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Critical ischaemia

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https://www.readbyqxmd.com/read/28224105/nutrient-stimulation-of-mesenteric-blood-flow-implications-for-older-critically-ill-patients
#1
REVIEW
Thu An Nguyen, Yasmine Ali Abdelhamid, Liza K Phillips, Leeanne S Chapple, Michael Horowitz, Karen L Jones, Adam M Deane
Nutrient ingestion induces a substantial increase in mesenteric blood flow. In older persons (aged ≥ 65 years), particularly those with chronic medical conditions, the cardiovascular compensatory response may be inadequate to maintain systemic blood pressure during mesenteric blood pooling, leading to postprandial hypotension. In older ambulatory persons, postprandial hypotension is an important pathophysiological condition associated with an increased propensity for syncope, falls, coronary vascular events, stroke and death...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28218306/plin5-alleviates-myocardial-ischaemia-reperfusion-injury-by-reducing-oxidative-stress-through-inhibiting-the-lipolysis-of-lipid-droplets
#2
Pengfei Zheng, Zhonglin Xie, Yuan Yuan, Wen Sui, Chao Wang, Xing Gao, Yuanlin Zhao, Feng Zhang, Yu Gu, Peizhen Hu, Jing Ye, Xuyang Feng, Lijun Zhang
Myocardial ischaemia-reperfusion (I/R) injury is a complex pathophysiological process. Current research has suggested that energy metabolism disorders, of which the abnormal consumption of fatty acids is closely related, compose the main pathological basis for myocardial I/R injury. Lipid droplets (LD) are critical regulators of lipid metabolism by LD-associated proteins. Among the lipid droplet proteins, the perilipin family members regulate lipolysis and lipogenesis through different mechanisms. Plin5, an important perilipin protein, promotes LD generation and lowers fatty acid oxidation, thus protecting the myocardium from lipotoxicity...
February 20, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28215512/angiosome-targeted-pta-is-more-important-in-endovascular-revascularisation-than-in-surgical-revascularisation-analysis-of-545-patients-with-ischaemic-tissue-lesions
#3
K Špillerová, N Settembre, F Biancari, A Albäck, M Venermo
INTRODUCTION: This study aimed to evaluate the impact of angiosome targeted (direct) revascularisation according to revascularisation method in patients with diabetes. MATERIALS AND METHODS: This retrospective study cohort comprised 545 diabetic patients with critical limb ischaemia and tissue loss (Rutherford 5, 6). All patients underwent infrapopliteal endovascular (PTA) or open surgical revascularisation between January 2008 and December 2013. Differences in the outcome after direct revascularisation, bypass surgery, and PTA were investigated by means of Cox proportional hazards analysis...
February 16, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28168570/early-enteral-nutrition-in-critically-ill-patients-esicm-clinical-practice-guidelines
#4
REVIEW
Annika Reintam Blaser, Joel Starkopf, Waleed Alhazzani, Mette M Berger, Michael P Casaer, Adam M Deane, Sonja Fruhwald, Michael Hiesmayr, Carole Ichai, Stephan M Jakob, Cecilia I Loudet, Manu L N G Malbrain, Juan C Montejo González, Catherine Paugam-Burtz, Martijn Poeze, Jean-Charles Preiser, Pierre Singer, Arthur R H van Zanten, Jan De Waele, Julia Wendon, Jan Wernerman, Tony Whitehouse, Alexander Wilmer, Heleen M Oudemans-van Straaten
PURPOSE: To provide evidence-based guidelines for early enteral nutrition (EEN) during critical illness. METHODS: We aimed to compare EEN vs. early parenteral nutrition (PN) and vs. delayed EN. We defined "early" EN as EN started within 48 h independent of type or amount. We listed, a priori, conditions in which EN is often delayed, and performed systematic reviews in 24 such subtopics. If sufficient evidence was available, we performed meta-analyses; if not, we qualitatively summarized the evidence and based our recommendations on expert opinion...
February 6, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28131538/dual-antiplatelet-therapy-safe-but-still-unsettled-for-endovascular-femoropopliteal-stenting-commentary-on-dual-antiplatelet-therapy-improves-outcome-in-diabetic-patients-undergoing-endovascular-femoropopliteal-stenting-for-critical-limb-ischaemia
#5
https://www.readbyqxmd.com/read/28131536/dual-antiplatelet-therapy-improves-outcome-in-diabetic-patients-undergoing-endovascular-femoropopliteal-stenting-for-critical-limb-ischaemia
#6
O Thott, F Granath, J Malmstedt, C-M Wahlgren
OBJECTIVE: The purpose of this study was to analyse the effect of dual antiplatelet therapy (DAPT) compared to aspirin on outcome after endovascular interventions in patients with CLI. METHODS: This was a population based retrospective nationwide cohort analysis. Several linked national databases in Sweden: Swedish National Vascular Registry, Prescribed Drug Registry and National Discharge Registry. A total of 1941 patients (median age 79; range 43-103 years; women 58%) were identified with CLI who had undergone primary femoropopliteal endovascular intervention between 2006 and 2012...
January 25, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28128018/german-guideline-on-the-diagnosis-and-treatment-of-peripheral-artery-disease-a-comprehensive-update-2016
#7
Holger Lawall, Peter Huppert, Christine Espinola-Klein, Claudia Silke Zemmrich, Gerhard Ruemenapf
The prevalence of peripheral artery disease (PAD) is increasing worldwide and is strongly age-related, affecting about 20 % of Germans over 70 years of age. Recent advances in endovascular and surgical techniques as well as clinical study results on comparative treatment methods strengthened the need for a comprehensive review of the published evidence for diagnosis, management, and prevention of PAD. The interdisciplinary guideline exclusively covers distal aorta and atherosclerotic lower extremity artery disease...
January 27, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28116780/r1-autonomic-nervous-system-in-acute-kidney-injury
#8
REVIEW
Dagmara Hering, Pawel J Winklewski
Acute kidney injury (AKI) is a rapid loss of kidney function resulting in accumulation of end metabolic products and associated abnormalities in fluid, electrolyte and acid-base homeostasis. The pathophysiology of AKI is complex and multifactorial involving numerous vascular, tubular and inflammatory pathways. Neurohumoral activation with heightened activity of the sympathetic nervous system and renin-angiotensin-aldosterone system play a critical role in this scenario. Inflammation and/or local renal ischaemia are underlying mechanisms triggering renal tissue hypoxia and resultant renal microcirculation dysfunction; a common feature of AKI occurring in numerous clinical conditions leading to a high morbidity and mortality rate...
February 2017: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/28089406/intervention-should-not-be-the-thermopylae-to-avoid-amputation-commentary-on-not-all-patients-with-critical-limb-ischaemia-require-revascularisation
#9
EDITORIAL
M A Cairols
No abstract text is available yet for this article.
January 12, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28069703/loss-of-osteoglycin-promotes-angiogenesis-in-limb-ischaemia-mouse-models-via-modulation-of-vascular-endothelial-growth-factor-and-vascular-endothelial-growth-factor-receptor-2-signalling-pathway
#10
Qi-Hong Wu, Yu Ma, Cheng-Chao Ruan, Yan Yang, Xin-He Liu, Qian Ge, Ling-Ran Kong, Ji-Wei Zhang, Chen Yan, Ping-Jin Gao
OBJECTIVE: Osteoglycin (OGN) has been noted for its implication in cardiovascular disease in recent studies. However, the relationship between OGN and angiogenesis remains unknown. Therefore, we aimed to investigate the effect of OGN on ischaemia-induced angiogenesis and to address the underlying mechanisms. METHODS AND RESULTS: The expression of OGN was decreased in a limb ischaemia mouse model. OGN knockout (KO) mice were used to further understand the role of OGN after ischaemia...
January 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28065441/clinimetric-evaluation-of-the-vascular-quality-of-life-questionnaire-in-patients-with-lower-limb-ischaemia
#11
A P Conijn, T B K Santema, S Bipat, M J W Koelemay, R J de Haan
OBJECTIVES: Although commonly used to measure health related quality of life in patients with lower limb ischaemia, the measurement properties of the VascuQol and its assumed underlying health dimensions have not been studied in depth. The objective of this study was therefore to evaluate aspects of reliability and validity of the Dutch version of the VascuQol in patients with intermittent claudication (IC) and critical limb ischaemia (CLI). METHODS: Two datasets containing 195 patients with IC and 150 patients with CLI were used...
January 4, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28049018/transactivation-of-the-epidermal-growth-factor-receptor-in-responses-to-myocardial-stress-and-cardioprotection
#12
REVIEW
Melissa E Reichelt, Shannon O'Brien, Walter G Thomas, John P Headrick
The epidermal growth factor receptor (EGFR) family comprises the ErbB1 (EGFR) and ErbB4 receptors as well as the 'co-receptors' ErbB2 (which does not bind EGF ligands) and ErbB3 (which lack tyrosine kinase activity). This family of receptors is essential for cardiac development, myocardial, renal and vascular function, and cardiac responses to physiological and pathological perturbations. The EGFR appears critical in protecting cardiac cells from injury, while considerable attention has focussed on neuregulin/ErbB4 signalling in potentially ameliorating cardiomyopathy/heart failure...
December 31, 2016: International Journal of Biochemistry & Cell Biology
https://www.readbyqxmd.com/read/28027892/venous-arterialisation-for-salvage-of-critically-ischaemic-limbs-a-systematic-review-and-meta-analysis
#13
REVIEW
M A Schreve, C G Vos, A C Vahl, J P P M de Vries, S Kum, G J de Borst, Ç Ünlü
BACKGROUND: Critical limb ischaemia (CLI) is the end stage of peripheral artery disease (PAD) and is associated with high amputation and mortality rates and poor quality of life. For CLI patients with no revascularisation options, venous arterialisation could be a last resort for limb salvage. OBJECTIVE: To review the literature on the clinical effectiveness of venous arterialisation for lower limb salvage in CLI patients with no revascularisation options. METHOD: Different databases were searched for papers published between January 1966 and January 2016...
December 24, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28006953/lymphocyte-communication-in-myocardial-ischemia-reperfusion-injury
#14
Stephen E Boag, Emanuele Andreano, Ioakim Spyridopoulos
SIGNIFICANCE: Myocardial ischaemia/reperfusion (I/R) is an important complication of reperfusion therapy for myocardial infarction. It is a complex process involving metabolic and immunological factors. To date no effective treatment has been identified. Recent Advances: Previous research has focused on the role of innate immune cells in I/R injury. In recent years increasing evidence has accumulated for an important role for adaptive immune cells, particularly T lymphocytes. Data from ST elevation myocardial infarction (STEMI) patients has identified prognostic significance for lymphocyte counts, particularly post-reperfusion lymphopenia...
December 23, 2016: Antioxidants & Redox Signaling
https://www.readbyqxmd.com/read/27991651/oxygen-therapy-for-acute-myocardial-infarction
#15
REVIEW
Juan B Cabello, Amanda Burls, José I Emparanza, Susan E Bayliss, Tom Quinn
BACKGROUND: Oxygen (O2) is widely used in people with acute myocardial infarction (AMI). Previous systematic reviews concluded that there was insufficient evidence to know whether oxygen reduced, increased or had no effect on heart ischaemia or infarct size. Our first Cochrane review in 2010 also concluded there was insufficient evidence to know whether oxygen should be used. Since 2010, the lack of evidence to support this widely used intervention has attracted considerable attention, prompting further trials of oxygen therapy in myocardial infarction patients...
19, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27959471/lumbar-sympathectomy-techniques-for-critical-lower-limb-ischaemia-due-to-non-reconstructable-peripheral-arterial-disease
#16
REVIEW
Veena Kl Karanth, Tulasi Kota Karanth, Laxminarayan Karanth
BACKGROUND: Critical lower limb ischaemia (CLI) is a manifestation of peripheral arterial disease (PAD) that is seen in patients with typical chronic ischaemic rest pain or patients with ischaemic skin lesions - ulcers or gangrene - for longer than 2 weeks. Critical lower limb ischaemia is the most severe form of PAD, and interventions to improve arterial perfusion become necessary. Although surgical bypass has been the gold standard for revascularisation, the extent or the site of disease may be such that the artery cannot be reconstructed or bypassed...
13, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27958688/results-of-surgical-interventions-for-critical-limb-ischaemia-due-to-vasculitis-or-collagen-tissue-related-disease
#17
Kota Yamamoto, Katsuyuki Hoshina, Atsushi Akai, Toshihiko Isaji, Daisuke Akagi, Takuya Miyahara, Toshiaki Watanabe
BACKGROUND: In this study, we aimed to clarify both systemic and local prognosis after surgical interventions for critical limb ischaemia (CLI) due to vasculitis or connective tissue related disease, and to search for any risk factors that can worsen the prognosis. METHODS: One hundred and ninety three patients that underwent surgical interventions for CLI between 2005 and 2014 were followed up for a median of 2.7 years. The patients were grouped into a group with vasculitis or connective tissue related disease (V) or with atherosclerosis (control: C)...
December 13, 2016: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/27939742/long-term-primary-patency-rate-after-nitinol-self-expandable-stents-implantation-in-long-totally-occluded-femoropopliteal-tasc-ii-c-d-lesions-retrospective-study
#18
Mahmoud Farouk Elmahdy, Piergiovanni Buonamici, Maurizio Trapani, Renato Valenti, Angela Migliorini, Guido Parodi, David Antoniucci
BACKGROUND: Endovascular therapy for long femoropopliteal lesions using percutaneous transluminal balloon angioplasty or first-generation of peripheral stents has been associated with unacceptable one-year restenosis rates. However, with recent advances in equipment and techniques, a better primary patency rate is expected. So, this study was conducted to detect the long-term primary patency rate of nitinol self-expandable stents implanted in long, totally occluded femoropopliteal lesions (TASC II type C & D), and determine the predictors of reocclusion or restenosis in the stented segments...
November 18, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/27935893/-results-of-using-various-methods-of-autovenous-femoropopliteal-bypass-grafting-below-the-knee-joint-fissure
#19
B S Sukovatykh, L N Belikov, M B Sukovatykh, D V Sidorov, M A Inarkhov, E B Inokhodova
The objective of the study was to improve therapeutic outcomes in patients presenting with lower limb critical ischaemia by means of optimizing the technique of femoropopliteal bypass grafting. The authors analysed the results of comprehensive examination and treatment of a total of 90 patients presenting with critical lower limb ischaemia on the background of atherosclerotic lesions of arteries of the femoropopliteal and crural segments. Depending on the technology of performing femoropopliteal bypass grafting, the patients were subdivided into three groups each consisting of 30 subjects...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/27935892/-two-year-results-of-infrainguinal-reconstructions-using-autovenous-shunts-and-xenografts
#20
COMPARATIVE STUDY
I S Tishchenko, V N Zolkin, N V Maksimov, I N Korotkov, I Yu Demidov, M A Barzaeva
The authors analysed two-year results of inftrainguinal distal arterial reconstructions using xenograft ("kemAngioprosthesis") as compared with an autovein. Ours was a retrospective study including a total of 110 patients who endured 57 femoropopliteal (distal) and 54 femorotibial bypasses by means of both an autovein and a xenograft used as a shunt. The indications for reconstructive operation in the majority of cases was critical ischaemia induced by an atherosclerotic lesion of the femoropoplitealtibial segment corresponding to type D according to the TASC II classification...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
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