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Acute limb ischemia

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https://www.readbyqxmd.com/read/28920529/surgical-interventions-for-organ-and-limb-ischemia-associated-with-primary-and-secondary-antiphospholipid-antibody-syndrome-with-arterial-involvement
#1
Carlos A Hinojosa, Javier E Anaya-Ayala, Karla Bermudez-Serrato, Ramón García-Alva, Hugo Laparra-Escareno, Adriana Torres-Machorro, Rene Lizola
OBJECTIVE: The association of antiphospholipid antibody syndrome (APS) and hypercoagulability is well known. Arterial compromise leading to ischemia of organs and/or limbs in patients with APS is uncommon, frequently unrecognized, and rarely described. We evaluated our institutional experience. METHODS: Retrospective review was conducted. From August 2007 to September 2016, 807 patients with diagnosis of APS were managed in our Institution. Patients with primary and secondary APS who required interventions were examined...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28902715/protecting-the-heart-from-ischemia-reperfusion-injury-an-update-on-remote-ischemic-preconditioning-and-postconditioning
#2
Martín Donato, Pablo Evelson, Ricardo J Gelpi
PURPOSE OF REVIEW: The most effective strategy for reducing acute myocardial ischemic injury is timely and effective reperfusion. However, myocardial reperfusion can induce further cardiomyocyte death (reperfusion injury). Interventions that protect the heart from ischemia/reperfusion injury, reducing infarct size, can involve remote ischemic preconditioning and postconditioning. These interventions have a promising potential clinical application, and have been the focus of recent research...
September 11, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28900672/extracorporeal-membrane-oxygenation-in-adult-patients-with-acute-fulminant-myocarditis-clinical-outcomes-and-risk-factor-analysis
#3
X Liao, B Li, Z Cheng
BACKGROUND: Our study aimed to summarize the clinical outcomes of extracorporeal membrane oxygenation (ECMO) in adult patients with acute fulminant myocarditis and to investigate the risk factors associated with its application. PATIENTS AND METHODS: We retrospectively examined patients with cardiogenic shock and acute fulminant myocarditis. The following data were collected: patients' preoperative general condition, related clinical factors during ECMO, complications, and outcomes of ECMO...
September 12, 2017: Herz
https://www.readbyqxmd.com/read/28887250/analysis-of-patients-undergoing-major-lower-extremity-amputation-in-the-vascular-quality-initiative
#4
Joshua Gabel, Brice Jabo, Sheela Patel, Sharon Kiang, Christian Bianchi, Jason Chiriano, Theodore Teruya, Ahmed M Abou-Zamzam
BACKGROUND: Despite an aggressive climate of limb salvage and revascularization, 7% of patients with peripheral artery disease undergo major lower extremity amputation (LEA). The purpose of this study was to describe the current demographics and early outcomes of patients undergoing major LEA in the Vascular Quality Initiative (VQI). METHODS: The VQI amputation registry was reviewed to identify patients who underwent major LEAs. Patient factors, limb characteristics, procedure type, and intraoperative variables were analyzed by level of amputation...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28878922/visualization-of-poikilothermia-using-handheld-thermography
#5
Yohei Okada, Hiromichi Narumiya
Poikilothermia is a fundamental symptom of acute limb ischemia (ALI) and is known as "6Ps". Herein, we present the visualization of poikilothermia caused by ALI using handheld thermography. We believe that handheld thermography could be useful to assess poikilothermia objectively as a supplementary method to physical examination.
September 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28878099/distal-cuff-occlusion-a-novel-simple-approach-for-distal-embolic-protection-in-peripheral-vascular-intervention
#6
Shwan Jalal, Jihad A Mustapha, Howard S Rosman, Rajendra H Mehta, Thomas P Davis
AIM: To evaluate the feasibility, effectiveness, and safety of the cuff-occlusion method for distal embolic protection in peripheral artery disease. METHODS AND RESULTS: We evaluated 61 patients who underwent peripheral vascular intervention (PVI) for infrainguinal lesion at a single center where a blood pressure cuff occlusion method for distal embolic protection was utilized during the procedure. Primary endpoint included incidence of distal embolization, acute limb ischemia, or emergency limb amputation...
September 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28872035/prevalence-and-severity-of-peripheral-arterial-disease-among-patient-with-heel-pressure-ulcer-a-retrospective-study-of-42-patients
#7
Guillaume Tisserand, Nora Zenati, Christophe Seinturier, Sophie Blaise, Gilles Pernod
Heel pressure ulcer is a major complication in elderly hospitalized patients. The association with peripheral arterial disease (PAD) which is also a frequent disease in this population is poorly known. The aim of this study was to assess the prevalence of PAD and critical limb ischemia (CLI) in patients with heel pressure ulcer. Patients referred to the vascular medicine department for heel pressure ulcer from October 2014 to June 2015 were included in the study. The assessment of peripheral arterial disease was made with the results of ankle brachial index and/or doppler ultra sound of lower limb arteries...
September 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28871521/astragaloside-iv-prevents-acute-kidney-injury-and-inflammation-by-normalizing-muscular-mitochondrial-function-associated-with-a-nitric-oxide-protective-mechanism-in-crush-syndrome-rats
#8
Isamu Murata, Yuji Abe, Yuka Yaginuma, Kayako Yodo, Yuka Kamakari, Yurika Miyazaki, Daichi Baba, Yuko Shinoda, Toru Iwasaki, Kunihiko Takahashi, Jun Kobayashi, Yutaka Inoue, Ikuo Kanamoto
BACKGROUND: Crush syndrome (CS) is a serious medical condition characterized by muscle cell damage resulting from decompression after compression (i.e., ischemia/reperfusion injury). A large number of CS patients develop cardiac failure, kidney dysfunction, and systemic inflammation, even when fluid therapy is administered. We evaluated whether the administration of astragaloside-IV (AS)-containing fluid improved survival by preventing kidney and muscular mitochondrial dysfunction in a rat model of CS...
September 4, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28870876/prevalence-and-impact-of-critical-limb-ischemia-on-in-hospital-outcome-in-transcatheter-aortic-valve-implantation-in-germany
#9
Nasser M Malyar, Klaus Kaier, Eva Freisinger, Florian Lüders, Gerrit Kaleschke, Helmut Baumgartner, Lutz Frankenstein, Holger Reinecke, Jochen Reinöhl
AIMS: Peripheral artery disease (PAD) is common in patients with aortic valve stenosis (AS). We assessed the prevalence of critical limb ischemia (CLI) and its impact on in-hospital outcome in patients undergoing transcatheter aortic valve implantation (TAVI) for severe AS. METHODS AND RESULTS: All isolated TAVI in Germany between 2007 and 2013 for AS were analysed regarding stage specific prevalence of PAD, comorbidities, in-hospital complications and mortality using diagnostic and procedural codes...
September 5, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28868311/occlusive-shrinkage-of-ovation-endograft-presenting-as-acute-lower-limb-ischemia-effective-endovascular-management
#10
Paolo Bianchi, Filippo Scalise, Andrea Mortara, Guido Lanzillo, Giuseppe Scardina, Santi Trimarchi, Gianfranco Parati, Valerio Tolva
The aim of this report is to describe the imaging and successful treatment of an acute shrinkage of the Ovation Abdominal Stent Graft System. The Ovation Prime system utilizes a polymer-filled sealing ring that is cast in situ at the margin of the aneurysm; however, the residual endograft inner volume after ring filling may reduce volume and graft flow. Nevertheless, there are no reports about severe complications using the Ovation Prime system. A 75-year-old male presented to our hospital for acute lower limb ischemia...
February 2017: Aorta (Stamford, Conn.)
https://www.readbyqxmd.com/read/28867642/phonomyography-as-a-non-invasive-continuous-monitoring-technique-for-muscle-ischemia-in-an-experimental-model-of-acute-compartment-syndrome
#11
Adriana P Martinez, Thomas P Moser, Neil Saran, Marilène Paquet, Thomas Hemmerling, Greg K Berry
BACKGROUND: In acute compartment syndrome (ACS), clinicians have difficulty diagnosing muscle ischemia provoked by increased intra-compartmental pressure in a timely and non-invasive manner. Phonomyography records the acoustic signal produced by muscle contraction. We hypothesize that alterations in muscle contraction caused by muscle ischemia can be detected with phonomyography, serving as a potential non-invasive technique in the detection of ACS. METHODS: The left hind limb of 15 Sprague-Dawley rats was submitted to a reversible ischemic model of limb injury for 30min and 1, 2, 4, 6h (3 rats in each group)...
August 26, 2017: Injury
https://www.readbyqxmd.com/read/28831705/predictors-of-first-ischemic-lower-limb-ulcer-in-dialysis-patients-an-observational-cohort-study
#12
Simeone Andrulli, Chiara Chiavenna, Maria Carla Bigi, Monica Crepaldi, Cesare Dell'Oro, Flavia Tentori, Celestina Manzoni, Giuseppe Bacchini, Mauro Maria Corti, Giuseppe Pontoriero
BACKGROUND: Lower limb ischemia affects the quality of life, physical activity and life expectancy of dialysis patients. The aim of this study was to investigate the risk factors associated with ischemic foot ulcers considering clinical, laboratory and therapeutic domains. METHODS: This observational cohort study was based on data from the Nephrology and Dialysis Department database of Alessandro Manzoni Hospital, Lecco (Italy). All of the incident patients who started dialysis between 1 January 1999 and 29 February 2012 were enrolled, excluding temporary guests, patients with acute renal failure and patients with previous limb ischemia or amputation...
August 22, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28819822/endovascular-aneurysm-repair-with-balloon-thrombectomy-for-acute-thrombosis-of-abdominal-aortic-aneurysm
#13
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/28811546/serum-derived-extracellular-vesicles-evs-impact-on-vascular-remodeling-and-prevent-muscle-damage-in-acute-hind-limb-ischemia
#14
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
#15
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
#16
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/28806175/point-of-care-ultrasound-facilitated-detection-of-femoral-occlusive-septic-emboli-during-mitral-valve-surgery-a-case-report
#17
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/28798201/remote-ischemic-preconditioning-does-not-prevent-acute-mountain-sickness-after-rapid-ascent-to-3450-m
#18
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/28781880/acute-aortic-occlusion-due-to-tumor-embolism-in-a-patient-with-lung-malignancy
#19
Stella Lioudaki, Nikolaos Kontopodis, Stefanos Palioudakis, Anastasios V Koutsopoulos, Ioannis Drositis, Christos V Ioannou
OBJECTIVES: Acute lower limb ischemia caused by tumor embolization is rare, despite the fact that cancer is a common cause of hypercoagulability predisposing to venous thrombosis. Arterial embolization is mostly associated with intracardiac tumors while lung malignancies are the second most common cause of tumor embolism. METHODS: In this report, we present a male patient who developed acute bilateral lower limb ischemia in the immediate postoperative period after a thoracotomy for attempted left upper lobe resection for lung cancer...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28764607/recycling-and-reinforcing-intimomedial-flap-of-the-infrarenal-aorta-using-anterior-longitudinal-ligament-in-patients-with-acute-trauma-with-bowel-injuries
#20
Milan Jovanovic, Milan Radojkovic, Predrag Djordjevic, Dejan Rancic, Nemanja Jovanovic, Zoran Rancic
We present a patient with blunt abdominal trauma with severe acute right limb ischemia and clinical signs of diffuse peritonitis. Computed tomography angiography showed circumferential dissection of the infrarenal aorta with occlusion of the right common iliac artery. We opted for simultaneous abdomen exploration and open repair of injured aorta. Critical weakening of the aortic wall with imminent rupture was identified intraoperatively. Aortotomy cranially from bifurcation showed circumferential intimomedial dissection...
January 1, 2017: Vascular and Endovascular Surgery
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