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https://www.readbyqxmd.com/read/29776002/the-chaos-of-hospitalisation-for-patients-with-critical-limb-ischaemia-approaching-major-amputation
#1
Susan Monaro, Sandra West, Jana Pinkova, Janice Gullick
AIMS AND OBJECTIVES: To illuminate the hospital experience for patients and families when major amputation has been advised for critical limb ischaemia (CLI). BACKGROUND: CLI creates significant burden to the health system and the family, particularly as the person with CLI approaches amputation. Major amputation is often offered as a late intervention for CLI in response to the marked deterioration of an ischaemic limb, and functional decline from reduced mobility, intractable pain, infection and/or toxaemia...
May 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29773586/seafood-long-chain-n-3-polyunsaturated-fatty-acids-and-cardiovascular-disease-a-science-advisory-from-the-american-heart-association
#2
REVIEW
Eric B Rimm, Lawrence J Appel, Stephanie E Chiuve, Luc Djoussé, Mary B Engler, Penny M Kris-Etherton, Dariush Mozaffarian, David S Siscovick, Alice H Lichtenstein
Since the 2002 American Heart Association scientific statement "Fish Consumption, Fish Oil, Omega-3 Fatty Acids, and Cardiovascular Disease," evidence from observational and experimental studies and from randomized controlled trials continues to emerge to further substantiate the beneficial effects of seafood long-chain n-3 polyunsaturated fatty acids and cardiovascular disease. A recent American Heart Association science advisory addressed the specific effect of n-3 polyunsaturated fatty acid supplementation on clinical cardiovascular events...
May 17, 2018: Circulation
https://www.readbyqxmd.com/read/29772334/quality-of-life-and-mortality-after-endovascular-surgical-or-conservative-treatment-of-elderly-patients-suffering-from-critical-limb-ischemia
#3
Stijn L Steunenberg, Jolanda de Vries, Jelle W Raats, Willem J Thijsse, Nathalie Verbogt, Paul Lodder, Geert-Jan van Eijck, Eelco J Veen, Hans G W de Groot, Gwan H Ho, Lijckle van der Laan
INTRODUCTION: Revascularisation to relieve ischemic pain and prevent limb loss is the cornerstone of critical limb ischemia (CLI) treatment, however not all elderly patients are deemed fit for revascularisation. Patient related outcome measurements are important in these patients. Quality of Life (QoL) results regarding the effect of endovascular, surgical, and conservative treatment on the quality of life (QoL) in the elderly are scarce in current literature. Goal of this study is to explore the outcome of the different treatment modalities in elderly patients suffering from CLI, with a specific focus on QoL...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29760308/cardiovascular-outcome-and-mortality-in-patients-undergoing-endovascular-treatment-for-symptomatic-peripheral-artery-disease-short-term-results-of-the-toma-code-registry
#4
Michiaki Higashitani, Yukari Uemura, Atsushi Mizuno, Makoto Utsunomiya, Tetsuo Yamaguchi, Akihiro Matsui, Shunsuke Ozaki, Kazuki Tobita, Atsushi Tosaka, Akitsugu Oida, Kenji Suzuki, Takahide Kodama, Kentaro Jujo, Tatsuki Doijiri, Yasuhiro Takahashi, Shunsuke Matsuno, Nobuhito Kaneko, Akira Moriguchi, Shohei Kishi, Hitoshi Anzai
BACKGROUND: The present study was performed to clarify whether the preoperative clinical symptoms for endovascular therapy (EVT) can predict post-EVT death and cardiovascular prognosis in Japanese patients with peripheral artery disease (PAD), including acute disease.Methods and Results:The TOkyo taMA peripheral vascular intervention research COmraDE (Toma-Code) Registry is a Japanese prospective cohort of 2,321 consecutive patients with PAD treated with EVT, in 34 hospitals in the Kanto and Kōshin'etsu regions, from August 2014 to August 2016...
May 11, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29753232/traditional-and-nontraditional-glycemic-markers-and-risk-of-peripheral-artery-disease-the-atherosclerosis-risk-in-communities-aric-study
#5
Ning Ding, Lucia Kwak, Shoshana H Ballew, Bernard Jaar, Ron C Hoogeveen, Christie M Ballantyne, A Richey Sharrett, Aaron R Folsom, Gerardo Heiss, Maya Salameh, Josef Coresh, Alan T Hirsch, Elizabeth Selvin, Kunihiro Matsushita
BACKGROUND AND AIMS: Traditional glycemic markers, fasting glucose and hemoglobin A1c (HbA1c), predict incident peripheral artery disease (PAD). However, it is unknown whether nontraditional glycemic markers, fructosamine, glycated albumin, and 1,5-anhydroglucitol, are associated with PAD and whether these glycemic markers demonstrate particularly strong associations with severe PAD, critical limb ischemia (CLI). METHODS: We quantified the associations of these five glycemic markers with incident PAD (hospitalizations with PAD diagnosis or leg revascularization) in 11,634 ARIC participants using Cox regression models...
April 30, 2018: Atherosclerosis
https://www.readbyqxmd.com/read/29750878/perfusion-scintigraphy-in-the-assessment-of-autologous-cell-therapy-in-diabetic-patients-with-critical-limb-ischemia
#6
A Nemcova, A Jirkovska, M Dubsky, R Bem, V Fejfarova, V Woskova, A Pysna, M Buncova
Perfusion scintigraphy with technetium-99-methoxy-isobutyl-isonitrile ((99m)Tc-MIBI) is often used for assessing myocardial function but the number of studies concerning lower limb perfusion is limited. The aim of our study was to assess whether (99m)Tc-MIBI was an eligible method for evaluation of the effect of cell therapy on critical limb ischemia (CLI) in diabetic patients. (99m)Tc-MIBI of calf muscles was performed before and 3 months after autologous cell therapy (ACT) in 24 diabetic patients with CLI...
May 10, 2018: Physiological Research
https://www.readbyqxmd.com/read/29748311/radiotracer-imaging-allows-for-noninvasive-detection-and-quantification-of-abnormalities-in-angiosome-foot-perfusion-in-diabetic-patients-with-critical-limb-ischemia-and-nonhealing-wounds
#7
Jessica L Alvelo, Xenophon Papademetris, Carlos Mena-Hurtado, Sangchoon Jeon, Bauer E Sumpio, Albert J Sinusas, Mitchel R Stacy
BACKGROUND: Single photon emission computed tomography (SPECT)/computed tomography (CT) imaging allows for assessment of skeletal muscle microvascular perfusion but has not been quantitatively assessed in angiosomes, or 3-dimensional vascular territories, of the foot. This study assessed and compared resting angiosome foot perfusion between healthy subjects and diabetic patients with critical limb ischemia (CLI). Additionally, the relationship between SPECT/CT imaging and the ankle-brachial index-a standard tool for evaluating peripheral artery disease-was assessed...
May 2018: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29745216/how-to-compare-results-from-open-with-endovascular-procedures
#8
Marc Bosiers, Koen Deloose, Joren Callaert, Patrick Peeters, Jeroen Wauters
BACKGROUND: According to the guidelines, bypass surgery is still the golden standard treatment in patients with femoropopliteal TASC C and D lesions and life-style limiting claudication or CLI. Over the past few decades, endovascular therapy has made great advancements. However, the success rates of surgical and endovascular procedures cannot be directly compared. According to the surgical term "patency", vessel patency can be maintained even in case of a high grade stenosis, whereas according to the endovascular primary patency definition, being binary restenosis, patency is lost from the moment there is a re-narrowing at any location within the treated segment...
May 9, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29731636/critical-limb-ischemia-current-challenges-and-future-prospects
#9
REVIEW
Luigi Uccioli, Marco Meloni, Valentina Izzo, Laura Giurato, Stefano Merolla, Roberto Gandini
Critical limb ischemia (CLI) is considered the most severe pattern of peripheral artery disease. It is defined by the presence of chronic ischemic rest pain, ulceration or gangrene attributable to the occlusion of peripheral arterial vessels. It is associated with a high risk of major amputation, cardiovascular events and death. In this review, we presented a complete overview about physiopathology, diagnosis and holistic management of CLI. Revascularization is the first-line treatment, but several challenging cases are not treatable by conventional techniques...
2018: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29713026/low-mean-platelet-volume-is-associated-with-critical-limb-ischemia-in-peripheral-arterial-occlusive-disease
#10
Peter Rief, Reinhard B Raggam, Alexander Avian, Franz Hafner, Mahdi Sareban, Martin Wehrschuetz, Marianne Brodmann, Thomas Gary
Mean platelet volume (MPV) was recently published as a possible marker of coronary artery disease in patients at high risk for major adverse cardiac events. Because platelets play an important role in atherosclerosis, we examined the relationship between critical limb ischemia (CLI) and MPV in patients with peripheral arterial occlusive disease (PAOD). Our study comprised 2124 PAOD patients. Univariate logistic regression was performed to analyze potential predictors for CLI. Nagelkerke's R² is reported. Cross validation was performed using the leave-one-out principle...
April 30, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29709112/a-five-year-study-of-the-efficacy-of-purified-cd34-cell-therapy-for-angiitis-induced-no-option-critical-limb-ischemia
#11
Yuan Fang, Zheng Wei, Bin Chen, Tianyue Pan, Shiyang Gu, Peng Liu, Daqiao Guo, Xin Xu, Junhao Jiang, Jue Yang, Zhenyu Shi, Ting Zhu, Yun Shi, Yifan Liu, Zhihui Dong, Weiguo Fu
Angiitis-induced critical limb ischemia (AICLI) patients constitute a remarkable proportion of no-option critical limb ischemia (CLI) patients. Stem cell therapy has become an innovative and promising option for no-option CLI patients. As one of these promising stem cell therapies, purified CD34+ cell transplantation (PuCeT) has shown favorable short-term results. However, the long-term efficacy of PuCeT has yet to be reported. This study evaluates the long-term efficacy of PuCeT in AICLI patients. Twenty-seven AICLI patients were enrolled from May 2009 to December 2011...
April 30, 2018: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/29703701/robust-revascularization-in-models-of-limb-ischemia-using-a-clinically-translatable-human-stem-cell-derived-endothelial-cell-product
#12
Mark G MacAskill, Jaimy Saif, Alison Condie, Maurits A Jansen, Thomas J MacGillivray, Adriana A S Tavares, Lucija Fleisinger, Helen L Spencer, Marie Besnier, Ernesto Martin, Giovanni Biglino, David E Newby, Patrick W F Hadoke, Joanne C Mountford, Costanza Emanueli, Andrew H Baker
Pluripotent stem cell-derived differentiated endothelial cells offer high potential in regenerative medicine in the cardiovascular system. With the aim of translating the use of a human stem cell-derived endothelial cell product (hESC-ECP) for treatment of critical limb ischemia (CLI) in man, we report a good manufacturing practice (GMP)-compatible protocol and detailed cell tracking and efficacy data in multiple preclinical models. The clinical-grade cell line RC11 was used to generate hESC-ECP, which was identified as mostly endothelial (60% CD31+ /CD144+ ), with the remainder of the subset expressing various pericyte/mesenchymal stem cell markers...
March 28, 2018: Molecular Therapy: the Journal of the American Society of Gene Therapy
https://www.readbyqxmd.com/read/29703251/allogeneic-transplantation-of-programmable-cells-of-monocytic-origin-pcmo-improves-angiogenesis-and-tissue-recovery-in-critical-limb-ischemia-cli-a-translational-approach
#13
Rouven Berndt, Lars Hummitzsch, Katharina Heß, Martin Albrecht, Karina Zitta, Rene Rusch, Beke Sarras, Andreas Bayer, Jochen Cremer, Fred Faendrich, Justus Groß
BACKROUND: Employing growth factor-induced partial reprogramming in vitro, peripheral human blood monocytes can acquire a state of plasticity along with expression of various markers of pluripotency. These so-called programmable cells of monocytic origin (PCMO) hold great promise in regenerative therapies. The aim of this translational study was to explore and exploit the functional properties of PCMO for allogeneic cell transplantation therapy in critical limb ischemia (CLI). METHODS: Using our previously described differentiation protocol, murine and human monocytes were differentiated into PCMO...
April 27, 2018: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/29697483/role-of-optical-coherence-tomography-in-identifying-sub-optimal-stent-positioning-and-predicting-major-adverse-cardiac-events-in-a-comparative-study-with-angiography-a-clio-opci-ii-sub-study
#14
Laura Gatto, Marco Golino, Valeria Marco, Alessio La Manna, Francesco Burzotta, Massimo Fineschi, Giovanni Ruscica, Alessandro Di Giorgio, Alberto Boi, Enrico Romagnoli, Mario Albertucci, Francesco Prati
BACKGROUND: Quantitative coronary angiography (QCA) is the gold standard for evaluating correct stenting, despite its limitation in recognizing features indicative of suboptimal deployment. This subanalysis of the CLI-OPCI II registry addressed the role of optical coherence tomography (OCT) to verify whether suboptimal OCT deployment occurs in the presence of an optimal angiographic result. PATIENTS AND METHODS: We retrospectively analyzed 125 lesions in the 105 patients with major adverse cardiac events of the CLI-OPCI II...
April 24, 2018: Coronary Artery Disease
https://www.readbyqxmd.com/read/29688737/endovascular-procedures-in-treatment-of-infrapopliteal-arterial-occlusive-disease-single-center-experience-with-69-infrapopliteal-procedures
#15
Pasternak J Janko, Budakov B Nebojsa, Petres V Andrej
BACKGROUND: Peripheral arterial occlusive disease (PAD) includes acute and chronic disorders of the blood supply as a result of obstruction of blood flow in the arteries of the limb. Treatment of PAD can be conservative, surgical and endovascular. Percutaneous transluminal angioplasty with or without stenting has become a recognized method, which is increasingly used in treatment of arterial occlusive disease. This study aimed to determine early results of endovascular treatment of critical limb ischemia (CLI) patients with infrapopliteal lesions...
March 1, 2018: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/29686880/a-rare-manifestation-of-severe-critical-limb-ischemia-caused-by-solitary-aorto-iliac-occlusive-disease
#16
Daisuke Miyawaki, Tetsuya Nomura, Yu Sakaue, Daisuke Ueno, Yusuke Hori, Kenichi Yoshioka, Hiroshi Kubota, Masakazu Kikai, Natsuya Keira, Tetsuya Tatsumi
Currently, there are more opportunities to treat patients complicated with critical limb ischemia (CLI), which is a very dismal medical condition associated with a high risk of major amputation, disability and death. Because CLI is usually caused by multi-level occlusive atherosclerotic disease, the condition of CLI induced by aorto-iliac occlusive disease (AIOD) alone is thought to be a rare pathological entity. We encountered a patient with severe CLI caused by solitary AIOD. Three vascular access routes were established and stiff guidewires retrogradely passed the occluded arteries on both sides...
April 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29683088/increase-in-skin-perfusion-pressure-predicts-amputation-free-survival-after-lower-extremity-bypass-surgery-for-critical-limb-ischemia
#17
Kota Yamamoto, Takuya Kawahara, Atsushi Akai, Toshihiko Isaji, Daisuke Akagi, Takuya Miyahara, Katsuyuki Hoshina
The objective of this study was to determine how postoperative skin perfusion pressure (SPP) as a measure of blood flow after revascularization affects limb prognosis in patients with critical limb ischemia (CLI). We retrospectively reviewed 223 consecutive bypass surgery cases performed in 192 patients with CLI during a 10-year period. SPP was measured 1-2 weeks before and after the procedure. An SPP of 40 mmHg was set as the cut-off value for revascularization. Patients were grouped according to their postoperative SPPs, and amputation-free survival (AFS) was analyzed...
April 1, 2018: Vascular Medicine
https://www.readbyqxmd.com/read/29683074/the-impact-of-decline-in-activities-of-daily-living-adl-of-patients-with-critical-limb-ischemia-cli-after-endovascular-treatment
#18
Takahiro Tokuda, Keisuke Hirano, Masahiro Yamawaki, Motoharu Araki, Norihiro Kobayashi, Yasunari Sakamoto, Shisuke Mori, Masakazu Tsutsumi, Yosuke Honda, Yoshiaki Ito
BACKGROUND: Certain patients with critical limb ischemia (CLI) experience significant decline in activities of daily living (ADL) during hospitalization. The prognosis of decline in ADL during hospitalization remains unknown. METHODS: A retrospective analysis was performed on collected data of patients with CLI treated by endovascular treatment between April 2007 and December 2015. We evaluated CLI in patients ADL at the time of hospitalization and after discharge using the Barthel index...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29682105/when-are-endovascular-and-open-bypass-treatments-preferred-for-femoropopliteal-occlusive-disease
#19
REVIEW
Ali F AbuRahma
Several meta-analyses and multicenter trials have shown that chronic limb ischemia did not occur for up to 5 years in 50%-70% of patients who underwent saphenous vein grafts, with limb salvage and perioperative mortality rates of >80% and 3%, respectively. However, open surgical bypass can have limitations, including postoperative morbidity/wound complications of 10%-20% and prolonged length of hospital stay and outpatient care. Several studies have analyzed clinical outcomes for patients with critical limb ischemia treated with endovascular therapies, but they have been mainly retrospective with significant heterogeneity or were single center...
March 25, 2018: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29679687/a-novel-technique-indocyanine-green-angiography-to-prognosticate-healing-of-foot-ulcer-in-critical-limb-ischemia
#20
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
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