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Acute limb ischemia

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https://www.readbyqxmd.com/read/28699679/one-session-of-remote-ischemic-preconditioning-does-not-improve-vascular-function-in-acute-normobaric-and-chronic-hypobaric-hypoxia
#1
Mathew G Rieger, Ryan L Hoiland, Joshua C Tremblay, Mike Stembridge, Anthony R Bain, Daniela Flück, Prajan Subedi, James D Anholm, Philip N Ainslie
Application of repeated short duration bouts of ischemia to the limbs, termed remote ischemic preconditioning (RIPC), is a novel technique that may have protective effects on vascular function during hypoxic exposures. In separate parallel-design studies, at sea-level (SL; n = 16), and after 8-12 days at high-altitude (HA; n = 12; White Mountain, 3800 m), participants underwent either a sham protocol or one session of 4 × 5 minutes of dual-thigh cuff occlusion with 5 minutes recovery. Brachial artery flow-mediated dilation (FMD; ultrasound), pulmonary artery systolic pressure (PASP; echocardiography), and internal carotid artery flow (ICA; ultrasound) were measured at SL in normoxia and isocapnic hypoxia [end-tidal PO₂ (PETO₂) maintained to 50 mmHg], and during normal breathing at HA...
July 12, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28690996/long-term-outcomes-of-femorofemoral-crossover-bypass-grafts
#2
Keun-Myoung Park, Yang-Jin Park, Young-Wook Kim, Dongho Hyun, Kwang Bo Park, Young-Soo Do, Dong-Ik Kim
PURPOSE: Femorofemoral crossover bypass (FCB) is a good procedure for patients with unilateral iliac artery disease. There are many articles about the results of FCB, but most of them were limited to 5 years follow-up. The purpose of our study was to analysis the results of FCB with a 10-year follow-up period. MATERIALS AND METHODS: Between January 1995 and December 2010, 133 patients were operated in Samsung Medical Center (median follow-up: 58.8 months). We retrospectively analysed patient characteristics, the preoperative treatment, the operative procedure, and material used...
June 2017: Vascular Specialist International
https://www.readbyqxmd.com/read/28676079/-pseudo-aortoiliac-bifurcation-leading-to-significant-plaque-shifting-in-the-endovascular-treatment-of-an-aortoiliac-bifurcation-lesion-a-case-report
#3
Yoshito Kadoya, Tsuneaki Kenzaka, Daisuke Naito, Kan Zen, Satoaki Matoba
BACKGROUND: Plaque shifting is a serious complication of endovascular treatment (EVT) for aortoiliac bifurcation lesions. It is challenging to predict the occurrence of unfavorable plaque shifting correctly. CASE PRESENTATION: We report the case of an 88-year-old Japanese woman who experienced constant pain at rest in her left leg. The ankle-brachial pressure index of her left leg was 0.57. Computed tomography (CT) angiography revealed severe stenosis of the left common iliac artery (CIA) and total occlusion of the left external iliac artery (EIA)...
July 4, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28672052/direct-acting-oral-anticoagulants-for-the-treatment-of-suspected-heparin-induced-thrombocytopenia
#4
Kyle A Davis, Daphne O Davis
OBJECTIVE: To evaluate the efficacy and safety of direct oral anticoagulant (DOAC) therapy in hospitalized patients with suspected heparin induced thrombocytopenia (HIT). METHODS: Retrospective cohort study of adult patients prescribed apixaban, dabigatran, or rivaroxaban for the treatment of acute HIT from January 1 2013 to January 1 2017. Eligibility requirements included an intermediate or high pretest probability for HIT (4T score ≥ 4) and a positive IgG-specific anti-PF4/ heparin complex assay...
July 3, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/28654852/adductor-canal-compression-syndrome-in-an-18-year-old-female-patient-leading-to-acute-critical-limb-ischemia-a-case-report
#5
Yi Zhou, Evan J Ryer, Robert P Garvin, Jeremy L Irvan, James R Elmore
BACKGROUND: Adductor canal compression syndrome is a rare non-atherosclerotic cause of arterial occlusion and limb ischemia. PRESENTATION OF CASE: The patient is an 18-year-old healthy female who presented to the emergency department with acute left lower extremity ischemia. Her symptoms began as sudden onset mild foot pain approximately two months ago. Over the 72h prior to presentation, she developed severe pain, pallor, paralysis, loss of pedal pulses, paresthesia, and poikilothermia...
June 17, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28653784/massive-tumor-embolism-in-the-abdominal-aorta-from-pulmonary-squamous-cell-carcinoma-case-report-and-review-of-the-literature
#6
Kenji Ohshima, Yuri Tsujii, Kazuya Sakai, Hiroshi Oku, Eiichi Morii
Acute arterial tumor embolism is a rare complication in cancer patients. Most of the previously reported cases of arterial tumor embolism have been associated with pulmonary malignancies and occurred during the intraoperative and postoperative periods. Very few cases occurred spontaneously. To our knowledge, there is no previous report of spontaneous and massive tumor embolism occluding the abdominal aorta in patients suffering from primary pulmonary carcinoma. We describe the case of 64-year-old man who presented with left homonymous hemianopsia and backache...
June 27, 2017: Pathology International
https://www.readbyqxmd.com/read/28648324/drug-coated-balloon-angioplasty-for-the-management-of-recurring-infrapopliteal-disease-in-diabetic-patients-with-critical-limb-ischemia
#7
Luis M Palena, Larry J Diaz-Sandoval, Efren Gòmez Jabalera, Olga Peypoch Perez, Enrico Sultato, Cesare Brigato, Enrico Brocco, Marco Manzi
OBJECTIVE: To describe the 1-year outcomes of recurring infrapopliteal disease after endovascular revascularization with the Lutonix drug-coated balloons (LDCB) in diabetic patients with critical limb ischemia (CLI), and to benchmark our findings with previously published objective performance goals (OPG) addressing safety and efficacy of new catheter-based therapies for CLI. METHODS: The present study was a retrospective, single-center, and single-arm trial of symptomatic diabetic patients with CLI, who underwent LDCB-angioplasty for recurring infrapopliteal disease...
June 20, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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