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https://www.readbyqxmd.com/read/28421855/midterm-outcomes-after-infrapopliteal-interventions-in-patients-with-critical-limb-ischemia-based-on-the-tasc-ii-classification-of-below-the-knee-arteries
#1
Gagan D Singh, Ellen K Brinza, Justin Hildebrand, Stephen W Waldo, T Raymond Foley, John R Laird, Ehrin J Armstrong
PURPOSE: To analyze the relationship between the new TransAtlantic Inter-Society Consensus (TASC II) infrapopliteal classification and limb outcomes among patients with critical limb ischemia (CLI). METHODS: A single-center retrospective study was performed on 166 consecutive CLI patients (mean age 71 years; 113 men) undergoing endovascular treatment of 244 infrapopliteal lesions from 2006 to 2013. Patient, procedural, angiographic, and limb outcomes were compared for the new TASC A/B vs C/D classification for infrapopliteal lesions...
April 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28419788/the-italian-stallions-of-cli-value-care-delivery
#2
EDITORIAL
Gary M Ansel, Michael R Jaff
Critical Limb ischemia with long segment occlusive disease typically reserved for surgery can be treated with a high degree of success in expert centers via an endovascular approach Nitinol woven stents appear to have high patency with proper deployment in all PAD groups Increased early expense that is associated with decreased re-intervention can be cost effective.
April 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28408154/outcomes-for-critical-limb-ischemia-are-driven-by-lower-extremity-revascularization-volume-not-distance-to-hospital
#3
Ankit N Medhekar, Doran S Mix, Christopher T Aquina, Lauren E Trakimas, Katia Noyes, Fergal J Fleming, Roan J Glocker, Michael C Stoner
OBJECTIVE: The objective of this study was to identify relationships among geographic access to care, vascular procedure volume, limb preservation, and survival in patients diagnosed with critical limb ischemia (CLI). METHODS: Using New York State administrative data from 2000 to 2013, we identified a patient's first presentation with CLI defined by International Classification of Diseases, Ninth Revision diagnosis and procedure codes. Distance from the patient's home to the index hospital was calculated using the centroids of the respective ZIP codes...
April 10, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28390770/rationale-and-design-of-the-marrowstim-pad-kit-for-the-treatment-of-critical-limb-ischemia-in-subjects-with-severe-peripheral-arterial-disease-mobile-trial-investigating-autologous-bone-marrow-cell-therapy-for-critical-limb%C3%A2-ischemia
#4
S Keisin Wang, Linden A Green, Raghu L Motaganahalli, Michael G Wilson, Andres Fajardo, Michael P Murphy
OBJECTIVE: Critical limb ischemia (CLI) continues to place a significant encumbrance on patients and the health care system as it progresses to limb loss and long-term disability. Traditional methods of revascularization offer a significant benefit; however, for one-third of CLI patients, these surgical options are not technically possible or patency is severely limited by disease burden (deemed "poor-option" for revascularization). In a previous phase I trial, we demonstrated intramuscular injection of concentrated bone marrow aspirate (cBMA) via MarrowStim (Zimmer Biomet, Warsaw, Ind) harvest is safe and may decrease major amputation in patients with CLI unfit for surgical revascularization...
April 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28384111/demographic-and-comorbidity-pattern-of-patients-with-critical-limb-ischemia
#5
Răzvan A Ciocan, Sorana D Bolboacă, Şerban Rădulescu, Bogdan Stancu, Andra Ciocan, Claudia D Gherman
AIM: The present study aimed at identifying the pattern of patients with critical limb ischemia (CLI) compared with those with peripheral arterial occlusive disease (PAOD). MATERIALS AND METHODS: A four-year retrospective study was conducted with patients hospitalized in the Second Surgical Clinic at the Emergency County Hospital Cluj-Napoca. The medical charts of patients with PAOD (n=466) and CLI (n=223) were reviewed and data were collected. RESULTS: The study included 689 patients; mean age 67 years for PAOD patients and 65 years for CLI patients...
March 1, 2017: Folia Medica
https://www.readbyqxmd.com/read/28378609/antegrade-vs-crossover-femoral-artery-access-in-the-endovascular-treatment-of-isolated-below-the-knee-lesions-in-patients-with-critical-limb-ischemia
#6
Yukun Li, Ali Esmail, Konstantinos P Donas, Georgios Pitoulias, Giovanni Torsello, Theodosios Bisdas, Stefano Michelagnoli, Nicola Troisi
PURPOSE: To evaluate the safety and effectiveness of antegrade vs crossover femoral artery access in the endovascular treatment of isolated below-the-knee (BTK) lesions in patients with critical limb ischemia (CLI). METHODS: Between January 2014 and December 2015, 224 high-risk patients (mean age 75.8±9.8 years; 151 men) with CLI underwent infragenicular interventions on 292 crural vessels in 3 European vascular centers. All patients had isolated TransAtlantic Inter-Society Consensus (TASC) C (n=26) or D (n=198) BTK lesions...
April 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28376797/impact-of-diabetes-on-outcome-in-critical-limb-ischemia-with-tissue-loss-a-large-scaled-routine-data-analysis
#7
Eva Freisinger, Nasser M Malyar, Holger Reinecke, Holger Lawall
BACKGROUND: Patients with diabetes concomitant to critical limb ischemia (CLI) represent a sub-group at particular risk. Objective of this analysis is to evaluate the actual impact of diabetes on treatment, outcome, and costs in a real-world scenario in Germany. METHODS: We obtained routine-data on 15,332 patients with CLI with tissue loss from the largest German health insurance, BARMER GEK from 2009 to 2011, including a follow-up until 2013. Patient data were analyzed regarding co-diagnosis with diabetes with respect to risk profiles, treatment strategy, in-hospital and long-term outcome including costs...
April 4, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28368090/bypass-surgery-for-chronic-lower-limb-ischaemia
#8
REVIEW
George A Antoniou, George S Georgiadis, Stavros A Antoniou, Ragai R Makar, Jonathan D Smout, Francesco Torella
BACKGROUND: Bypass surgery is one of the mainstay treatments for patients with critical lower limb ischaemia (CLI). This is the second update of the review first published in 2000. OBJECTIVES: To assess the effects of bypass surgery in patients with chronic lower limb ischaemia. SEARCH METHODS: For this update, the Cochrane Vascular Group searched its trials register (last searched October 2016) and the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library (last searched Issue 9, 2016)...
April 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28365482/distributed-vasculogenesis-from-modular-agarose-hydroxyapatite-fibrinogen-microbeads
#9
Ana Y Rioja, Ethan L H Daley, Julia C Habif, Andrew J Putnam, Jan P Stegemann
Critical limb ischemia impairs circulation to the extremities, causing pain, disrupted wound healing, and potential tissue necrosis. Therapeutic angiogenesis seeks to repair the damaged microvasculature directly to restore blood flow. In this study, we developed modular, micro-scale constructs designed to possess robust handling qualities, allow in vitro pre-culture, and promote microvasculature formation. The microbead matrix consisted of an agarose (AG) base to prevent aggregation, combined with cell-adhesive components of fibrinogen (FGN) and/or hydroxyapatite (HA)...
March 29, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28357515/clinical-features-and-predictors-of-patients-with-critical-limb-ischemia-who-responded-to-autologous-mononuclear-cell-transplantation-for-therapeutic-angiogenesis
#10
Naoyoshi Aoyama, Makoto Nishinari, Shinichi Ohtani, Akifumi Kanai, Chiharu Noda, Mitsuhiro Hirata, Akira Miyamoto, Masafumi Watanabe, Tohru Minamino, Tohru Izumi, Jyunya Ako
The clinical features of patients with critical limb ischemia (CLI) who responded to angiogenesis using autologous peripheral blood mononuclear cell transplantation (PB-MNC) have not yet been fully characterized, and there are no useful predictors to judge the curative effect in the early period after PB-MNC. This study sought to clarify the clinical features and predictors in patients with CLI who were successfully treated using PB-MNC. 30 consecutive patients [arteriosclerosis obliterans: 24 patients, thromboangiitis obliterans: 6 patients] who were diagnosed with major amputation despite maximal medical therapy were enrolled in this study...
March 29, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28353328/the-frontline-in-the-battle-to-eliminate-major-amputation-from-the-landscape-of-treatment-for-cli
#11
Ramon L Varcoe
No abstract text is available yet for this article.
June 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28351310/one-year-outcomes-of-the-paclitaxel-eluting-self-expanding-stentys-stent-system-in-the-treatment-of-infrapopliteal-lesions-in-patients-with-critical-limb-ischemias
#12
Marc Bosiers, Joren Callaert, Koen Keirse, Jeroen M H Hendriks, Patrick Peeters, Jürgen Verbist, Lieven Maene, Roel Beelen, Koen Deloose
PURPOSE: To investigate the efficacy of the paclitaxel-coated, self-expanding, nitinol Stentys Stent System in tibioperoneal lesions ≤50 mm long. METHODS: The prospective, single-arm, multicenter PES-BTK-70 trial ( ClinicalTrials.gov identifier NCT01630070) evaluated the safety and efficacy of the coronary Stentys Stent System in the treatment of a stenotic or occlusive lesion ≤50 mm long in the tibioperoneal arteries of patients with critical limb ischemia (CLI)...
March 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28344615/usefulness-of-the-platelet-to-lymphocyte-ratio-in-predicting-long-term-cardiovascular-mortality-in-patients-with-peripheral-arterial-occlusive-disease
#13
Fatih Uzun, Mehmet Erturk, Huseyin Altug Cakmak, Ali Kemal Kalkan, Ibrahim Faruk Akturk, Ahmet Arif Yalcin, Begum Uygur, Umit Bulut, Kursat Oz
INTRODUCTION: Inflammation and increased platelet activation play a crucial role in the initiation and progression of atherosclerosis. Platelet-to-lymphocyte ratio (PLR) has recently been reported as a new independent predictor for major adverse cardiovascular events in cardiovascular diseases. AIM: To investigate the relation between PLR and cardiovascular mortality in patients with intermittent claudication or critical limb ischemia (CLI) or both. MATERIAL AND METHODS: In our retrospective study, 602 consecutive patients who were admitted to a large tertiary hospital with the diagnosis of symptomatic peripheral arterial occlusive disease (PAOD) were included...
2017: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/28342514/angiosome-directed-revascularization-in-patients-with-critical-limb-ischemia
#14
REVIEW
Hidde Jongsma, Joost A Bekken, George P Akkersdijk, Sanne E Hoeks, Hence J Verhagen, Bram Fioole
OBJECTIVE: Direct revascularization (DR), according to the angiosome concept, provides direct blood flow to the site of tissue loss in patients with critical limb ischemia (CLI). DR may lead to improved outcomes; however, evidence for this is controversial. This systematic review and meta-analysis investigated the outcomes of surgical and endovascular DR compared with indirect revascularization (IR) in patients with CLI. METHODS: A systematic review was undertaken using the Cochrane Collaboration specified tool, and a meta-analysis was done according to the MOOSE (Meta-analysis of Observational Studies in Epidemiology) criteria...
April 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28297569/administration-of-adult-human-bone-marrow-derived-cultured-pooled-allogeneic-mesenchymal-stromal-cells-in-critical-limb-ischemia-due-to-buerger-s-disease-phase-ii-study-report-suggests-clinical-efficacy
#15
Pawan K Gupta, Murali Krishna, Anoop Chullikana, Sanjay Desai, Rajkumar Murugesan, Santanu Dutta, Uday Sarkar, Radhakrishnan Raju, Anita Dhar, Rajiv Parakh, Lakshmanan Jeyaseelan, Pachaiyappan Viswanathan, Prasanth Kulapurathu Vellotare, Raviraja N Seetharam, Charan Thej, Mathiyazhagan Rengasamy, Sudha Balasubramanian, Anish S Majumdar
Critical limb ischemia (CLI) due to Buerger's disease is a major unmet medical need with a high incidence of morbidity. This phase II, prospective, nonrandomized, open-label, multicentric, dose-ranging study was conducted to assess the efficacy and safety of i.m. injection of adult human bone marrow-derived, cultured, pooled, allogeneic mesenchymal stromal cells (BMMSC) in CLI due to Buerger's disease. Patients were allocated to three groups: 1 and 2 million cells/kg body weight (36 patients each) and standard of care (SOC) (18 patients)...
March 2017: Stem Cells Translational Medicine
https://www.readbyqxmd.com/read/28295990/role-of-residual-acute-stent-malapposition-in-percutaneous-coronary-interventions
#16
Enrico Romagnoli, Laura Gatto, Alessio La Manna, Francesco Burzotta, Nevio Taglieri, Francesco Saia, Francesco Amico, Valeria Marco, Vito Ramazzotti, Alessandro Di Giorgio, Luca Di Vito, Alberto Boi, Marco Contarini, Fausto Castriota, Gary S Mintz, Francesco Prati
OBJECTIVES: Assess clinical consequences of acute stent malapposition (ASM) in the context of the multicenter Centro per la Lotta Contro l'Infarto-Optimization of Percutaneous Coronary Intervention (CLI-OPCI) registry. BACKGROUND: ASM as important determinant of stent thrombosis (ST) risk remains controversial. METHODS: From 2009 to 2013, we retrospectively analyzed postprocedural optical coherence tomography (OCT) findings in 864 patients undergoing percutaneous coronary intervention, assessing prevalence and magnitude of ASM and exploring correlation with outcome, especially ST...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28295971/mid-term-outcomes-of-orbital-atherectomy-combined-with-drug-coated-balloon-angioplasty-for-treatment-of-femoropopliteal-disease
#17
T Raymond Foley, Ryan P Cotter, Damianos G Kokkinidis, Daniel D Nguyen, Stephen W Waldo, Ehrin J Armstrong
PURPOSE: To assess the intraprocedural and mid-term outcomes of orbital atherectomy (OA) combined with drug-coated balloon (DCB) angioplasty for the treatment of calcified femoropopliteal disease. METHODS: In this single-center cohort, 89 patients (139 lesions) were treated with DCB angioplasty for claudication or critical limb ischemia (CLI). Angiographic characteristics and procedural outcomes were reviewed for patients treated with or without adjunctive OA. Lesion calcification was graded using two previously published scoring systems, the angiographic calcium score (ACS) and the peripheral artery calcification scoring system (PACSS)...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28292886/optical-probing-of-gastrocnemius-in-patients-with-peripheral-artery-disease-characterizes-myopathic-biochemical-alterations-and-correlates-with-stage-of-disease
#18
Ryan A Becker, Kim Cluff, Nithyanandhi Duraisamy, Hootan Mehraein, Hussam Farhoud, Tracie Collins, George P Casale, Iraklis I Pipinos, Jeyamkondan Subbiah
Peripheral artery disease (PAD) is a condition caused by atherosclerotic blockages in the arteries supplying the lower limbs and is characterized by ischemia of the leg, progressive myopathy, and increased risk of limb loss. The affected leg muscles undergo significant changes of their biochemistry and metabolism including variations in the levels of many key proteins, lipids, and nucleotides. The mechanisms behind these changes are poorly understood. The objective of this study was to correlate the severity of the PAD disease stage and associated hemodynamic limitation (determined by the ankle brachial index, ABI) in the legs of the patients with alterations in the biochemistry of chronically ischemic leg muscle as determined by ATR-Fourier transform infrared micro-spectroscopy...
March 2017: Physiological Reports
https://www.readbyqxmd.com/read/28289069/omega-3-polyunsaturated-fatty-acid-fish-oil-supplementation-and-the-prevention-of-clinical-cardiovascular-disease-a-science-advisory-from-the-american-heart-association
#19
REVIEW
David S Siscovick, Thomas A Barringer, Amanda M Fretts, Jason H Y Wu, Alice H Lichtenstein, Rebecca B Costello, Penny M Kris-Etherton, Terry A Jacobson, Mary B Engler, Heather M Alger, Lawrence J Appel, Dariush Mozaffarian
Multiple randomized controlled trials (RCTs) have assessed the effects of supplementation with eicosapentaenoic acid plus docosahexaenoic acid (omega-3 polyunsaturated fatty acids, commonly called fish oils) on the occurrence of clinical cardiovascular diseases. Although the effects of supplementation for the primary prevention of clinical cardiovascular events in the general population have not been examined, RCTs have assessed the role of supplementation in secondary prevention among patients with diabetes mellitus and prediabetes, patients at high risk of cardiovascular disease, and those with prevalent coronary heart disease...
April 11, 2017: Circulation
https://www.readbyqxmd.com/read/28288436/cell-therapy-of-critical-limb-ischemia-in-diabetic-patients-state-of-art
#20
REVIEW
Michal Dubský, Alexandra Jirkovská, Robert Bem, Andrea Nemcová, Vladimira Fejfarová, Edward B Jude
In this review we report on the state of cell therapy of critical limb ischemia (CLI) with respect to differences between diabetic and non-diabetic patients mainly from the clinical point of view. CLI is the most severe form of peripheral arterial disease and its diagnosis and treatment in diabetic patients is very difficult. The therapeutic effect of standard methods of CLI treatment is only partial - more than one third of diabetic patients are not eligible for standard revascularization; therefore, new therapeutic techniques such as cell therapy have been studied in clinical trials...
February 27, 2017: Diabetes Research and Clinical Practice
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