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Acute limb ischemia

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https://www.readbyqxmd.com/read/28811546/serum-derived-extracellular-vesicles-evs-impact-on-vascular-remodeling-and-prevent-muscle-damage-in-acute-hind-limb-ischemia
#1
Claudia Cavallari, Andrea Ranghino, Marta Tapparo, Massimo Cedrino, Federico Figliolini, Cristina Grange, Valentina Giannachi, Paolo Garneri, Maria Chiara Deregibus, Federica Collino, Pietro Rispoli, Giovanni Camussi, Maria Felice Brizzi
Serum is an abundant and accessible source of circulating extracellular vesicles (EVs). Serum-EV (sEV) pro-angiogenic capability and mechanisms are herein analyzed using an in vitro assay which predicts sEV angiogenic potential in vivo. Effective sEVs (e-sEVs) also improved vascular remodeling and prevented muscle damage in a mouse model of acute hind limb ischemia. e-sEV angiogenic proteomic and transcriptomic analyses show a positive correlation with matrix-metalloproteinase activation and extracellular matrix organization, cytokine and chemokine signaling pathways, Insulin-like Growth Factor and platelet pathways, and Vascular Endothelial Growth Factor signaling...
August 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28810647/limb-graft-occlusion-following-endovascular-aortic-repair-incidence-causes-treatment-and-prevention-in-a-study-cohort
#2
Guoquan Wang, Shuiting Zhai, Tianxiao Li, Xuan Li, Danghui Lu, Bo Wang, Dongbin Zhang, Shuaitao Shi, Zhidong Zhang, Kai Liang, Kewei Zhang, Xiaoyang Fu, Kun Li, Weixiao Li
The present study investigated the incidence, causes, treatment and prevention of limb graft occlusion following endovascular aortic repair (EVAR). A total of 66 cases of abdominal aortic aneurysm receiving EVAR at our department from January 2005 to December 2013 were enrolled. After EVAR, patients received routine antiplatelet therapy of 75 mg PLAVIX for 6 months and then 100 mg Aspirin for another 6 months by oral administration. According to previous clinical experiences, antiplatelet therapy is able to effectively reduce the incidence of iliac occlusion after EVAR...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28810573/warfarin-induced-life-threatening-bleeding-associated-with-a-cyp3a4-loss-of-function-mutation-in-an-acute-limb-ischemia-patient-case-report-and-review-of-the-literature
#3
Xiao-Wei Ma, Chang-Ning Hao, Zhi-Chun Gu, Meng Ye, Min Li, Lan Zhang
Patients with acute limb ischemia, deep venous thrombosis and pulmonary artery embolism may be treated with warfarin. The dose-response interaction of warfarin is associated with numerous factors, depending on which an uncommon life-threatening bleeding may occur. The present case study reported on a patient with acute limb ischemia and a history of warfarin-induced bleeding ten years previously and who again developed life threatening bleeding associated with warfarin treatment and received vascular surgery...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28806175/point-of-care-ultrasound-facilitated-detection-of-femoral-occlusive-septic-emboli-during-mitral-valve-surgery-a-case-report
#4
Melissa L Bellomy, Susan Eagle, Mias Pretorius, Ben R Barton, Yafen Liang
Acute lower extremity ischemia from septic emboli is a surgical emergency. Timely diagnosis and management are critical to improve patient outcome. However, traditional diagnostic modalities such as intraoperative angiogram are time-consuming, require special equipment and personnel, and introduce contrast exposure for critically ill patients. There are limited reports of utilization of point-of-care ultrasound to detect peripheral septic emboli. We present a case where femoral occlusive septic emboli were identified by point-of-care ultrasound after mitral valve replacement...
August 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28798201/remote-ischemic-preconditioning-does-not-prevent-acute-mountain-sickness-after-rapid-ascent-to-3450-m
#5
Marc M Berger, Franziska Macholz, Lukas Lehmann, Daniel Dankl, Marcel Hochreiter, Bernhard Bacher, Peter Bärtsch, Heimo Mairbäurl
Remote ischemic preconditioning (RIPC) has been shown to protect remote organs, such as the brain and the lung, from damage induced by subsequent hypoxia or ischemia. Acute mountain sickness (AMS) is a syndrome of non-specific neurologic symptoms and in high altitude pulmonary edema excessive hypoxic pulmonary vasoconstriction (HPV) plays a pivotal role. We hypothesized that RIPC protects the brain from AMS and attenuates the magnitude of HPV after rapid ascent to 3450 m. Forty non-acclimatized volunteers were randomized into 2 groups...
August 10, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28781880/acute-aortic-occlusion-due-to-tumor-embolism-in-a-patient-with-lung-malignancy
#6
Stella Lioudaki, Nikolaos Kontopodis, Stefanos Palioudakis, Anastasios V Koutsopoulos, Ioannis Drositis, Christos V Ioannou
OBJECTIVES: Acute lower limb ischemia caused by tumor embolization is rare, despite the fact that cancer is a common cause of hypercoagulability predisposing to venous thrombosis. Arterial embolization is mostly associated with intracardiac tumors while lung malignancies are the second most common cause of tumor embolism. METHODS: In this report, we present a male patient who developed acute bilateral lower limb ischemia in the immediate postoperative period after a thoracotomy for attempted left upper lobe resection for lung cancer...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28764607/recycling-and-reinforcing-intimomedial-flap-of-the-infrarenal-aorta-using-anterior-longitudinal-ligament-in-patients-with-acute-trauma-with-bowel-injuries
#7
Milan Jovanovic, Milan Radojkovic, Predrag Djordjevic, Dejan Rancic, Nemanja Jovanovic, Zoran Rancic
We present a patient with blunt abdominal trauma with severe acute right limb ischemia and clinical signs of diffuse peritonitis. Computed tomography angiography showed circumferential dissection of the infrarenal aorta with occlusion of the right common iliac artery. We opted for simultaneous abdomen exploration and open repair of injured aorta. Critical weakening of the aortic wall with imminent rupture was identified intraoperatively. Aortotomy cranially from bifurcation showed circumferential intimomedial dissection...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28762154/the-aortic-bifurcation-angle-as-a-factor-in-application-of-the-outback-for-femoropopliteal-lesions-in-ipsilateral-versus-contralateral-approaches
#8
Daniel Raskin, Boris Khaitovich, Shmuel Balan, Daniel Silverberg, Moshe Halak, Uri Rimon
PURPOSE: To assess the technical success of the Outback reentry device in contralateral versus ipsilateral approaches for femoropopliteal arterial occlusion. MATERIALS AND METHODS: A retrospective review of patients treated for critical limb ischemia (CLI) using the Outback between January 2013 and July 2016 was performed. Age, gender, length and site of the occlusion, approach site, aortic bifurcation angle, and reentry site were recorded. Calcification score was assigned at both aortic bifurcation and reentry site...
July 31, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28758761/-malignant-fibrous-histiocytoma-as-a-rare-cause-of-acute-limb-ischemia
#9
J Pobehová, M Zavacká, P Závacký, P Pobeha, M Koščo, M Frankovičová
Malignant fibrous histiocytoma (MFH) represents a rare malignant affection of heart and aorta. Its clinical presentation depends on the localisation, size, degree of invasion and metastasis. Previously, relatively few cases of acute tumour mass embolisation into the visceral and limb arterial system were described in the literature. In the present case study we describe a case of acute ischemia of both lower extremities caused by thromboembolic mass of MFH cells. According to literary sources this tumour type is characterized by poor prognosis as it was in the case of our patient...
2017: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
https://www.readbyqxmd.com/read/28753228/use-of-arterialized-saphenous-vein-venous-flow-through-flaps-as-a-temporizing-measure-for-hand-salvage-in-contaminated-wounds-presenting-with-limb-ischemia-a-case-series
#10
Julian Diaz-Abele, Bauback Safa, Rudolf F Buntic, Avinash Islur
BACKGROUND: Vascular injuries resulting in limb ischemia are traditionally treated acutely with autologous or prosthetic bypass grafts. Traumatic contaminated injuries with soft tissue and vascular segmental loss are challenging as prosthetic bypasses are at risk of erosion, infection, and occlusion; and autologous bypasses are at risk of desiccation, blow-out, infection, and clotting. We propose a novel approach to these injuries by using arterialized saphenous vein venous flow-through free flaps (S-VFTF) as an autologous bypass, and present the results of its application in a series of cases...
July 28, 2017: Microsurgery
https://www.readbyqxmd.com/read/28747047/novel-approach-in-using-ultrasound-in-treating-acute-limb-ischemia
#11
Michael H Wholey, Raul G Palacios, Alejandro Mendez-Castillo, Lori C Pounds
BACKGROUND: It is imperative to gain safe access into the occluded targeted vessel and begin treating acute extremity limb ischemia. Often the origin of the targeted native artery or bypass graft will have a flush occlusion making it difficult to cannulate. This paper looks at the novel use of portable ultrasound to evaluate the origin of the artery or bypass graft to help facilitate the start of thrombolysis. METHODS: We reviewed our last 2 years of acute limb ischemia in our patients with high risk factors and co-morbidities...
July 26, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28739471/comparison-of-low-dose-catheter-directed-thrombolysis-with-and-without-pharmacomechanical-thrombectomy-for-acute-lower-extremity-ischemia
#12
Sagar S Gandhi, Joseph A Ewing, Emily Cooper, Jose Mauro Chaves, Bruce H Gray
INTRODUCTION: Catheter directed thrombolysis (CDT) and/or pharmacomechanical thrombectomy (PMT) can dissolve/remove thrombus; PMT alone, however, may require the adjunctive use of CDT. The aim of this study was to compare the use of CDT with and without PMT for the treatment of acute limb ischemia (ALI). METHODS: We retrospectively reviewed all patients with ALI who underwent CDT with or without PMT between January 2008 and April 2014 (N=99). Patients with incomplete medical charts were excluded (n=16)...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28739456/acute-type-b-dissection-causing-collapse-of-evar-endograft-and-iliac-limb-occlusion
#13
Nathan K Itoga, Tiffany Wu, Michael D Dake, Ronald L Dalman, Jason T Lee
We describe a rare case of acute type B dissection causing collapse of a previously placed infrarenal stent-graft, resulting in acute limb ischemia due to left iliac limb thrombosis in a 59-year-old male. The patient presented with acute back and abdominal discomfort radiating to his back, bilateral buttock stabbing discomfort, and left> right thigh and calf rest pain. CTA showed a spiral type B dissection with collapse of the proximal portion of the EVAR device and left limb occlusion. Urgent treatment with TEVAR distal to the left subclavian covered the entry tear and redirected the majority of the flow to the true lumen leading to near immediate expansion of the proximal portion of the EVAR device...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28721011/effect-of-picroside-ii-on-hind-limb-ischemia-reperfusion-injury-in-rats
#14
Yiğit Kılıç, Abdullah Özer, Tolga Tatar, Mustafa Hakan Zor, Mehmet Kirişçi, Hakan Kartal, Ali Doğan Dursun, Deniz Billur, Mustafa Arslan, Ayşegül Küçük
INTRODUCTION: Many structural and functional damages are observed in cells and tissues after reperfusion of previously viable ischemic tissues. Acute ischemia reperfusion (I/R) injury of lower extremities occurs especially when a temporary cross-clamp is applied to the abdominal aorta during aortic surgery. Research regarding the treatment of I/R injury has been increasing day-by-day. In this study, we aimed to investigate the effect of picroside II on skeletal muscle of rats experiencing simulated I/R...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28699679/one-session-of-remote-ischemic-preconditioning-does-not-improve-vascular-function-in-acute-normobaric-and-chronic-hypobaric-hypoxia
#15
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
#16
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
#17
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
#18
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
#19
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...
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
#20
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
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