Voegelin, Mihai A Constantinescu, Robert Rieben
Revascularization of an amputated limb within 4-6h is essential to avoid extensive ischemia/reperfusion (I/R) injury leading to vascular leakage, edema and tissue necrosis. I/R injury is a pathological inflammatory condition that occurs during reperfusion of an organ or tissue after prolonged ischemia. It is characterized by a complex crosstalk between endothelial cell activation and the activation of plasma cascades. Vasculoprotective pharmacological intervention to prevent I/R injury might be an option to prolong the time window between limb amputation and successful replantation...
June 19, 2017: Molecular Immunology
https://www.readbyqxmd.com/read/28640077/improvement-of-peripheral-artery-disease-with-sildenafil-and-bosentan-combined-therapy-in-a-patient-with-limited-cutaneous-systemic-sclerosis-a-case-report
#7
Loukman Omarjee, Cedric Fontaine, Guillaume Mahe, Vincent Jaquinandi
RATIONALE: Sildenafil, a phosphodiesterase-5-inhibitor and Bosentan, an endothelin-1-receptor antagonist combined therapy could have beneficial effect in systemic sclerosis (SSc) patients with peripheral artery disease. PATIENT CONCERNS: We report a case of a 48-year-old Black woman, who developed severe left limb claudication and walking limitation following a left femoropopliteal bypass occlusion in 2014. She was a heavy smoker and had a history of right middle cerebral artery ischemic stroke and bilateral Raynaud phenomenon...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28637396/modulation-of-mir29a-improves-impaired-post-ischemic-angiogenesis-in-hyperglycemia
#8
Lingdan Chen, Emmanuel Okeke, Dawit Ayalew, Danny Wang, Lyeba Shahid, Ayotunde O Dokun
Individuals with diabetes mellitus suffer from impaired angiogenesis and this contributes to poorer peripheral arterial disease outcomes. In experimental peripheral arterial disease, angiogenesis and perfusion recovery are impaired in mice with diabetes. We recently showed that a disintegrin and metalloproteinase domain-containing protein 12 (ADAM12) is upregulated in ischemic endothelial cells and plays a key role in post-ischemic angiogenesis and perfusion recovery following experimental peripheral arterial disease...
January 1, 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28635661/hypoxic-preconditioning-promotes-the-bioactivities-of-mesenchymal-stem-cells-via-the-hif-1%C3%AE-grp78-akt-axis
#9
Jun Hee Lee, Yeo Min Yoon, Sang Hun Lee
Mesenchymal stem cells (MSC) are ideal materials for stem cell-based therapy. As MSCs reside in hypoxic microenvironments (low oxygen tension of 1% to 7%), several studies have focused on the beneficial effects of hypoxic preconditioning on MSC survival; however, the mechanisms underlying such effects remain unclear. This study aimed to uncover the potential mechanism involving 78-kDa glucose-regulated protein (GRP78) to explain the enhanced MSC bioactivity and survival in hindlimb ischemia. Under hypoxia (2% O₂), the expression of GRP78 was significantly increased via hypoxia-inducible factor (HIF)-1α...
June 21, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28634450/leonurine-improves-age-dependent-impaired-angiogenesis-possible-involvement-of-mitochondrial-function-and-hif-1%C3%AE-dependent-vegf-activation
#10
Jia Qi, Jing J Wang, Jun L Duan, Zhao Y Lu, Yang G Yuan
Objective: Advanced age is associated with impaired angiogenesis in part because of mitochondrial dysfunction. We have recently reported that leonurine exerts protective effects in neuron via regulation of mitochondrial function. The aim of this study was to explore whether leonurine is able to attenuate mitochondrial dysfunction and to enhance angiogenesis in old rats with hindlimb ischemia. Methods and Results: At day 14 after surgery, hypoxia-inducible factor (HIF)-1α and vascular endothelial growth factor (VEGF) expression was decreased in the ischemic muscle of aged animals, which was accompanied by enhanced oxidative stress, increased mitochondrial damage, decreased capillary density, and reduced limb perfusion compared with young mice...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28632147/crossover-iliofemoral-bypass-graft-through-tension-free-abdominal-wall-repair-mesh
#11
Mircea Muresan, Ovidiu Jimborean, Gabriela Jimborean, Radu Neagoe, Serban Bancu, Muresan Simona, Cristian Borz
INTRODUCTION: In vascular surgery the crossover iliofemoral bypass grafting is a well-known surgical technique. In general surgery the repair of an abdominal defect using a Polypropylene mesh is also a standard procedure. A particular technique is defined by the performance of these 2 separate procedures inside a single operation in which the crossover arterial graft is directed from the retroperitoneal space toward the contra-lateral femoral bifurcation through a Polypropylene mesh which closes the musculoaponeurotic layers of the abdominal wall...
June 8, 2017: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/28630829/are-we-justified-doing-salvage-or-amputation-procedure-based-on-mangled-extremity-severity-score-in-mangled-upper-extremity-injury
#12
R Siva Kumar, Prahalad Kumar Singhi, M Chidambaram
INTRODUCTION: Mangled upper limb injuries are at surge because of industrialization, modernization, and severe motor vehicle accidents. The utility of various scoring systems are meant for decision making in mangled lower limb injuries, and the same have been extrapolated for mangled upper limb injuries to make a decision of salvage or amputation for the lack of separate scoring system. MATERIALS AND METHODS: We applied mangled extremity severity score (MESS) and mangled extremity syndrome index (MESI) scoring systems to 10 cases of mangled upper limb injuries during the period of November 2010 to September 2012 presented at our tertiary trauma care center...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28630267/a-structured-review-of-antithrombotic-therapy-in-peripheral-artery-disease-with-a-focus-on-revascularization-a-tasc-intersociety-consensus-for-the-management-of-peripheral-artery-disease-initiative
#13
REVIEW
Connie N Hess, Lars Norgren, Gary M Ansel, Warren H Capell, John P Fletcher, F Gerry R Fowkes, Anders Gottsäter, Kerry Hitos, Michael R Jaff, Joakim Nordanstig, William R Hiatt
Peripheral artery disease affects >200 million people worldwide and is associated with significant limb and cardiovascular morbidity and mortality. Limb revascularization is recommended to improve function and quality of life for symptomatic patients with peripheral artery disease with intermittent claudication who have not responded to medical treatment. For patients with critical limb ischemia, the goals of revascularization are to relieve pain, help wound healing, and prevent limb loss. The baseline risk of cardiovascular and limb-related events demonstrated among patients with stable peripheral artery disease is elevated after revascularization and related to atherothrombosis and restenosis...
June 20, 2017: Circulation
https://www.readbyqxmd.com/read/28629476/stromal-vascular-fraction-cells-for-the-treatment-of-critical-limb-ischemia-a-pilot-study
#14
Adas Darinskas, Mindaugas Paskevicius, Gintaras Apanavicius, Gintaris Vilkevicius, Liutauras Labanauskas, Thomas E Ichim, Rytis Rimdeika
BACKGROUND: Cell-based therapy is being explored as an alternative treatment option for critical limb ischemia (CLI), a disease associated with high amputation and mortality rates and poor quality of life. However, therapeutic potential of uncultured adipose-derived stromal vascular fraction (SVF) cells has not been evaluated as a possible treatment. In this pilot study, we investigated the efficacy of multiple injections of autologous uncultured adipose-derived SVF cells to treat patients with CLI...
June 19, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28629353/lipid-emulsion-mitigates-impaired-pulmonary-function-induced-by-limb-ischemia-reperfusion-in-rats-through-attenuation-of-local-cellular-injury-and-the-subsequent-systemic-inflammatory
#15
Fangfang Xia, Yun Xia, Sisi Chen, Lulu Chen, Weijuan Zhu, Yuanqing Chen, Thomas J Papadimos, Xuzhong Xu, Le Liu
BACKGROUND: Limb ischemia/reperfusion causes inflammation and elicits oxidative stress that may lead to local tissue damage and remote organ such as lung injury. This study investigates pulmonary function after limb ischemia/reperfusion and the protective effect of a lipid emulsion (Intralipid). METHODS: Twenty-four rats were divided into three groups: sham operation group (group S), ischemia/reperfusion group (group IR), and lipid emulsion treatment group (group LE)...
June 19, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28625238/-risk-factors-of-perioperative-intra-aortic-balloon-pump-complications-in-cardiac-surgery-a-12-year-single-institution-analysis
#16
Hongyan Zhou, Yonghui Zhang, Yu Du, Fangfang Cao, Ji Wang, Li Zhao, Yu Nie, Haitao Zhang
OBJECTIVE: To investigate the incidence and risk factors of the complications in perioperative intra-aortic balloon pump (IABP) supported cardiac surgical patients. METHODS: The clinical data of adult cardiac surgery patients undergoing IABP in Fuwai Hospital from January 2005 to January 2017 were enrolled. The patients were divided into complications group and no complications group. Demographic characteristics, diagnosis, perioperative clinical parameters, IABP related data, and IABP complications (including ischemia, bleeding, vascular injury and mechanical problems) were collected...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28624225/inhibition-of-mef2a-enhances-neovascularization-via-post-transcriptional-regulation-of-14q32-micrornas-mir-329-and-mir-494
#17
Sabine M J Welten, Margreet R de Vries, Erna A B Peters, Sudhir Agrawal, Paul H A Quax, A Yaël Nossent
Improving the efficacy of neovascularization is a promising strategy to restore perfusion of ischemic tissues in patients with peripheral arterial disease. The 14q32 microRNA cluster is highly involved in neovascularization. The Mef2a transcription factor has been shown to induce transcription of the microRNAs within this cluster. We inhibited expression of Mef2a using gene-silencing oligonucleotides (GSOs) in an in vivo hind limb ischemia model. Treatment with GSO-Mef2a clearly improved blood flow recovery within 3 days (44% recovery versus 25% recovery in control) and persisted until 14 days after ischemia induction (80% recovery versus 60% recovery in control)...
June 16, 2017: Molecular Therapy. Nucleic Acids
https://www.readbyqxmd.com/read/28623098/acquired-inhibition-of-microrna-124-protects-against-spinal-cord-ischemia-reperfusion-injury-partially-through-a-mitophagy-dependent-pathway
#18
Kun Liu, Lihui Yan, Xiaojing Jiang, Yang Yu, Hongbo Liu, Tianxiang Gu, Enyi Shi
OBJECTIVE: Mitophagy results in selective clearance of damaged mitochondria. We investigated whether mitophagy was involved in the neuroprotection by inhibiting microRNA (miRNA)-124 on ischemic spinal cords. METHODS: Inhibition of miRNA-124 was conducted by intrathecal injection of lentivirus vectors containing antagomiR-124. Spinal cord ischemia was induced in rats by crossclamping the descending aorta just distal to the left subclavian artery for 14 minutes. Hind-limb motor function was assessed with the motor deficit index (MDI)...
May 23, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28618138/expansion-of-umbilical-cord-blood-aldehyde-dehydrogenase-expressing-cells-generates-myeloid-progenitor-cells-that-stimulate-limb-revascularization
#19
David M Putman, Tyler T Cooper, Stephen E Sherman, Ayesh K Seneviratne, Mark Hewitt, Gillian I Bell, David A Hess
Uncompromised by chronic disease-related comorbidities, human umbilical cord blood (UCB) progenitor cells with high aldehyde dehydrogenase activity (ALDH(hi) cells) stimulate blood vessel regeneration after intra-muscular transplantation. However, implementation of cellular therapies using UCB ALDH(hi) cells for critical limb ischemia, the most severe form of severe peripheral artery disease, is limited by the rarity (<0.5%) of these cells. Our goal was to generate a clinically-translatable, allogeneic cell population for vessel regenerative therapies, via ex vivo expansion of UCB ALDH(hi) cells without loss of pro-angiogenic potency...
June 15, 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28616910/-effects-of-limb-ischemic-postconditioning-on-behavioral-improvement-and-proliferation-of-neural-cells-in-rats-with-transient-cerebral-ischemia
#20
Dan Huang, Hong-Hong Liu, Zhen Yang, Yun Qu
OBJECTIVES: To determine the effects of non-invasive limb ischemic postconditioning (NLIP) on the behavioral performance and the expression and distribution of neural cells in rats with ischemic cortex. METHODS: Rats were randomly divided into 3 groups: sham group (n=10), ischemia/reperfusion (I/R) group (n=50), and NLIP group (n=50). Focal cerebral ischemia was induced by intraluminal MCAO in the rats in the I/R and NLIP groups, while no suture was inserted in the sham-operated rats...
May 2017: Sichuan da Xue Xue Bao. Yi Xue Ban, Journal of Sichuan University. Medical Science Edition
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