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Acute limb ischemia

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https://www.readbyqxmd.com/read/28191744/endovascular-therapy-for-angio-seal-tm-related-acute-limb-ischemia-perioperative-and-long-term-results
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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.
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28067686/persistent-knee-pain-after-falling-off-of-a-bicycle
#7
Muhammad Waseem, Julissa Garrido-Joyce, Frances Quee, Soula Priovolos
We present the case of an 18-year-old young man with severe persistent knee pain secondary to a popliteal artery thrombosis. This occurred as a result of a fall from a bicycle. Acute compartment syndrome refers to the sequelae that can occur because of increased fascial compartment pressures, such as crush injuries, burns, traumatic or spontaneous hemorrhage, or constrictive casts. Increased pressures in nonelastic fascial compartments result in decreased perfusion distally, leading to ischemia of muscles and neurovascular tissue...
January 6, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28058104/severe-lower-limb-ischemia-by-massive-arterial-thrombosis-revealing-an-acute-myeloid-leukemia-needing-for-leg-amputation-clinical-and-emotional-aspects-related-to-the-communication-with-the-patient-and-his-family
#8
Paolo D'Angelo, Calogero Taormina, Clara Mosa, Floriana Di Marco, Fabrizio Valentino, Angela Trizzino, Paola Guadagna, Francesco Talarico
Large vessel thrombosis is a very rare clinical presentation of acute leukemia, generally associated with coagulopathy, usually characteristic of acute promyelocytic leukemia. A 13- year-old boy with a previously undiagnosed acute myeloid leukemia was referred to our hospital with acute ischemia of the right lower limb due to occlusion of the right external iliac artery, treated with emergency double surgical thromboembolectomy and chemotherapy. The thrombotic complication resulted in leg amputation. Now the boy is well in complete remission, with a good social integration and quality of life, 30 months after completing treatment...
November 17, 2016: Pediatric Reports
https://www.readbyqxmd.com/read/28043728/acute-compartment-syndrome-caused-by-uncontrolled-hypothyroidism
#9
Anar Modi, Hari Amin, Matthew Salzman, Farah Morgan
Acute compartment syndrome is increased tissue pressure exceeding perfusion pressure in a closed compartment resulting in nerve and muscle ischemia. Common precipitating causes are crush injuries, burns, substance abuse, osseous or vascular limb trauma. This is a case of 42year old female with history of hypothyroidism who presented to emergency room with acute onset of severe pain and swelling in right lower extremity. Physical examination was concerning for acute compartment syndrome of right leg which was confirmed by demonstration of elevated compartmental pressures...
December 23, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28041804/endovascular-treatment-of-the-common-femoral-artery-in-the-vascular-quality-initiative
#10
Jeffrey J Siracuse, Kathryn Van Orden, Jeffrey A Kalish, Mohammad H Eslami, Marc L Schermerhorn, Virendra I Patel, Denis Rybin, Alik Farber
OBJECTIVE: Endovascular interventions of the common femoral (CFA) and deep (DFA) femoral arteries are becoming more common. However, there is very little published data for guidance. Our objective was to analyze practice patterns and outcomes from these interventions. METHODS: The Vascular Quality Initiative (2010-2015) was queried for all endovascular interventions of the CFA and DFA. Cases that were emergent or for acute limb ischemia were excluded. Those with isolated CFA with or without DFA treatment were analyzed...
December 29, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28028564/evolution-of-diffusion-tensor-imaging-parameters-after-acute-subarachnoid-haemorrhage-a-prospective-cohort-study
#11
Isabel Fragata, Patrícia Canhão, Marta Alves, Ana Luísa Papoila, Nuno Canto-Moreira
INTRODUCTION: Few studies assessed diffusion tensor imaging (DTI) changes in the acute phase of subarachnoid haemorrhage (SAH). We prospectively evaluated DTI parameters in the acute phase of SAH and 8-10 days after and analysed whether changes could be related to SAH severity or to the development of delayed cerebral ischemia (DCI). METHODS: Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) changes over time were assessed in a prospective cohort of patients with acute SAH...
January 2017: Neuroradiology
https://www.readbyqxmd.com/read/28027191/intentional-intra-arterial-injection-of-heroin-a-case-report
#12
Joji Suzuki, Erin S Valenti
Intravenous injection of drugs is associated with a host of medical complications, notably soft-tissue infections. On the contrary, intra-arterial injections of drugs have also been reported, largely restricted to inadvertent injections. Here we describe a patient who engaged in repeated intra-arterial injections of heroin when she exhausted most of her venous access, and presented acutely with a radial artery occlusion requiring thrombolytic therapy. Clinicians should have a high index of suspicion for intra-arterial injection in injection drug users who present with limb pain, ischemia, and motor/sensory deficits...
January 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28017783/anti-apoptotic-and-angiogenic-effects-of-intelectin-1-in-rat-cerebral-ischemia
#13
Naibing Gu, Yaru Dong, Ye Tian, Zhengli Di, Zhiqin Liu, Mingze Chang, Xiaotao Jia, Yihua Qian, Weiping Zhang
Ischemic stroke is an acute life-threatening disease, which causes neurological dysfunction. The formation of new blood vessels around the infarct is vital to the restoration of perfusion and healing of brain tissue. Studies have shown that intelectin-1 (omentin) promotes endothelial cell function and angiogenesis in response to ischemia and inhibits apoptosis in rats with unilateral hind limb surgery. In the present study, we investigated the neuroprotective role of intelectin-1 following focal cerebral ischemia...
December 23, 2016: Brain Research Bulletin
https://www.readbyqxmd.com/read/28006943/cardioprotection-induced-by-remote-ischemic-preconditioning-preserves-the-mitochondrial-respiratory-function-in-acute-diabetic-myocardium
#14
I Kancirová, M Jašová, M Muráriková, Z Sumbalová, O Uličná, T Ravingerová, I Waczulíková, A Ziegelhöffer, M Ferko
A 2×2 factorial design was used to evaluate possible preservation of mitochondrial functions in two cardioprotective experimental models, remote ischemic preconditioning and streptozotocin-induced diabetes mellitus, and their interaction during ischemia/reperfusion injury (I/R) of the heart. Male Wistar rats were randomly allocated into four groups: control (C), streptozotocin-induced diabetic (DM), preconditioned (RPC) and preconditioned streptozotocin-induced diabetic (DM+RPC). RPC was conducted by 3 cycles of 5-min hind-limb ischemia and 5-min reperfusion...
December 22, 2016: Physiological Research
https://www.readbyqxmd.com/read/28003319/hypothyroid-induced-acute-compartment-syndrome-in-all-extremities
#15
Matthew C Musielak, Jung Hee Chae
Acute compartment syndrome (ACS) is an uncommon complication of uncontrolled hypothyroidism. If unrecognized, this can lead to ischemia, necrosis and potential limb loss. A 49-year-old female presented with the sudden onset of bilateral lower and upper extremity swelling and pain. The lower extremity anterior compartments were painful and tense. The extensor surface of the upper extremities exhibited swelling and pain. Motor function was intact, however, limited due to pain. Bilateral lower extremity fasciotomies were performed...
December 20, 2016: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/27986482/high-dose-rate-brachytherapy-for-the-treatment-of-lower-extremity-in-stent-restenosis
#16
Karen J Ho, Phillip M Devlin, Arin L Madenci, Marcus E Semel, Edwin C Gravereaux, Louis L Nguyen, Michael Belkin, Matthew T Menard
OBJECTIVE: Historically, edge stenosis and late thrombosis limited the effectiveness of adjunctive endovascular brachytherapy (EVBT) for in-stent restenosis (ISR) after percutaneous transluminal angioplasty (PTA) and stenting. We evaluated an updated protocol of PTA and EVBT for ISR among patients with lower extremity occlusive disease. METHODS: This is a retrospective, single-center review of patients treated with PTA and EVBT for ISR in the iliac and femoropopliteal segments between 2004 and 2012...
December 13, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27959717/ticagrelor-versus-clopidogrel-in-symptomatic-peripheral-artery-disease
#17
RANDOMIZED CONTROLLED TRIAL
William R Hiatt, F Gerry R Fowkes, Gretchen Heizer, Jeffrey S Berger, Iris Baumgartner, Peter Held, Brian G Katona, Kenneth W Mahaffey, Lars Norgren, W Schuyler Jones, Juuso Blomster, Marcus Millegård, Craig Reist, Manesh R Patel
Background Peripheral artery disease is considered to be a manifestation of systemic atherosclerosis with associated adverse cardiovascular and limb events. Data from previous trials have suggested that patients receiving clopidogrel monotherapy had a lower risk of cardiovascular events than those receiving aspirin. We wanted to compare clopidogrel with ticagrelor, a potent antiplatelet agent, in patients with peripheral artery disease. Methods In this double-blind, event-driven trial, we randomly assigned 13,885 patients with symptomatic peripheral artery disease to receive monotherapy with ticagrelor (90 mg twice daily) or clopidogrel (75 mg once daily)...
5, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/27928584/endovascular-management-of-infected-femoral-artery-pseudoaneurysms-in-high-risk-patients-a-case-series
#18
Mario D'Oria, Giada Sgorlon, Cristiano Calvagna, Francesca Zamolo, Stefano Chiarandini, Roberto Adovasio, Filippo Griselli
We report our experience with the urgent treatment of two high-risk patients with infected femoral artery pseudoaneurysms (IFAPs) with the placement of a self-expandable covered stent (SECS). In both cases, there was no perioperative mortality and the aneurysm exclusion was successful without early or late stent thrombosis/stent fracture nor acute or chronic limb ischemia or limb loss. There was no recurrence of local or systemic infection during the follow-up period. Endovascular therapy represents a feasible treatment option for IFAPs in those patients for whom the risk of open surgical repair would be prohibitive, especially under urgent circumstances...
December 7, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27921154/peripheral-stent-thrombosis-leading-to-acute-limb-ischemia-and-major-amputation-incidence-and-risk-factors-in-the-aortoiliac-and-femoropopliteal-arteries
#19
Konstantinos Katsanos, Said A M Al-Lamki, Aneeta Parthipun, Stavros Spiliopoulos, Sanjay Dhanji Patel, Ioannis Paraskevopoulos, Hany Zayed, Athanasios Diamantopoulos
PURPOSE: To report the real-world incidence and risk factors of stent thrombosis in the aortoiliac and femoropopliteal arteries in case of bare nitinol stent (BNS) or covered nitinol stent (CNS) placement from a single-centre retrospective audit. MATERIALS AND METHODS: Medical records of consecutive patients treated with peripheral stent placement for claudication or critical limb ischemia were audited for definite stent thrombosis defined as imaging confirmed stent thrombosis that presented as acute limb-threatening ischemia...
March 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27909643/source-control-and-graft-preservation-using-negative-pressure-wound-therapy-with-antibiotic-instillation-a-case-report
#20
Victoria Gilbert, Timothy Kelly, Robert Grossi
Negative pressure wound therapy (NPWT) is widely used to treat many types of complex wounds, and the advent of the instillation and dwell time (NPWTi-d) technique has enhanced this system with the addition of automated treatment with topical solutions. In the field of vascular surgery, NPWT is utilized to help close wounds over underlying grafts; however keeping these wounds free of infection and avoiding large reoperation when infection occurs remains a challenge. In this case report we present a patient who required acute intervention for limb ischemia, with a large wound created in the groin for anastomosis of a prosthetic graft bypass...
October 31, 2016: Curēus
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