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Acute limb ischemia

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https://www.readbyqxmd.com/read/28508973/phlegmasia-cerulean-dolens-complication-of-femoral-vein-catheterization
#1
M Hari Krishna Reddy, B Sangeetha, M Aruna, V Sarat Chandra, Anil C Venkata Kumar, R Ram, V Sivakumar
There are three less frequent manifestations of acute massive venous thrombosis and obstruction of the venous drainage of an extremity. They are phlegmasia alba dolens, phlegmasia cerulean dolens (PCD), and venous gangrene. The term PCD differentiates ischemia-associated massive venous thrombosis from phlegmasia alba dolens, which describes fulminant venous thrombosis without ischemia. We present a 55-year-old hypertensive, who presented with paedal oedema and breathlessness at rest. About a month prior to this admission, she suffered dislocation of left patella...
November 2016: CEN Case Reports
https://www.readbyqxmd.com/read/28487393/potent-thrombolytic-effect-of-n-acetylcysteine-on-arterial-thrombi
#2
Sara Martinez de Lizarrondo, Clément Gakuba, Bradley A Herbig, Yohann Repessé, Carine Ali, Cécile V Denis, Peter Lenting, Emmanuel Touzé, Scott L Diamond, Denis Vivien, Maxime Gauberti
Background -Platelet crosslinking during arterial thrombosis involves von Willebrand Factor (VWF) multimers. Therefore, proteolysis of VWF appears promising to disaggregate platelet-rich thrombi and restore vessel patency in acute thrombotic disorders such as ischemic stroke, acute coronary syndrome or acute limb ischemia. N-Acetylcysteine (NAC, a clinically approved mucolytic drug) can reduce intrachain disulfide bonds in large polymeric proteins. In the present study, we postulated that NAC might cleave the VWF multimers inside occlusive thrombi, thereby leading to their dissolution and arterial recanalization...
May 9, 2017: Circulation
https://www.readbyqxmd.com/read/28483627/endovascular-treatment-with-primary-stenting-of-acutely-thrombosed-popliteal-artery-aneurysms
#3
Aaron Fargion, Fabrizio Masciello, Giovanni Pratesi, Elena Giacomelli, Walter Dorigo, Carlo Pratesi
PURPOSE: Only anecdotal cases concerning primary stenting of thrombosed popliteal artery aneurysm (PAA) without a preoperative intra-arterial thrombolysis are reported. We report our series of six patients treated with this technique. CASE REPORT: Six male patients, aged between 63 and 88, came to our attention in the last 10 years for acute limb ischemia due to thrombosis of a PAA. In all the cases immediate digital subtraction angiography (DSA) was performed, the occlusion was crossed with an angiographic guidewire and, once an adequate distal landing zone was identified in the distal popliteal artery, a primary stenting was performed...
May 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28483615/severe-mesenteric-ischemia-in-a-pregnant-woman-with-antiphospholipid-syndrome
#4
Andrea Padricelli, Anna Maria Giribono, Doriana Ferrara, Flavia Spalla, Umberto Bracale, Luca Del Guercio, Giuseppe Servillo, Carlo Ruotolo, Umberto Marcello Bracale
The antiphospholipid syndrome (APS), either primary or secondary form, is considered an autoimmune disease with presence of at least one clinical and one laboratory abnormalities as defined by The Sydney criteria. Clinical criteria include vascular thrombosis of venous, artery, small vessel in any organ and recurrent pregnancy pathologies. Mesenteric ischemia is a rare and threatening manifestation of APS. We herein report a case of 34-years old pregnant woman referred to our Emergency Room with thoracic and abdominal acute pain...
May 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28479471/an-original-article-impact-of-ambient-temperature-on-incidence-of-acute-lower-limb-ischemia
#5
Y Law, Y C Chan, S W Cheng
BACKGROUND: This was a retrospective study to explore the possible association between atmospheric temperatures with the occurrence of acute leg ischemia (ALI). METHODS: A linear regression analysis was performed for a period of ten years on the impact of ambient temperature on the incidence of ALI. Mean ambient temperature on a daily basis was retrieved electronically from our Observatory, and the daily incidence of ALI was retrieved from the CDAR (Clinical Data Analysis and Reporting) System...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28479446/laser-atherectomy-for-the-treatment-of-peripheral-arterial-disease
#6
Alexandros Mallios, John Blebea, Bryan Buster, Ryan Messiner, Kevin Taubman, Harry Ma
OBJECTIVE: To investigate the clinical results of laser atherectomy in the treatment of peripheral arterial disease. METHODS: Retrospective analysis of consecutive patients undergoing laser atherectomy at a single institution during a seven year period by vascular surgeons and interventional cardiologists in a tertiary university-affiliated hospital. Clinical data was retrieved from patient charts and hospital electronic medical records along with the associated arteriograms...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28479431/transient-acute-leg-ischemia-in-a-professional-athlete-caused-by-isolated-popliteal-artery-dissection-mimicking-popliteal-entrapment-syndrome
#7
Milos Sladojevic, Marko Dragas, Igor Končar, Oliver Radmili, Miroslav Markovic, Lazar Davidovic
INTRODUCTION: Exertional leg pain includes a broad range of conditions induced by different vascular, musculoskeletal and neurological disorders. We report a case with isolated popliteal artery dissection as a cause of a transient acute lower limb ischemia. CASE REPORT: We report a patient with popliteal artery dissection which occurred during squatting exercise. After initial signs of transient acute limb ischemia, physical and ultrasound examination pointed to entrampement syndrome as a likely cause...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28473087/acr-appropriateness-criteria-%C3%A2-sudden-onset%C3%A2-of%C3%A2-cold-painful-leg
#8
Clifford R Weiss, Ezana M Azene, Bill S Majdalany, Ali F AbuRahma, Jeremy D Collins, Christopher J Francois, Marie D Gerhard-Herman, Heather L Gornik, John M Moriarty, Patrick T Norton, Thomas Ptak, Stephen P Reis, Frank J Rybicki, Sanjeeva P Kalva
Acute limb ischemia (ALI) requires urgent diagnosis and treatment to prevent limb loss. Invasive digital subtraction arteriography (DSA) is the gold standard for diagnosing ALI. DSA is the only diagnostic modality that permits simultaneous treatment of acute arterial occlusion. Noninvasive imaging with MRA or CT angiography may also be appropriate before treatment, especially when the diagnosis of ALI is in doubt or where DSA is unavailable. Other imaging and noninvasive physiologic tests may prove important for longer term management but are less recommended in the acute setting...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28470393/aortic-aneurysm-rupture-after-urokinase-treatment-for-acute-limb-ischemia-in-two-patients-after-evar
#9
Davy R Sudiono, Rigo Hoencamp, Jaap Ottevanger, Daniel Eefting, Edwin van der Linden
Endovascular aneurysm repair (EVAR) is first-choice treatment for many patients with abdominal aortic aneurysms. Complications unique to endovascular treatment include endoleak and endotension, which can eventually lead to rupture. We present two cases of late aortic rupture after EVAR, where both patients had recent preceding catheter-directed thrombolysis with urokinase for acute limb ischemia. These cases suggest a relation between thrombolytic therapy and aortic rupture after EVAR, and we should therefore be aware of this possible complication...
May 3, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28465288/thirty-day-readmissions-after-endovascular-or-surgical-therapy-for-critical-limb-ischemia-analysis-of-the-2013-2014-nationwide-readmissions-databases
#10
Dhaval Kolte, Kevin F Kennedy, Mehdi H Shishehbor, J Dawn Abbott, Sahil Khera, Peter A Soukas, Shafiq T Mamdani, Omar N Hyder, Douglas E Drachman, Herbert D Aronow
Background -Thirty-day readmission rates have gained increasing importance as a key quality metric. A significant number of patients are hospitalized for the management of critical limb ischemia (CLI), but limited data are available on the incidence, predictors, and causes of 30-day readmission after hospitalization for CLI. Methods -Hospitalizations for a primary diagnosis of CLI during which patients underwent endovascular or surgical therapy (revascularization and/or amputation) and were discharged alive were identified in the 2013-2014 Nationwide Readmissions Databases...
May 2, 2017: Circulation
https://www.readbyqxmd.com/read/28461183/endovascular-solution-of-acute-limb-ischemia-engendered-by-persistent-sciatic-artery-pseudoaneurysm-due-to-stent-fracture
#11
Alessandro d'Adamo, Pasqualino Sirignano, Fabrizio Fanelli, Wassim Mansour, Nunzio Montelione, Carlo Cirelli, Laura Capoccia, Francesco Speziale
We report a case of acute limb ischemia (ALI) due to a thromboembolism from a persistent sciatic artery (PSA) pseudoaneurysm precipitated by a fractured stent. Patient, previously treated for ALI by fibrinolysis and stent implantation, presented with a PSA pseudoaneurysm (undetected during first hospitalization), stent fracture (SF) and occlusion of vessels below the knee. Fibrinolysis was performed, restoring direct flow to the foot. A week later, an endovascular procedure was attempted to reline SF and exclude the PSA pseudoaneurysm by deployment of two 13x100mm peripheral endografts (Viabahn; W...
April 28, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28461181/traumatic-anterior-knee-dislocation-with-popliteal-artery-injury-the-importance-of-a-prompt-diagnosis-and-treatment-to-obtain-lower-limb-salvage
#12
Mafalda Massara, Roberto Prunella, Giovanni De Caridi, Domenico Cito, Raffaele Serra, Pasquale Gerardi, Stefano Notarstefano, Giovanni Impedovo
We report a case of traumatic anterior dislocation of the left knee in association with disruption of the soft tissues including knee ligaments, popliteal artery and common peroneal nerve, resulting in lower limb acute ischemia. All components of this complex trauma were recognised and treated promptly with rehabilitation commencing early. The present case is important in two aspects: firstly it reports a very rare occurrence of simultaneous anterior dislocation of the knee associated with vascular insult and common peroneal nerve injury, that was rarely reported in the current literature; secondly it highlights that with timely intervention and a team approach excellent results could be achieved...
April 28, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28458517/a-comparative-study-on-endovascular-treatment-of-sub-acute-critical-limb-ischemia-mechanical-thrombectomy-vs-thrombolysis
#13
Mariya Kronlage, Ilka Printz, Britta Vogel, Erwin Blessing, Oliver J Müller, Hugo A Katus, Christian Erbel
OBJECTIVE: The aim of this study was to compare different interventional methods for treatment of (sub)acute limb ischemia upon thrombotic occlusions of the lower extremity in terms of their safety and efficacy in a tertiary hospital setting. DESIGN: This is a retrospective, single-center study of non-randomized data. METHODS: A total of 202 patients, including 26 critically ill patients, underwent rotational thrombectomy (Rotarex(®)), local thrombolysis (recombinant tissue plasminogen activator), or combination of both at the University Hospital Heidelberg (2006-2015)...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28456813/early-thrombosuction-and-tirofiban-use-in-knee-and-below-knee-arterial-thrombosis
#14
Ulas Bildirici, Umut Celikyurt, Sadan Yavuz, Emir Dervis, Qurban Adina, Dilek Ural
BACKGROUND Acute limb ischemia (ALI) is a clinical entity with a high rate of morbidity and mortality. Despite advances and variety of its management, there is still no criterion standard treatment. The goal of this study was to evaluate the effect of tirofiban use on the early and 6-month prognosis of patients with knee and below-knee arterial thrombosis who were treated with percutaneous thrombosuction (PT) within 24 h. MATERIAL AND METHODS Data of consecutive ALI patients who were diagnosed with popliteal and infra-popliteal arterial thrombosis and underwent PT procedure within 24 h between January 2010 and September 2015 were evaluated retrospectively...
April 30, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28450103/regional-variation-in-outcomes-for-lower-extremity-vascular-disease-in-the-vascular-quality-initiative
#15
Peter A Soden, Sara L Zettervall, Katie E Shean, Ageliki G Vouyouka, Philip P Goodney, Joseph L Mills, John W Hallett, Marc L Schermerhorn
BACKGROUND: Increased focus has been placed on perioperative and long-term outcomes in the treatment of peripheral artery disease (PAD), both for purposes of quality improvement and for assessment of performance at a surgeon and institutional level. This study evaluates regional variation in outcomes after treatment for PAD within the Vascular Quality Initiative (VQI). By describing the variation in practice patterns and outcomes across regions, we hope that each regionally based quality group can select which areas are most important for them to focus on as they will have access to their regional data to compare...
April 24, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28422865/crystalglobulinemia-manifesting-as-chronic-arthralgia-and-acute-limb-ischemia-a-clinical-case-report
#16
Nobuya Abe, Tomoko Tomita, Miyuki Bohgaki, Hideki Kasahara, Takao Koike
RATIONALE: Crystalglobulinemia is a rare disease caused by monoclonal immunoglobulins, characterized by irreversible crystallization on refrigeration. It causes systemic symptoms including purpura, arthralgia, and vessel occlusive conditions to be exacerbated by exposure to cold. We report a patient with crystalglobulinemia associated with monoclonal gammopathy of undetermined significance (MGUS) manifesting as chronic arthralgia and recurrent acute arterial occlusion. PRESENTING CONCERNS: A 61-year-old man, who had been diagnosed with MGUS and who had arthralgia of unknown origin, presented with recurrent acute limb ischemia after surgical thromboembolectomy...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28410939/acute-hand-ischemia-following-elective-venous-sclerotherapy-for-dorsal-hand-varicose-veins
#17
Steven M Andelman, Amanda L Walsh, Todd A Rubin, Michael R Hausman
Venous sclerotherapy is an emerging cosmetic treatment option for dorsal hand varicose veins. Although venous sclerotherapy is considered a safe and effective procedure for treatment of venous malformations and varicosities in both the upper and lower extremities, inadvertent injection of the sclerosing agent into the arterial system has led to reported instances of acute ischemic events and distal limb necrosis. This is a rare but well-documented complication of lower-extremity venous sclerotherapy. Only 2 cases have been reported in upper-extremity venous sclerotherapy, both of which occurred during treatment of complex vascular malformations...
April 12, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28407473/trimodal-rescue-of-hind-limb-ischemia-with-growth-factors-cells-and-nanocarriers-fundamentals-to-clinical-trials
#18
Rajesh Lakshmanan, Gopi Ukani, Muhammad Tipu Rishi, Nilanjana Maulik
Peripheral artery disease is a severe medical condition commonly characterized by critical or acute limb ischemia. Gradual accumulation of thrombotic plaques in peripheral arteries of the lower limb may lead to intermittent claudication or ischemia in muscle tissue. Ischemic muscle tissue with lesions may become infected, resulting in a non-healing wound. Stable progression of the non-healing wound associated with severe ischemia might lead to functional deterioration of the limb, which, depending on the severity, can result in amputation...
April 13, 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28400218/outcomes-of-the-japanese-multicenter-viabahn-trial-of-endovascular-stent-grafting-for-superficial-femoral-artery-lesions
#19
Takao Ohki, Kimihiko Kichikawa, Hiroyoshi Yokoi, Masaaki Uematsu, Terutoshi Yamaoka, Koji Maeda, Yuji Kanaoka
OBJECTIVE: The objective of this study was to assess 1-year safety, efficacy, and invasiveness outcomes of endovascular stent grafting of symptomatic long lesions (≥10 cm) in the superficial femoral artery (SFA) as a substitute for above-knee open bypass surgery. METHODS: This prospective, multicenter (15 hospitals) study assessed heparin-coated stent grafts for the treatment of long SFA lesions in Japanese subjects with peripheral arterial disease. Inclusion criteria were Rutherford category 2 to 5 symptoms (grade 5 without active infection), ankle-brachial index ≤0...
April 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28400063/first-case-of-ischemic-stroke-which-happened-during-continuous-intravenous-infusion-of-rt-pa
#20
Anna Zurawska, Jaroslaw Czeczotka, Jacek J Rozniecki
Catheter-directed thrombolysis (CDT) is one of the methods in the treatment of patients with acute lower limb ischemia. It is based on intrathrombus infusion of one of the thrombolytic agents. The most common complication of CDT is bleeding. We present a patient with left lower limb ischemia, treated by CDT, in which symptoms of stroke, proved to have ischemic etiology, started during continuous intra-arterial infusion of rt-PA. As the patient presented with the history of atrial fibrillation, the most probable mechanism of stroke was related to detachment of possible intra-atrial thrombus...
May 2017: Neurologia i Neurochirurgia Polska
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