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Acute limb ischemia

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https://www.readbyqxmd.com/read/28610773/contrast-induced-acute-kidney-injury-in-interventional-cardiology-emerging-evidence-and-unifying-mechanisms-of-protection-by-remote-ischemic-conditioning
#1
REVIEW
Adebayo C Atanda, Oladipupo Olafiranye
Contrast-induced acute kidney injury (CI-AKI) is a common complication of many diagnostic and therapeutic cardiovascular procedures. It is associated with longer in-hospital stay, more complicated hospitalization course, and higher in-hospital morbidity and mortality. With increasing use of contrast media in various diagnostic and interventional procedures, the prevalence of CI-AKI is expected to rise. Although pre-hydration with intravenous normal saline is recommended in patients with elevated risk of CI-AKI, this approach is often not feasible in many clinical settings...
June 6, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28604581/vascular-tos-creating-a-protocol-and-sticking-to-it
#2
REVIEW
Meena Archie, David Rigberg
Thoracic Outlet Syndrome (TOS) describes a set of disorders that arise from compression of the neurovascular structures that exit the thorax and enter the upper extremity. This can present as one of three subtypes: neurogenic, venous, or arterial. The objective of this section is to outline our current practice at a single, high-volume institution for venous and arterial TOS. VTOS: Patients who present within two weeks of acute deep vein thrombosis (DVT) are treated with anticoagulation, venography, and thrombolysis...
June 10, 2017: Diagnostics
https://www.readbyqxmd.com/read/28579237/case-of-percutaneous-extracorporeal-femoro-femoral-bypass-for-acute-limb-ischemia-from-large-bore-access
#3
Saurav Chatterjee, Riyaz Bashir, Vladimir Lakhter, Brian O'Murchu, Brian O'Neill, Vikas Aggarwal
No abstract text is available yet for this article.
May 24, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28567352/endovascular-versus-surgical-treatment-for-acute-limb-ischemia-a-systematic-review-and-meta-analysis-of-clinical-trials
#4
Tariq H Enezate, Jad Omran, Ehtisham Mahmud, Mitul Patel, Mazen S Abu-Fadel, Christopher J White, Ashraf S Al-Dadah
BACKGROUND: A number of small studies have suggested that outcomes following endovascular (ENDO) therapy are comparable to those following surgical (SURG) revascularization for patients presenting with acute limb ischemia (ALI). We sought to compare mortality, limb amputation and recurrent ischemia across both revascularization strategies. METHODS: A comprehensive database search of MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL) electronic databases from January 1990 through January 2016 was performed to identify studies of ENDO versus SURG for ALI...
June 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28566501/prevention-of-contrast-induced-nephropathy-by-limb-ischemic-preconditioning-underlying-mechanisms-and-clinical-effects
#5
George Dugbartey, Andrew N Redington
Contrast-induced nephropathy (CIN) is an important complication following diagnostic radiographic imaging and interventional therapy. It results from administration of intravascular iodinated contrast media (CM) and is currently the third most common cause of hospital-acquired acute kidney injury. CIN is associated with increased morbidity, prolonged hospitalization and higher mortality. Although the importance of CIN is widely appreciated, and its occurrence can be mitigated by the use of pre- and post-hydration protocols and low osmolar instead of high osmolar iodine-containing CM, specific prophylactic therapy is lacking...
May 31, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28559976/quantitative-photoacoustic-imaging-for-early-detection-of-muscle-ischemia-injury
#6
Liang Chen, Hengheng Ma, Hong Liu, Kangquan Shou, Xun Zheng, Quli Fan, Aixi Yu, Xiang Hu
Acute lower extremity ischemia is a limb-and life-threatening problem. The timing of clinical intervention is critical to achieving optimal outcomes. However, there has been a lack of effective techniques capable of evaluating muscle and limb damage. Microcirculatory injury is the initial pathological change during ischemic muscle injury. Here, we performed photoacoustic imaging (PAI) in real time to quantitatively detect the degree of microcirculatory injury of ischemic muscles in a rat model in which Evans blue (EB), which strongly binds to albumin in blood, was used as a nontoxic molecular PA probe...
2017: American Journal of Translational Research
https://www.readbyqxmd.com/read/28555191/percutaneous-mechanical-thrombectomy-using-rotarex%C3%A2-s-device-in-acute-limb-ischemia-in-infrainguinal-occlusions
#7
Samuel Heller, Jean-Claude Lubanda, Petr Varejka, Miroslav Chochola, Pavel Prochazka, David Rucka, Sylvie Kuchynkova, Johana Horakova, Ales Linhart
PURPOSE: To evaluate the effectiveness of percutaneous mechanical thrombectomy using Rotarex S in the treatment of acute limb ischemia (ALI) in infrainguinal occlusions in a retrospective study of patients treated in our institution. METHODS: In this study, we identified a total of 147 ALI patients that underwent mechanical thrombectomy using Rotarex S at our institution. In 82% of the cases, percutaneous thrombectomy was used as first-line treatment, and for the remainder of the cases, it was used as bailout after ineffective aspiration or thrombolysis...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28553783/a-retrospective-cohort-analysis-of-percutaneous-versus-side-graft-perfusion-techniques-for-veno-arterial-extracorporeal-membrane-oxygenation-in-patients-with-refractory-cardiogenic-shock
#8
Mehmet Cakici, Evren Ozcinar, Cagdas Baran, Ahmet Onat Bermede, Mehmet Cahit Sarıcaoglu, Mustafa Bahadır Inan, Mustafa Serkan Durdu, Atilla Aral, Mustafa Sirlak, Ahmet Ruchan Akar
OBJECTIVES: This study was designed to compare vascular complications and the outcomes of ultrasound (US)-guided percutaneous cannulation with distal perfusion catheter (PC-DP) and arterial side-graft perfusion (SGP) techniques in patients who require veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support for refractory cardiogenic shock (RCS). METHODS: We conducted a retrospective, observational cohort study of consequtive patients with RCS treated with VA-ECMO at a single transplant center from March 2010 until August 2015...
July 2017: Perfusion
https://www.readbyqxmd.com/read/28508973/phlegmasia-cerulean-dolens-complication-of-femoral-vein-catheterization
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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