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https://www.readbyqxmd.com/read/28642793/repair-of-thoracoabdominal-aortic-aneurysm-with-thrombosed-infrarenal-component-a-modified-hybrid-technique-without-aortic-cross-clamping
#1
Hussam Abou-Al-Shaar, Khaled J Zaza, Muhammad Anees Sharif, Samer Koussayer
The authors report the successful repair of a Crawford type III thoracoabdominal aortic aneurysm (TAAA) with a thrombosed infrarenal component using a modified hybrid technique without aortic clamping in a high-risk patient. A 64-year-old male with a history of hypertension, diabetes, and severe chronic obstructive pulmonary disease presented with acute on chronic backache and bilateral short distance claudication. A computerized tomography scan demonstrated a large, nonleaking Crawford type III TAAA with thrombosed infrarenal component of the aneurysm...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28642065/severe-and-resistant-hypertension-in-an-older-woman-with-claudication
#2
Puneet Gupta, Robert Hagberg, Electra Kaloudis, Anika Lucas, Parth Shah, William B White
Coarctation of the aorta is an uncommon cause of treatment-resistant hypertension in adults. It is typically detected and treated in infancy or childhood with surgical or endovascular procedures. Most cases of recurrence of coarctation after repair occur in childhood or early adulthood; recurrence in older persons (>70 years) has rarely been reported. A 73-year-old woman was referred to us for the management of treatment-resistant hypertension accompanied by symptoms of claudication and headaches, which had resulted in multiple emergency room visits...
June 1, 2017: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/28640077/improvement-of-peripheral-artery-disease-with-sildenafil-and-bosentan-combined-therapy-in-a-patient-with-limited-cutaneous-systemic-sclerosis-a-case-report
#3
Loukman Omarjee, Cedric Fontaine, Guillaume Mahe, Vincent Jaquinandi
RATIONALE: Sildenafil, a phosphodiesterase-5-inhibitor and Bosentan, an endothelin-1-receptor antagonist combined therapy could have beneficial effect in systemic sclerosis (SSc) patients with peripheral artery disease. PATIENT CONCERNS: We report a case of a 48-year-old Black woman, who developed severe left limb claudication and walking limitation following a left femoropopliteal bypass occlusion in 2014. She was a heavy smoker and had a history of right middle cerebral artery ischemic stroke and bilateral Raynaud phenomenon...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28638968/-large-vessel-vasculitis-giant-cell-arteritis-and-takayasu-arteritis
#4
P M Villiger
According to the Chapel Hill Classification, large vessel vasculitides encompass giant cell arteritis (GCA) and the histologically related Takakaysu arteritis (TAK). The two diseases lack autoantibodies and present with a systemic inflammatory response. GCA typically shows a sudden onset with profound sickness, loss of appetite and of body weight, and temporal headache. Due to the substantial risk of sudden blindness, diagnostic work-up has to be performed immediately and treatment started without delay. A close association between polymyalgia rheumatica (PMR) and GCA is well established...
June 21, 2017: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/28630267/a-structured-review-of-antithrombotic-therapy-in-peripheral-artery-disease-with-a-focus-on-revascularization-a-tasc-intersociety-consensus-for-the-management-of-peripheral-artery-disease-initiative
#5
REVIEW
Connie N Hess, Lars Norgren, Gary M Ansel, Warren H Capell, John P Fletcher, F Gerry R Fowkes, Anders Gottsäter, Kerry Hitos, Michael R Jaff, Joakim Nordanstig, William R Hiatt
Peripheral artery disease affects >200 million people worldwide and is associated with significant limb and cardiovascular morbidity and mortality. Limb revascularization is recommended to improve function and quality of life for symptomatic patients with peripheral artery disease with intermittent claudication who have not responded to medical treatment. For patients with critical limb ischemia, the goals of revascularization are to relieve pain, help wound healing, and prevent limb loss. The baseline risk of cardiovascular and limb-related events demonstrated among patients with stable peripheral artery disease is elevated after revascularization and related to atherothrombosis and restenosis...
June 20, 2017: Circulation
https://www.readbyqxmd.com/read/28629476/stromal-vascular-fraction-cells-for-the-treatment-of-critical-limb-ischemia-a-pilot-study
#6
Adas Darinskas, Mindaugas Paskevicius, Gintaras Apanavicius, Gintaris Vilkevicius, Liutauras Labanauskas, Thomas E Ichim, Rytis Rimdeika
BACKGROUND: Cell-based therapy is being explored as an alternative treatment option for critical limb ischemia (CLI), a disease associated with high amputation and mortality rates and poor quality of life. However, therapeutic potential of uncultured adipose-derived stromal vascular fraction (SVF) cells has not been evaluated as a possible treatment. In this pilot study, we investigated the efficacy of multiple injections of autologous uncultured adipose-derived SVF cells to treat patients with CLI...
June 19, 2017: Journal of Translational Medicine
https://www.readbyqxmd.com/read/28625669/role-of-language-discordance-in-complication-and-readmission-rate-after-infrainguinal-bypass
#7
Elica Inagaki, Alik Farber, Jeffrey Kalish, Jeffrey J Siracuse, Clara Zhu, Denis V Rybin, Gheorghe Doros, Mohammad H Eslami
OBJECTIVE: Studies have shown that language discordance between treatment teams and patients leads to worse patient outcomes, including longer hospital stays, higher rates of readmission, impaired comprehension of discharge instructions, and lower treatment adherence. Yet, there is a paucity of data evaluating the effects of language discordance on postoperative outcomes among vascular surgery patients. This study compared 30-day postoperative complications and readmissions after nonemergent infrainguinal bypass between non-English-speaking (NES) and English-speaking (ES) patients...
June 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28622743/endovascular-treatment-for-chronic-lower-extremity-ischaemia-with-sub-acute-deterioration
#8
Liangxi Yuan, Songlin Guo, Jian Dong, Jian Zhou, Qingsheng Lu, Junmin Bao, Zaiping Jing
OBJECTIVES: The purpose of this study is to report the efficacy of endovascular treatment for patients with sub-acute (14-day to 2-month) deterioration of chronic lower extremity ischaemia. MATERIALS AND METHODS: Between June 2013 and May 2015, 26 consecutive patients (22 men, 4 women; mean age, 68.6 years; range, 50-86 years) were treated for sub-acute deterioration of chronic lower extremity ischaemia in our hospital. All patients were treated with catheter-directed thrombolysis initially and then adjunctive percutaneous transluminal angioplasty and/or stenting was performed to correct underlying lesions...
July 2017: Diabetes & Vascular Disease Research
https://www.readbyqxmd.com/read/28620055/the-effects-of-rsr13-on-microvascular-po2-kinetics-and-muscle-contractile-performance-in-the-rat-arterial-ligation-model-of-peripheral-arterial-disease
#9
Aiko Watanabe, David C Poole, Yutaka Kano
Exercise intolerance and claudication are symptomatic of peripheral arterial disease. There is a close relationship between muscle O2 delivery, microvascular oxygen partial pressure (PmvO2) and contractile performance. We therefore hypothesized that a reduction of hemoglobin-oxygen affinity via RSR13 would maintain a higher PmvO2 and enhance blood-muscle O2 transport and contractile function. In male Wistar rats we created hindlimb ischemia via right side iliac artery ligation (AL). The contralateral (left) muscle served as control (CONT)...
June 15, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28618851/crush-deformation-of-a-balloon-expandable-stent-implanted-in-an-infrainguinal-bypass-graft
#10
Nida Ahmed, Rym El-Khoury, Moustafa N Sabri, John V White, Chad E Jacobs, Lewis B Schwartz
A 59-year-old man with critical claudication underwent left femoro-anterior bypass grafting, which was uneventful. The graft was tunneled medially across the knee, then anterior to the tibia. His symptoms recurred 1 year later and he was found to have critical stenosis of the vein graft just proximal to the anterior tibial arterial anastomosis. This was treated with scaffolded balloon angioplasty and implantation of a coronary, zotarolimus-eluting balloon-expandable stent, which was also uneventful. However, his claudication again recurred 1 year later...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28612417/length-and-pressure-matter-expediting-evidence-based-progress-in-femoropoliteal-intervention
#11
EDITORIAL
Arka Chatterjee, William B Hillegass
Preprocedural lesion length and ankle-brachial indices (ABI) synergistically predict 12-month patency and repeat revacularization in claudicants treated with bare metal nitinol stents for femoropopliteal disease. This predictive length-ABI model will permit broader evidence-based indirect comparisons of newer femoropopliteal approaches such as drug eluting balloon treatment with or without atherectomy. The length-ABI model is a step to supplement and supplant randomized controlled trials with indirect comparisons as the necessary evidence source expediting innovation and optimizing personalized endovascular therapy for infrainguinal obstructive peripheral arterial disease...
June 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28612128/-vascular-diagnostics-in-peripheral-arteries
#12
REVIEW
C Espinola-Klein, G Weißer
Peripheral artery disease (PAD) is the most frequent cause for reduced perfusion in peripheral arteries. Patients with PAD have often manifestations of atherosclerosis in other vascular territories. Typical symptoms are intermittent claudication or rest pain and acral lesions in patients with critical limb ischemia. The majority of PAD patients are clinically asymptomatic; therefore, it makes sense to screen for PAD in patients with cardiovascular risk factors. The ankle brachial index (ABI) is regarded as an easy and cost-effective method for baseline diagnostics...
June 13, 2017: Der Internist
https://www.readbyqxmd.com/read/28604581/vascular-tos-creating-a-protocol-and-sticking-to-it
#13
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/28602902/case-report-a-durable-open-repair-of-a-rare-profunda-aneurysm
#14
Pouria Parsa, Anthony Rios, Kristha Cantu, John Eidt, Dennis Gable, Gregory Pearl
Profunda femoris artery aneurysms (PFAAs) are rare and difficult to diagnose in the early stages of development due to location and encasement in the deep thigh musculature. We report the case of a 74-year-old male who was discovered to have a right PFAA during evaluation for progressively worsening short distance claudication. He had undergone an angioplasty of the left iliofemoral system several months ago with no improvement of his symptoms. The PFAA was diagnosed through CT angiography and repaired via syndactylization of profunda femoris branches and interposition grafting with a polytetrafluoroethylene stretch graft...
June 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28602895/risk-factors-for-sub-optimal-utilization-of-statins-and-antiplatelet-therapy-in-patients-undergoing-revascularization-for-symptomatic-peripheral-arterial-disease
#15
Andrew J Meltzer, Art Sedrakyan, Peter H Connolly, Sharif Ellozy, Darren B Schneider
OBJECTIVE: The objective of this study is to identify risk factors for sub-optimal medical therapy (defined as reported antiplatelet and statin use) among patients undergoing lower extremity bypass (LEB) and percutaneous interventions (PVI) for symptomatic peripheral arterial disease (PAD). METHODS: The Vascular Study Group of Greater New York (VSGGNY) database was used to identify all patients undergoing PVI or LEB for PAD (2011-2013). Bivariate analyses were performed to identifycharacteristics of patients who were not prescribed statins and/or antiplatelet agents prior to revascularization...
June 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28601316/oral-administration-of-cilostazol-improves-survival-rate-after-rat-liver-ischemia-reperfusion-injury
#16
Taku Fujii, Hideaki Obara, Kentaro Matsubara, Naoki Fujimura, Hiroshi Yagi, Taizo Hibi, Yuta Abe, Minoru Kitago, Masahiro Shinoda, Osamu Itano, Minoru Tanabe, Yohei Masugi, Michiie Sakamoto, Yuko Kitagawa
BACKGROUND: Cilostazol is a type III phosphodiesterase inhibitor used to treat the symptoms of intermittent claudication. Recent studies have shown that cilostazol decreases ischemia/reperfusion (I/R) injury in several organs. MATERIALS AND METHODS: We evaluated the effects of cilostazol in a rat model of liver I/R injury. Thirty male Wistar rats with liver I/R injury were divided into a cilostazol or saline (control) group (n = 15 each). Each rat was orally administered cilostazol or saline for 3 d before I/R injury...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28600006/is-there-still-a-role-for-interspinous-spacers-in-the-management-of-neurogenic-claudication
#17
REVIEW
Vijay M Ravindra, Zoher Ghogawala
Lumbar spinal stenosis with neurogenic claudication is prevalent in the elderly population. Decompression for this condition is the operation most commonly used to treat older patients. Because of the risks associated with open decompression procedures, particularly in older patients with comorbidities, minimally invasive procedures with implantation of interspinous process devices have been developed. This article reviews the current role of interspinous spacers in the treatment of lumbar spinal stenosis with neurogenic claudication and discusses the body of literature surrounding this treatment alternative...
July 2017: Neurosurgery Clinics of North America
https://www.readbyqxmd.com/read/28599258/prognostic-impact-of-subclinical-or-manifest-extracoronary-artery-diseases-after-acute-myocardial-infarction
#18
Maja Eriksson Östman, Fredrik Calais, Andreas Rosenblad, Ole Fröbert, Jerzy Leppert, Pär Hedberg
BACKGROUND AND AIMS: In patients with coronary artery disease (CAD), clinically overt extracoronary artery diseases (ECADs), including claudication or previous strokes, are associated with poor outcomes. Subclinical ECADs detected by screening are common among such patients. We aimed to evaluate the prognostic impact of subclinical versus symptomatic ECADs in patients with acute myocardial infarction (AMI). METHODS: In a prospective observational study, 654 consecutive patients diagnosed with AMI underwent ankle brachial index (ABI) measurements and ultrasonographic screening of the carotid arteries and abdominal aorta...
May 26, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28598295/pelvic-retroversion-a-compensatory-mechanism-for-lumbar-stenosis
#19
Sina Pourtaheri, Akshay Sharma, Jason Savage, Iain Kalfas, Thomas E Mroz, Edward Benzel, Michael P Steinmetz
OBJECTIVE The flexed posture of the proximal (L1-3) or distal (L4-S1) lumbar spine increases the diameter of the spinal canal and neuroforamina and can relieve symptoms of neurogenic claudication. Distal lumbar flexion can result in pelvic retroversion; therefore, in cases of flexible sagittal imbalance, pelvic retroversion may be compensatory for lumbar stenosis and not solely compensatory for the sagittal imbalance as previously thought. The authors investigate underlying causes for pelvic retroversion in patients with flexible sagittal imbalance...
June 9, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28597323/stent-induced-flow-disturbances-in-the-ipsilateral-external-carotid-artery-following-internal-carotid-artery-stenting-a%C3%A2-temporary-cause-of-jaw-claudication
#20
Georgiana-Aura Giurgea, Markus Haumer, Irene Mlekusch, Schila Sabeti-Sandor, Petra Dick, Martin Schillinger, Erich Minar, Wolfgang Mlekusch
BACKGROUND: We hypothesize that stenting of the internal carotid artery can immediately impede blood flow to the external carotid artery by either plaque shift or stent coverage of the ostium, and thereby cause ischemic symptoms like ipsilateral jaw claudication. METHODS: Thirty-three patients with high-grade asymptomatic stenosis of the internal carotid artery who underwent endovascular treatment were examined by ultrasound of the external carotid artery and performed an exercise test by chewing chewing gum synchronously to an electronic metronome for 3 min...
June 9, 2017: Wiener Klinische Wochenschrift
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