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Acute limb ischemia

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https://www.readbyqxmd.com/read/28318856/balloon-aortic-valvuloplasty-in-the-transcatheter-aortic-valve-implantation-era-a-single-center-registry
#1
Ana Rita G Francisco, Miguel Nobre Menezes, Pedro Carrilho Ferreira, Cláudia Jorge, Doroteia Silva, Eduardo Infante de Oliveira, Fausto J Pinto, Pedro Canas da Silva
INTRODUCTION: Percutaneous balloon aortic valvuloplasty (BAV) has been limited by the risk of complications and restenosis. However, growing use of transcatheter aortic valve implantation (TAVI) has revived interest in this technique. We analyzed the current indications for BAV and outcomes in a single center. METHODS: Acute results and long-term outcomes were analyzed in a retrospective single-center registry of patients undergoing BAV between January 2013 and January 2016...
March 16, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28318517/-intracardiac-myxoma-complicated-by-acute-aortic-occlusion-case-report
#2
O Zizi, B Benfor, H Jiber, A Bouarhroum, S Benlamkaddem, N Kanjaa
We report the case for a 44-year-old patient without medical history, admitted in our department for bilateral acute limb ischemia (H6). The patient was hemodynamically stable and the physical examination shows limb sever ischemia (no femoral arterial pulses, coldness, cyanosis and paralysis). Abdominal CT angiography showed a complete occlusion of the infra renal abdominal aorta compatible with embolus. An embolectomy with Fogarty catheters was performed. Echocardiography showed a mass in the left atrium. Pathological examination of the material embolic confirmed the diagnosis of the cardiac myxoma...
March 16, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/28300357/pilot-randomized-controlled-trial-on-early-and-late-remote-ischemic-preconditioning-prior-to-complex-cardiac-surgery-in-young-infants
#3
Gonzalo Garcia Guerra, Ari R Joffe, Rob Seal, Ernest Phillipos, Maggie Wong, Elham Khodayari Moez, Irina A Dinu, Jonathan P Duff, David Ross, Ivan Rebeyka, Charlene M T Robertson
BACKGROUND: Remote ischemic preconditioning involves providing a brief ischemia-reperfusion event to a tissue to create subsequent protection from a more severe ischemia-reperfusion event to a different tissue/organ. The few pediatric remote ischemic preconditioning studies in the literature show conflicting results. AIM: We conducted a pilot randomized controlled trial to determine the feasibility of conducting a larger trial and to gather provisional data on the effect of early and late remote ischemic preconditioning on outcomes of infants after surgery for congenital heart disease...
April 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28288884/the-profile-of-circulating-matrix-metalloproteinases-in-patients-undergoing-lower-limb-endovascular-interventions-for-peripheral-arterial-disease
#4
Ioakeim T Giagtzidis, Nikolaos P Kadoglou, George Mantas, Aris Spathis, Konstantinos O Papazoglou, Petros Karakitsos, Christos D Liapis, Christos D Karkos
BACKGROUND: Matrix metalloproteinases (MMPs) play a significant role in the development and progression of atherosclerotic vascular disease. We aimed to document the profile of circulating MMPs in peripheral arterial disease (PAD) patients undergoing lower limb endovascular revascularization. METHODS: A total of 46 patients (37 male; mean age 66±11 years) undergoing elective lower limb percutaneous revascularization (angioplasty/stent) for symptomatic PAD were recruited from two vascular centers...
March 10, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28279723/physiologic-cryoamputation-in-managing-critically-ill-patients-with-septic-advanced-acute-limb-ischemia
#5
Samuel L Chen, Isabella J Kuo, Nii-Kabu Kabutey, Roy M Fujitani
OBJECTIVES: Certain critically ill patients with advanced acute limb ischemia with a non-viable extremity may be unsuitable for transport to the operating room to undergo definitive amputation. In these unstable patients, rapid regional cryotherapy allows for prompt infectious source control and correction of hemodynamic and metabolic abnormalities, thereby lessening the risk associated with definitive surgical amputation. We describe our refined technique for lower extremity physiologic cryoamputation and review our institutional experience...
March 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28272470/meta-analysis-of-remote-ischemic-conditioning-in-patients-with-acute-myocardial-infarction
#6
Changfeng Man, Dandan Gong, Yongjing Zhou, Yu Fan
Effects of remote ischemic conditioning (RIC) in acute myocardial infarction (AMI) patients remain conflicting. We performed this meta-analysis of randomized clinical trials (RCTs) to evaluate the benefits of the RIC in patients with AMI. Potentially relevant RCTs were identified by searching PubMed, Embase, Cochrane Library, VIP, CNKI, and Wanfang database until November 2016. RCTs evaluating RIC using intermittent limb ischemia-reperfusion in AMI patients were included. Thirteen RCTs were identified and analyzed...
March 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28265014/recast-remote-ischemic-conditioning-after-stroke-trial-a-pilot-randomized-placebo-controlled-phase-ii-trial-in-acute-ischemic-stroke
#7
Timothy J England, Amanda Hedstrom, Saoirse O'Sullivan, Richard Donnelly, David A Barrett, Sarir Sarmad, Nikola Sprigg, Philip M Bath
BACKGROUND AND PURPOSE: Repeated episodes of limb ischemia and reperfusion (remote ischemic conditioning [RIC]) may improve outcome after acute stroke. METHODS: We performed a pilot blinded placebo-controlled trial in patients with acute ischemic stroke, randomized 1:1 to receive 4 cycles of RIC within 24 hours of ictus. The primary outcome was tolerability and feasibility. Secondary outcomes included safety, clinical efficacy (day 90), putative biomarkers (pre- and post-intervention, day 4), and exploratory hemodynamic measures...
March 6, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28257767/current-endovascular-management-of-acute-limb-ischemia
#8
REVIEW
Javier A Valle, Stephen W Waldo
Acute limb ischemia is a vascular emergency, threatening the viability of the affected limb and requiring immediate recognition and treatment. Even with revascularization of the affected extremity, acute limb ischemia is associated with significant morbidity and mortality resulting in up to a 15% risk of amputation during the initial hospitalization and a 1 in 5 risk of mortality within 1 year of the index event. This review summarizes the current management of acute limb ischemia. Understanding the diagnosis and therapeutic options will aid clinicians in treating these critically ill patients...
April 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28256175/recanalization-of-peripheral-chronic-total-occlusions-no-fancy-devices-just-a-crossing-catheter
#9
Alessandro Cannavale, Tariq Ali, Chen-Yang Shen, George Kassimis, Miltiadis Krokidis
BACKGROUND: Chronic total occlusions (CTOs) are challenging to treat endovascularly. Classic subintimal approach is offering only moderate success rates mainly due of the lack of dedicated crossing catheters. Purpose of this study is to assess the acute procedural success of the use of a novel hydrophilic crossing catheter in the recanalization of peripheral CTOs. MATERIALS AND METHODS: This is a retrospective, single-centre study of patients with femoropopliteal CTOs...
March 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28243167/effect-of-single-and-double-administration-of-human-umbilical-cord-blood-derived-mesenchymal-stem-cells-following-focal-cerebral-ischemia-in-rats
#10
Hyung Woo Park, Yona Kim, Jong Wook Chang, Yoon Sun Yang, Wonil Oh, Jae Min Lee, Hye Ran Park, Dong Gyu Kim, Sun Ha Paek
Stem cell therapies are administered during the acute phase of stroke to preserve the penumbral tissues from ischemic injury. However, the effect of repeated cell therapy during the acute phase remains unclear. In this study, we investigated and compared the functional outcome of single (two days post-injury) and repeated (two and nine days post-injury) treatment with human umbilical cord derived mesenchymal stem cells (hUCB-MSCs) after middle cerebral artery occlusion (MCAO). The rotarod and limb placement tests were utilized to investigate functional outcomes, while infarct volume and tissue damage were measured by immunofluorescent staining for neovascularization, neurogenesis, apoptosis, and inflammation in the penumbral zones...
February 2017: Experimental Neurobiology
https://www.readbyqxmd.com/read/28228367/blockade-of-hmgb1-preserves-vascular-homeostasis-and-improves-blood-perfusion-in-rats-of-acute-limb-ischemia-reperfusion
#11
Yang Liu, Changyou Zhou, Jianjun Jiang, Qingbo Su, Xiangjiu Ding
Acute limb ischemia is one of the most common peripheral arterial disease, while surgical restoration of blood flow often results in ischemia/reperfusion (I/R) injury. Our previous study revealed the inflammation intensity in arterial tissue, characterized by expression of high mobility group box protein 1 (HMGB1), was contrary to the fluctuation of hemodynamics in reperfusion limbs in a rat model. This study meant to clarify the role of HMGB1 during this process. Laser Doppler perfusion imaging evaluated limb hemodynamics in mean and max perfusion unit (PU)...
February 21, 2017: Microvascular Research
https://www.readbyqxmd.com/read/28222984/index-complications-predict-secondary-complications-after-infrainguinal-lower-extremity-bypass-for-critical-limb-ischemia
#12
Matthew R Peacock, Nishant K Shah, Alik Farber, Su Yeon Lee, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Jeffrey J Siracuse
OBJECTIVE: Patients undergoing lower extremity bypass (LEB) are at high risk of perioperative complications that can lead to a cascade of secondary complications. Our goal was to understand the association of index complications with secondary complications after LEB. METHODS: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database from 2005 to 2012 was used to analyze secondary complications after five index complications after LEB: deep/organ space surgical site infection, urinary tract infection (UTI), myocardial infarction (MI), pneumonia, and acute renal failure (ARF)...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28217986/the-effects-of-remote-ischemic-conditioning-in-patients-with-st-segment-elevation-myocardial-infarction-treated-with-primary-percutaneous-coronary-intervention-a-meta-analysis
#13
Jing Gao, Qingjie Chen, Fen Liu, Qian Zhao, Bangdang Chen, Yun Zhou, Qiang Zhao, Yitong Ma, Yining Yang
INTRODUCTION: Timely and successful reperfusion is effective at improving outcome in patients presenting with STEMI. However, abrupt restoration of blood flow may cause detrimental myocardial repercussion injury. Remote ischemic conditioning (RIC) is a potent activator of innate protection against ischemia-reperfusion injury. This study assessed remote ischemic conditioning in patients presenting with STEMI treated with primary PCI. EVIDENCE ACQUISITION: Relevant studies were identified through electronic literature search from PubMed, Medline, EMBASE, CNKI, WANFANG, and VIP...
February 17, 2017: Minerva Medica
https://www.readbyqxmd.com/read/28216347/systemic-application-of-carbon-monoxide-releasing-molecule-3-protects-skeletal-muscle-from-ischemia-reperfusion-injury
#14
Aurelia Bihari, Gediminas Cepinskas, Thomas L Forbes, Richard F Potter, Abdel-Rahman Lawendy
OBJECTIVE: Ischemia-reperfusion (IR) is a limb- and life-threatening complication of acute limb ischemia and musculoskeletal trauma. Carbon monoxide-releasing molecules (CORMs) have recently been shown to protect microvascular perfusion and to reduce inflammation and injury in various ischemic animal models. The purpose of this study was to examine the effects of water-soluble CORM-3 on the extent of IR-induced muscle injury. METHODS: Wistar rats were randomized into three groups: sham (no ischemia), IR + CORM-3 (10 mg/kg intraperitoneally), and IR + inactive CORM-3 (iCORM-3; 10 mg/kg intraperitoneally)...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28191744/endovascular-therapy-for-angio-seal-tm-related-acute-limb-ischemia-perioperative-and-long-term-results
#15
Hui Dong, Meng Peng, Xiongjing Jiang, Wuqiang Che, Yubao Zou, Bo Xu, Yuejin Yang, Runlin Gao
OBJECTIVES: To investigate the perioperative and long-term outcomes of endovascular therapy for Angio-seal(TM) -related acute limb ischemia. BACKGROUND: Currently, limited data are available on the optimal treatment strategy for Angio-seal(TM) -related acute lower limb ischemia. METHODS: The prospectively maintained patient database of our institution was retrospectively searched to identify all patients who developed acute lower limb ischemia after use of the Angio-Seal(TM) and received endovascular treatment from January 2010 to February 2016...
February 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28184959/endovascular-treatment-strategy-using-catheter-directed-thrombolysis-percutaneous-aspiration-thromboembolectomy-and-angioplasty-for-acute-upper-limb-ischemia
#16
Tatsuo Ueda, Satoru Murata, Izumi Miki, Daisuke Yasui, Fumie Sugihara, Hiroyuki Tajima, Tetsuro Morota, Shin-Ichiro Kumita
PURPOSE: To evaluate the usefulness and safety of endovascular treatments for acute upper limb ischemia (AULI) by using multiple techniques, and to compare catheter-directed thrombolysis (CDT) and percutaneous aspiration thromboembolectomy (PAT) as initial procedures. MATERIALS AND METHODS: The study included 18 patients (4 men and 14 women) with AULI, who underwent a total of 20 sessions of endovascular treatment using various endovascular techniques between January 2005 and April 2016...
February 9, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28161267/-lower-limb-arterial-thrombosis-in-a-nephrotic-syndrome
#17
Raja Arrab, Aicha Bourrahouate, Mohamed Sbihi, Imane Ait Sab
Thromboembolic complications are frequent in the nephrotic syndrome. Arterial localizations have been rarely reported. There is no consensus on their management; it depends on the location and hypercoagulable state. We report a case of acute lower limb ischemia occurring in children with a history of nephrotic syndrome, complicated by toes necrosis. The diagnosis was made by Doppler ultrasonography. Thrombectomy was performed and the patient received an anticoagulant treatment. Local cares have improved the local state, avoiding surgical necrosectomy...
February 1, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/28159709/role-of-the-plasma-cascade-systems-in-ischemia-reperfusion-injury-of-bone
#18
Shengye Zhang, Carlos Wotzkow, Anjan K Bongoni, Jane Shaw-Boden, Mark Siegrist, Adriano Taddeo, Fabian Blank, Willy Hofstetter, Robert Rieben
Ischemia/reperfusion (I/R) injury has been extensively studied in organs such as heart, brain, liver, kidney, and lung. As a vascularized organ, bone is known to be susceptible to I/R injury too, but the respective mechanisms are not well understood to date. We therefore hypothesized that, similar to other organs, plasma cascade-induced inflammation also plays a role in bone I/R injury. Reperfusion injury in rat tibia was induced by unilateral clamping of the femoral artery and additional use of a tourniquet, while keeping the femoral vein patent to prevent venous congestion...
January 31, 2017: Bone
https://www.readbyqxmd.com/read/28151868/impact-of-betablockers-on-general-and-local-outcome-in-patients-hospitalized-for-lower-extremity-peripheral-artery-disease-the-copart-registry
#19
MULTICENTER STUDY
Tristan Mirault, Alexandre Galloula, Jean-Pierre Cambou, Philippe Lacroix, Victor Aboyans, Carine Boulon, Joel Constans, Alessandra Bura-Riviere, Emmanuel Messas
Lower extremity peripheral artery disease (PAD) is one manifestation of atherosclerosis. Patients with PAD have an increased rate of mortality due to concurrent coronary artery disease and hypertension. Betablockers (BB) may, therefore, be prescribed, especially in case of heart failure. However, BB safety in PAD is controversial, because of presumed peripheral hemodynamic consequences of BB that could lead to worsening of symptoms in patients with PAD. In this context, we aimed to determine the impact of BB on all-cause and cardiovascular mortality and amputation rate at 1 year after hospitalization for PAD from the COPART Registry population...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28110619/type-b-dissection-resulting-in-acute-limb-ischemia-in-a-patient-with-a-history-of-evar
#20
REVIEW
Lalithapriya Jayakumar, Joseph V Lombardi, Francis J Caputo
Type B aortic dissection (TBAD) can be complicated due to visceral and limb malperfusion. We present the case of a patient with a TBAD 5 months after endovascular aneurysm repair (EVAR) for an infrarenal aortic aneurysm, which resulted in a right leg acute limb ischemia due to impingement of the EVAR from to the dissection. In the following discussion, we will review the literature and describe our technique for the treatment of this infrequent problem.
February 2017: Vascular and Endovascular Surgery
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