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Acute limb ischemia

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https://www.readbyqxmd.com/read/28422865/crystalglobulinemia-manifesting-as-chronic-arthralgia-and-acute-limb-ischemia-a-clinical-case-report
#1
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
#2
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
#3
Rajesh Laksmanan, 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
#4
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
#5
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...
March 18, 2017: Neurologia i Neurochirurgia Polska
https://www.readbyqxmd.com/read/28392250/unusual-clinical-complication-acute-lower-limb-ischemia-caused-by-a-tibial-osteochondroma
#6
Noelia Alonso-Gómez, Miguel Cuesta-de Diego, Antonio Martínez-Izquierdo, Felipe Sáinz-González
No abstract text is available yet for this article.
April 6, 2017: Reumatología Clinica
https://www.readbyqxmd.com/read/28389290/symptomatic-intragraft-thrombus-following-endovascular-repair-of-blunt-thoracic-aortic-injury
#7
Sherwin Abdoli, Sung Wan Ham, Alison G Wilcox, Fernando Fleischman, Lydia Lam
INTRODUCTION: Thoracic endovascular aortic repair (TEVAR) can be complicated by graft collapse, endoleaks, and stent migration. The incidence of these complications and other outcomes is poorly understood in young trauma victims who receive endovascular aortic repair of blunt thoracic aortic injury. REPORT: A 29 year-old pedestrian was struck by a vehicle resulting in polytrauma including blunt thoracic aortic injury (BTAI) with transection distal to the left subclavian artery origin...
April 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28382271/acute-limb-ischemia-and-coronary-artery-disease-in-a-case-of-kimura-s-disease
#8
Woon Heo, Hee Jae Jun, Do Kyun Kang, Ho-Ki Min, Youn-Ho Hwang, Ji Yong Kim, Kyung Han Nam
Kimura disease (KD) is an immune-mediated chronic inflammatory disease of unknown etiology. KD has many complications associated with hypereosinophilia, including various forms of allergic reactions and eosinophilic lung disease. Additionally, hypereosinophilia is associated with hypercoagulability, which may lead to thromboembolic events. A 36-year-old man with KD presented with acute limb ischemia and coronary artery occlusion. He underwent thrombectomy, partial endarterectomy of both popliteal arteries, and coronary artery stent insertion...
April 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28377910/symptomatic-growth-of-a-thrombosed-persistent-sciatic-artery-aneurysm-after-bypass-and-distal-exclusion
#9
Song-Yi Kim, Sungsin Cho, Min-Ji Cho, Sang-Il Min, Sanghyun Ahn, Jongwon Ha, Seung-Kee Min
A 71-year-old woman presented with an enlarging mass in the right buttock, with pain and tingling sensation in sitting position. Five years ago, she was diagnosed with acute limb ischemia due to acute thrombosis of right persistent sciatic artery (PSA), and she underwent successful thromboembolectomy and femoro-tibioperoneal trunk bypass. Computed tomography angiography revealed a huge PSA aneurysm (PSAA). During the previous bypass, the distal popliteal artery was ligated just above the distal anastomosis to exclude the PSAA, whose proximal end was already thrombosed...
March 2017: Vascular Specialist International
https://www.readbyqxmd.com/read/28366306/the-largpad-trial-phase-iia-evaluation-of-l-arginine-infusion-in-patients-with-peripheral-arterial-disease
#10
Vikram S Kashyap, Ryan O Lakin, Patricia Campos, Matthew Allemang, Ann Kim, Timur P Sarac, Alfred Hausladen, Jonathan S Stamler
OBJECTIVE: Endothelial function is improved by l-arginine (l-arg) supplementation in preclinical and clinical studies of mildly diseased vasculature; however, endothelial function and responsiveness to l-arg in severely diseased arteries is not known. Our objective was to evaluate the acute effects of catheter-directed l-arg delivery in patients with chronic lower extremity ischemia secondary to peripheral arterial disease. METHODS: The study enrolled 22 patients (45% male) with peripheral arterial disease (mean age, 62 years) requiring lower extremity angiography...
March 30, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28364777/in-vivo-mri-and-ex-vivo-histological-assessment-of-the-cardioprotection-induced-by-ischemic-preconditioning-postconditioning-and-remote-conditioning-in-a-closed-chest-porcine-model-of-reperfused-acute-myocardial-infarction-importance-of-microvasculature
#11
Tamás Baranyai, Zoltán Giricz, Zoltán V Varga, Gábor Koncsos, Dominika Lukovic, András Makkos, Márta Sárközy, Noémi Pávó, András Jakab, Csilla Czimbalmos, Hajnalka Vágó, Zoltán Ruzsa, Levente Tóth, Rita Garamvölgyi, Béla Merkely, Rainer Schulz, Mariann Gyöngyösi, Péter Ferdinandy
BACKGROUND: Cardioprotective value of ischemic post- (IPostC), remote (RIC) conditioning in acute myocardial infarction (AMI) is unclear in clinical trials. To evaluate cardioprotection, most translational animal studies and clinical trials utilize necrotic tissue referred to the area at risk (AAR) by magnetic resonance imaging (MRI). However, determination of AAR by MRI' may not be accurate, since MRI-indices of microvascular damage, i.e., myocardial edema and microvascular obstruction (MVO), may be affected by cardioprotection independently from myocardial necrosis...
April 1, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28360261/computed-tomography-imaging-features-in-acute-uncomplicated-stanford-type-b-aortic-dissection-predict-late-adverse-events
#12
Anna M Sailer, Sander M J van Kuijk, Patricia J Nelemans, Anne S Chin, Aya Kino, Mark Huininga, Johanna Schmidt, Gabriel Mistelbauer, Kathrin Bäumler, Peter Chiu, Michael P Fischbein, Michael D Dake, D Craig Miller, Geert Willem H Schurink, Dominik Fleischmann
BACKGROUND: Medical treatment of initially uncomplicated acute Stanford type-B aortic dissection is associated with a high rate of late adverse events. Identification of individuals who potentially benefit from preventive endografting is highly desirable. METHODS AND RESULTS: The association of computed tomography imaging features with late adverse events was retrospectively assessed in 83 patients with acute uncomplicated Stanford type-B aortic dissection, followed over a median of 850 (interquartile range 247-1824) days...
April 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28359715/simplified-total-aortic-arch-replacement-with-an-in-situ-stent-graft-fenestration-technique-for-acute-type-a-aortic-dissection
#13
Xiaoping Hu, Zhiwei Wang, Zongli Ren, Rui Hu, Hongbing Wu
OBJECTIVE: Total arch replacement combined with stented elephant trunk implantation in the descending aorta has successfully improved the outcomes of acute type A aortic dissection (AAAD). However, the optimal surgical strategy for the left subclavian artery (LSA) during the procedure remains a challenge. This study aimed to present our new technique of in situ stent graft fenestration to simplify the surgical procedure for suitable cases of AAAD. METHODS: From August 2008 to December 2015, a total of 106 patients underwent simplified total aortic arch replacement with an in situ stent graft fenestration technique...
March 27, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28351415/role-of-carbonyl-sulfide-in-acute-lung-injury-following-limb-ischemia-reperfusion-in-rats
#14
Yan-Rui Zhao, Wen-Rui Lv, Jun-Lin Zhou
OBJECTIVE: To investigate the effect of carbonyl sulfide (COS) on limb ischemia/reperfusion (I/R)-induced acute lung injury (ALI) and the associated mechanism in rats. METHODS: ALI was induced by bilateral hind limb I/R in Sprague-Dawley (SD) rats. Sixty-four SD rats were randomly divided into the control group, I/R group, I/R + COS group, and I/R + AIR group. We observed the survival rate of the rats and the morphological changes of lung tissues, and we measured the change in the lung coefficient, the expression levels of the intercellular adhesion factor-1 (ICAM-1) protein in lung tissue, the expression of tumor necrosis factor (TNF)-α, interleukin (IL)-lβ, and interleukin (IL)-6 in both lung tissue and serum, and cell apoptosis...
March 28, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/28318856/balloon-aortic-valvuloplasty-in-the-transcatheter-aortic-valve-implantation-era-a-single-center-registry
#15
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...
April 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
#16
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
#17
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
#18
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
#19
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
#20
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
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