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Acute limb ischemia

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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
#1
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...
December 5, 2016: 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
#2
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
https://www.readbyqxmd.com/read/27909265/prevention-of-the-collapse-of-pial-collaterals-by-remote-ischemic-perconditioning-during-acute-ischemic-stroke
#3
Junqiang Ma, Yonglie Ma, Bin Dong, Mischa V Bandet, Ashfaq Shuaib, Ian R Winship
Collateral circulation is a key variable determining prognosis and response to recanalization therapy during acute ischemic stroke. Remote ischemic perconditioning (RIPerC) involves inducing peripheral ischemia (typically in the limbs) during stroke and may reduce perfusion deficits and brain damage due to cerebral ischemia. In this study, we directly investigated pial collateral flow augmentation due to RIPerC during distal middle cerebral artery occlusion (MCAo) in rats. Blood flow through pial collaterals between the anterior cerebral artery (ACA) and the MCA was assessed in male Sprague Dawley rats using in vivo laser speckle contrast imaging (LSCI) and two photon laser scanning microscopy (TPLSM) during distal MCAo...
December 1, 2016: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/27901322/risk-factors-analysis-of-thromboembolectomy-for-acute-thromboembolic-lower-extremity-ischemia-in-native-arteries
#4
Gabriele Piffaretti, Alessandro Angrisano, Marco Franchin, Massimo Ferrario, Nicola Rivolta, Alessandro Bacuzzi, Patrizio Castelli, Matteo Tozzi
BACKGROUND: Aim of this study is to report the results of thromboembolectomy (ThEmb) for acute thromboembolic lower limb ischemia (ATLI) in native arteries and to create a predictive score for amputation-free survival (AFS) at 30 days. METHODS: It is a single center, retrospective analysis of a four years period. All patients had ThEmb: adjunctive procedures included femoral and/or popliteal endarterectomy in 30 (18.3%) cases, PTA- stent in 24 (14.6%), and femoral endarterectomy plus PTA-stent in 12 (7...
November 30, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27890841/development-of-a-scoring-system-for-the-prediction-of-early-graft-failure-after-peripheral-arterial-bypass-surgery
#5
Andreas M Lazaris, Sotiria Mastoraki, Evangelos Kontopantelis, Konstantinos Seretis, Maria Karouki, Konstantinos Moulakakis, Miltiadis Matsagkas, Spyros N Vasdekis
OBJECTIVES: An occluded lower limb arterial bypass is associated with poor prognosis for the limb. Currently, no risk assessment method to estimate the risk of early graft failure exists. Aim of this study was to investigate the effect of various potential factors on early graft failure of infrainguinal bypass surgery and to develop a risk-scoring model to predict it. DESIGN AND METHODS: A prospective observational clinical study was performed. One hundred infrainguinal bypass procedures (60 autologous and 40 synthetic grafts), throughout a 3-year period were included...
November 24, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27884944/ruptured-abdominal-aortic-aneurysm-after-endovascular-aortic-aneurysm-repair-thrombosis
#6
Jesse Victory, Syed Ali Rizvi, Enrico Ascher, Anil Hingorani
BACKGROUND: Complete thrombosis of an aortic endograft after an endovascular aortic aneurysm repair is a rare complication. The majority of thrombotic events occur in the iliac limbs. CASE PRESENTATION: We present the case of a patient who presented with acute limb ischemia as the result of a thrombosed infra-renal aortic endograft. After restoration of blood flow to the lower extremities with an axillary to bi-femoral artery bypass, the patient was lost to follow-up...
November 24, 2016: Vascular
https://www.readbyqxmd.com/read/27882913/persistent-sciatic-artery-aneurysm-a-potential-cause-of-acute-lower-limb-ischemia-in-young-patients
#7
Konstantinos Spanos, Sokol Xhepa, Athanasios D Giannoukas
No abstract text is available yet for this article.
November 24, 2016: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/27862880/feasibility-and-1-year-outcomes-of-subintimal-revascularization-with-supera-%C3%A2-stenting-of-long-femoropopliteal-occlusions-in-critical-limb-ischemia-the-supersub-study
#8
Luis M Palena, Larry J Diaz-Sandoval, Enrico Sultato, Cesare Brigato, Alessandro Candeo, Enrico Brocco, Marco Manzi
BACKGROUND: Stent-based revascularization of long femoro-popliteal (FP) lesions has been mainly studied in claudicants and compromised by restenosis and stent fractures. The Supera(®) stent's biomimetic design allows enhanced fracture resistance. Data for Supera(®) stenting to treat long chronic total occlusions (CTOs) in patients with critical limb ischemia (CLI), are scarce. OBJECTIVE: To assess long-term outcomes of subintimal revascularization with Supera(®) stenting, for long FP CTOs in patients with CLI...
November 12, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27853042/polyarteritis-nodosa-presenting-as-peripheral-vascular-disease-and-acute-limb-ischemia
#9
A Shukla, A Aggarwal
Acute limb ischemia and peripheral vascular disease (PVD) are unusual presentations of polyarteritis nodosa (PAN). Here, we present a case with PVD of both lower limbs leading to foot claudication. Digital subtraction angiography showed narrowing, irregularity, and occlusion of both lower limb arteries with no involvement of the abdomen visceral arteries. Based on significant weight loss, diastolic blood pressure >90 mmHg, myalgia, testicular pain, and angiographic abnormalities in medium-sized arteries, he was diagnosed as having PAN...
November 16, 2016: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/27842952/-acute-arterial-thrombosis-in-a-context-of-hyperhomocysteinemia-case-report-and-literature-review
#10
G Raybaud, M Lambert, C Douillard, A F Dessein, S Morell-Dubois, M Guillou, S Haulon, P-Y Hatron
INTRODUCTION: Hyperhomocysteinemia is a biological marker that could be identified in the venous thrombotic events and rarely during acute arterial thrombotic events. The consequences can be serious. Effective diagnostic strategy is needed to optimize the management. CASE REPORT: Following bariatric surgery, a 40-year-old patient was admitted with an acute encephalopathy associated with peripheral lower limb arterial ischemia. The diagnostic work-up identified a major hyperhomocysteinemia whose causes were several...
November 11, 2016: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/27832292/takayasu-arteritis-ta-first-presenting-with-intestinal-ischemia-a-case-report-and-review-of-gastrointestinal-tract-involvement-ischemic-and-non-ischemic-associated-with-ta
#11
REVIEW
Durga Prasanna Misra, Nagarajan Krishnan, Debasis Gochhait, Dantis Emmanuel, Vir Singh Negi
Takayasu arteritis (TA) is a large vessel vasculitis involving the aorta and its major branches. Insidious inflammation usually results in gradual arterial narrowing; however, critical organ ischemia is rare. We describe a young male with TA who presented with acute mesenteric ischemia requiring intestinal resection, followed by critical limb ischemia. In our literature review, we identified intestinal gangrene as a rare manifestation of TA. However, intestinal ischemia as the first manifestation of TA has been scarcely reported in the literature...
November 10, 2016: Rheumatology International
https://www.readbyqxmd.com/read/27826790/direct-stenting-in-patients-with-acute-lower-limb-arterial-occlusions-immediate-and-long-term-results
#12
Nikolaos Galanakis, Nikolaos Kontopodis, Ioannis Peteinarakis, Elias Kehagias, Christos V Ioannou, Dimitrios Tsetis
PURPOSE: The purpose of this study is to accentuate the efficacy of direct stenting (stent placement without predilatation of the lesion) in patients with acute lower limb arterial ischemia (ALLI). MATERIALS AND METHODS: Between January 2010 and September 2015, 16 patients (11 men and 5 women) underwent direct stenting of acute arterial occlusions. All patients had contraindication for surgical revascularization or catheter-directed thrombolysis. According to SVS/ISCVS Classification, six patients had IIa and ten patients IIb ALLI...
November 8, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27807802/acute-aortic-occlusion-in-a-patient-with-chronic-paralysis-due-to-spinal-cord-injury-a-case-report
#13
Satoshi Yamamoto, Yuriko Yokomizo, Takafumi Akai, Takehiro Chiyoda, Hiroshi Goto, Yukiyoshi Masaki
Patients with spinal cord injury experience changes in the cardiovascular system and a high morbidity associated with peripheral artery disease. We report a case of acute aortic occlusion in a patient with chronic paralysis due to spinal cord injury. A 65-year-old man with chronic paralysis due to spinal cord injury developed mottling of the right extremity. Because of the complete tetraplegia, the patient had no subjective symptoms. Computed tomography revealed occlusion of the infrarenal abdominal aorta. An emergency thromboembolectomy established adequate blood flow, and the postoperative course was uneventful...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27807319/combined-brachial-embolectomy-and-stent-graft-endovascular-exclusion-in-the-treatment-of-acute-arm-ischemia-due-to-subclavian-artery-aneurysms-thrombosis-or-distal-embolization
#14
Andrea Siani, Federico Accrocca, Gennaro De Vivo, Luca Maria Siani, Federica Mounayergi
AIM: Purpose of this study is to report our results after simultaneous transbrachial embolectomy and endovascular aneurysm exclusion with stentgraft in the treatment of upper limb acute ischemia due to subclavian artery aneurysm thrombosis and embolization . METHODS: From January 2010 to December 2015, seven consecutive patients (6 men; mean age 71.5, range 44-85) underwent to emergent revascularization for upper limb ischemia due to thrombosis/embolization of SAA by means of brachial embolectomy and endovascular exclusion...
October 14, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27793619/patterns-in-the-management-of-acute-limb-ischemia-a-vess-survey
#15
Matthew R Smeds, Harleen K Sandhu, Samuel S Leake, Charles C Miller, Kristofer M Charlton-Ouw
BACKGROUND: Treatment strategies for acute limb ischemia (ALI) are abundant with few established guidelines. We sought to determine nationwide ALI treatment patterns in the modern era. METHODS: Anonymous electronic surveys examining the management of ALI involving native vessel and bypass occlusion were sent to all members of the Vascular and Endovascular Surgery Society (n = 738). Treatment options included catheter-directed lysis (CDL) or pharmacomechanical (PMT) thrombolysis and open surgery...
October 26, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27777537/giant-cardiac-lipoma-refined-hypothesis-proposes-invagination-from-extracardiac-to-intracardiac-sites
#16
W Gerald Rainer, David J Bailey, Harris W Hollis
Cardiac lipomas are rare and usually present as benign, encapsulated masses outside the heart; however, they can also be found within the atria. No single theory-including molecular genetic mutation-adequately explains why this occurs. Extensive career experience and broadened knowledge in embryology and cardiac physiology have helped us to develop a hypothesis based on invagination of extracardiac tumors. This report describes a vexing case of a giant right atrial lipoma, from 1985, in which the diagnosis was made incidentally during management of a patient's acute limb ischemia...
October 2016: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/27765312/peripheral-revascularization-in-patients-with%C3%A2-peripheral-artery-disease-with%C3%A2-vorapaxar-insights-from-the-tra-2%C3%A2-p-timi-50-trial
#17
Marc P Bonaca, Mark A Creager, Jeffrey Olin, Benjamin M Scirica, Ian C Gilchrist, Sabina A Murphy, Erica L Goodrich, Eugene Braunwald, David A Morrow
OBJECTIVES: The aim of this study was to determine whether the reduction in peripheral revascularization with vorapaxar in patients with peripheral artery disease (PAD) is directionally consistent across indications, including acute limb ischemia, progressively disabling symptoms, or both. BACKGROUND: The protease-activated receptor-1 antagonist vorapaxar reduces peripheral revascularization in patients with PAD. METHODS: The TRA 2°P-TIMI 50 (Thrombin Receptor Antagonist in Secondary Prevention of Atherothrombotic Ischemic Events-Thrombolysis in Myocardial Infarction 50) trial randomized 26,449 patients with histories of myocardial infarction, stroke, or symptomatic PAD to vorapaxar or placebo on a background of standard therapy...
October 24, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27745943/-prevalence-and-prognosis-of-aspirin-resistance-in-critical-limb-ischemia-patients
#18
J-S Doly, E Lorian, I Desormais, J Constans, A Bura Rivière, P Lacroix
OBJECTIVES: To assess the prevalence and the association between aspirin resistance in critical limb ischemia patients using the VerifyNow(®) bed-side platelet test, and occurrence of cardiovascular morbidity and/or death at one year. MATERIALS AND METHODS: National multicenter prospective observational study related to COPART II centers. From 2010 through 2014, 64 subjects hospitalized for critical limb ischemia and already treated by aspirin before the VerifyNow(®) test were included...
October 13, 2016: Journal des Maladies Vasculaires
https://www.readbyqxmd.com/read/27743809/initial-clinical-experience-with-a-polytetrafluoroethylene-vascular-dialysis-graft-reinforced-with-nitinol-at-the-venous-end
#19
Filippo Benedetto, Domenico Spinelli, Narayana Pipitò, Giambattista Gagliardo, Alberto Noto, Simona Villari, Antonio David, Francesco Spinelli
OBJECTIVE: The purpose of this study was to examine the outcomes of a vascular hybrid polytetrafluoroethylene (PTFE) graft, provided with a nitinol-reinforced section (NRS) on one end, in hemodialysis vascular access placement. METHODS: A retrospective study was conducted including all the consecutive patients who underwent Gore Hybrid Vascular Graft (GHVG; W. L. Gore & Associates, Flagstaff, Ariz) implantation for hemodialysis access placement between October 2013 and November 2015...
October 12, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27734003/essential-thrombocytosis-associated-thromboembolism-in-the-abdominal-aorta
#20
Byung Kwon Chong, Dana Mun, Chae Hoon Kang, Chong-Bin Park, Won Chul Cho
Essential thrombocytosis (ET) is a myeloproliferative disorder characterized by an anomalous increase in platelet production. Many patients with ET are asymptomatic. Few studies have reported ET-associated thromboembolism in large vessels such as the aorta. We report a patient with ET who presented with peripheral embolism from an abdominal aortic thrombus and developed acute limb ischemia. The patient underwent aortic replacement successfully. The patient's platelet count was controlled with hydroxyurea, and no recurrence was noted over 2 years of follow-up...
October 2016: Korean Journal of Thoracic and Cardiovascular Surgery
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