keyword
https://read.qxmd.com/read/35975230/lower-limb-re-vascularization-based-on-the-angiosome-concept-with-immediate-early-local-flap-reconstruction-a-case-report
#21
Yu Ming Lai, Kae-Sian Tay, Shaun Qing Wei Lee, Allen Wei-Jiat Wong
Lower extremity wounds are a healthcare issue that can result in debilitating consequences. Peripheral arterial occlusive disease (PAOD) being a major contributing factor to the disease, advance revascularization procedures (Angioplasty) based on the angiosome concept has been established in the literature to improve blood supply and promote better healing outcomes. We present a case of a 59-year-old lady with background of hypertension, diabetes and PAOD, was diagnosed with a non-healing foot wound with exposed metal implant...
August 2022: Journal of Surgical Case Reports
https://read.qxmd.com/read/35432658/the-patency-of-tibial-peroneal-arteries-affects-the-increment-of-regional-tissue-saturation-of-oxygen-in-each-angiosome-after-superficial-femoral-artery-revascularization
#22
JOURNAL ARTICLE
Naoki Unno, Kazunori Inuzuka, Naoto Yamamoto, Masaki Sano, Kazuto Katahashi, Takafumi Kayama, Tatsuro Yata, Yuta Yamanaka, Hajime Tsuyuki, Yusuke Endo, Nozomu Ishikawa, Ena Naruse, Masatsugu Niwayama, Hiroya Takeuchi
Objective : The angiosome model is a controversial concept in the revascularization of patients with chronic limb-threatening ischemia (CLTI). The aim of this study was to demonstrate the importance of patency of the tibial/peroneal arteries for regional tissue oxygenation in each angiosome during endovascular therapy (EVT) of the superficial femoral artery (SFA). Materials and Methods : We devised a novel near-infrared spectroscopy oximeter, "TOE-20," for real-time monitoring of regional tissue oxygen saturation (rSO2 )...
March 25, 2022: Annals of Vascular Diseases
https://read.qxmd.com/read/35372736/real-time-assessment-of-tissue-oxygen-saturation-during-endovascular-therapy-for-chronic-limb-threatening-ischemia-using-a-novel-oximeter
#23
JOURNAL ARTICLE
Naoki Unno, Kazunori Inuzuka, Masaki Sano, Masatsugu Niwayama, Ena Naruse, Hiroya Takeuchi
In the present study, we have introduced a novel real-time, near-infrared spectroscopy oximeter, the TOE-20 (Astem, Co, Ltd, Kawasaki, Japan), which can simultaneously measure the regional tissue oxygen saturation (rSO2 ) in the skin and subcutaneous tissue at three angiosomes of the foot. Seven patients with chronic limb threatening ischemia who had undergone successful revascularization of the superficial femoral artery were included. The analysis revealed a significant correlation between the rSO2 and skin perfusion pressure...
June 2022: Journal of Vascular Surgery Cases and Innovative Techniques
https://read.qxmd.com/read/35307686/surgical-treatment-immediate-results-of-lower-limbs-chronic-critical-ischemia-in-immultaneous-direct-and-indirect-revascularization
#24
JOURNAL ARTICLE
Mykhailo M Lopit, Vasily I Rusin, Patricia O Boldizhar, Fedir V Gorlenko, Olexander M Kochmar
OBJECTIVE: The aim: To assess the immediate results of autovenous femoral-tibial shunting in combination with rotary osteotrepanation of the tibia by studying changes in the transcutaneous ptO2 tension in the tibia and foot tissues depending on the revascularization of the tibial arteries. PATIENTS AND METHODS: Materials and methods: We analyzed the treatment of 69 patients with obliterating atherosclerosis of the vessels of the lower extremities. According to the degree of ischemia of the lower extremities, the patients were distributed as follows: III A degree of ischemia - 20 (29%), III B - 28 (40...
2022: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://read.qxmd.com/read/35016873/comprehensive-imaging-of-microcirculatory-changes-in-the-foot-during-endovascular-intervention-a-technical-feasibility-study
#25
JOURNAL ARTICLE
Martin Hultman, Sofie Aronsson, Ingemar Fredriksson, Helene Zachrisson, Håkan Pärsson, Marcus Larsson, Tomas Strömberg
Chronic limb-threatening ischemia (CLTI) has a major impact on patients' lives and is associated with a heavy health care burden with high morbidity and mortality. Treatment by endovascular intervention is mostly based on macrocirculatory information from angiography and does not consider the microcirculation. Despite successful endovascular intervention according to angiographic criteria, a proportion of patients fail to heal ischemic lesions. This might be due to impaired microvascular perfusion and variations in the supply to different angiosomes...
May 2022: Microvascular Research
https://read.qxmd.com/read/34964396/evaluation-of-tissue-perfusion-by-wound-blush-and-2d-color-coded-digital-subtraction-angiography-during-endovascular-intervention-and-its-impact-on-limb-salvage-in-critical-limb-ischemia
#26
JOURNAL ARTICLE
Hassan Lotfy, Ahmed Abou El-Nadar, Wael Shaalan, Ali El Emam, Akram Ibrahim, Ahmad Naga
PURPOSE: Critical limb ischemia (CLI) is an entity with high mortality if not properly treated. The primary aim of CLI revascularization is to enhance wound healing, which greatly depends on microvascular circulation. The available tools for assessment of revascularization success are deficient in the evaluation of local microvascular tissue perfusion, that wound blush (WB) reflects. A reliable technique that assesses capillary flow to foot lesions is needed. This study aims to assess WB angiographically at sites of interest in the foot after revascularization and its impact on limb salvage in CLI...
October 2022: Journal of Endovascular Therapy
https://read.qxmd.com/read/34956078/stimulation-tcpo2-testing-improves-diagnosis-of-peripheral-arterial-disease-in-patients-with-diabetic-foot
#27
JOURNAL ARTICLE
Vladimíra Fejfarová, Jiří Matuška, Edward Jude, Pavlína Piťhová, Milan Flekač, Karel Roztočil, Veronika Wosková, Michal Dubský, Alexandra Jirkovská, Robert Bém, Jitka Husáková, Věra Lánská
Background: All diagnostic procedures of peripheral arterial disease (PAD) in diabetic foot (DF) are complicated due to diabetes mellitus and its late complications.The aim of our study is to enhance diagnosis of PAD using a novel transcutaneous oximetry (TcPO2) stimulation test. Methods: The study comprised patients with mild-to-moderate PAD(WIfI-I 1 or 2) and baseline TcPO2 values of 30-50 mmHg.TcPO2 was measured across 107 different angiosomes. Stimulation examination involved a modification of the Ratschow test...
2021: Frontiers in Endocrinology
https://read.qxmd.com/read/34780951/grades-of-below-the-ankle-arterial-occlusive-disease-following-the-angiosome-perfusion-a-new-morphological-assessment-and-correlations-with-the-inframalleolar-gvg-stratification-in-clti-patients
#28
JOURNAL ARTICLE
Vlad Adrian Alexandrescu, Sophie Brochier, Sophie Schoenen, Elisa Antonelli, Khalid Azdad, Ines Zekhnini, Mihaela Nodit
PURPOSE: To assess a specific classification of the foot atherosclerotic disease concerning the angiosomal source arteries, the connected foot arches and attached collaterals for Rutherford 5, CLTI patients. To compare eventual analogies of this novel grading system with previously reported GLASS/GVG inframalleolar patterns of occlusive disease (P0-P2). MATERIALS AND METHODS: A series of 336 ischemic feet (221 diabetics) were selected and retrospectively analyzed...
April 2022: Annals of Vascular Surgery
https://read.qxmd.com/read/34669226/the-triple-conjoined-scapular-latissimus-dorsi-groin-flap-for-reconstruction-of-long-lower-extremity-degloving-injury-a-case-report
#29
Francesco Amendola, Davide Spadoni, Jonathan Velazquez-Mujica, Loukas Platsas, Hung-Chi Chen
Since the introduction of the angiosome concept, many attempts have been made to push the dimensional limits of free tissue transfers. While initially limited by the boundaries of random vascularization of adjacent angiosomes, wider flaps were transferred by combining contiguous source vessels. Combined flaps, either chimeric or conjoined, represent nowadays the largest reconstructive options in the human body. This is the first report of a triple conjoined free flap with two vascular anastomoses, able to cover the anterior surface of the entire lower limb, representing the longest flap ever reported in history...
March 2022: Microsurgery
https://read.qxmd.com/read/34644650/hybrid-deep-venous-arterialisation-dvar-for-no-option-chronic-limb-threatening-ischemia
#30
Sherif Sultan, Yogesh Acharya, Mohieldin Hezima, Hiba Salahat, Niamh Hynes
BACKGROUND: Hybrid Deep Venous ARterialisation (DVAR) is offered as a last-ditch attempt for limb salvage in patients with chronic limb threatening ischemia (CLTI). It provides non-selective arterialisation independent of the angiosome, which harnesses the complex venous capillary network bed developed in the leg and foot. METHODS: We present two elderly men who underwent DVAR to salvage limb with CLTI. DVAR was performed by creating an arteriovenous connection by anastomosis of the great saphenous vein (GSV) at the level of the distal popliteal and proximal tibio-peroneal trunk...
February 2022: Annals of Vascular Surgery
https://read.qxmd.com/read/34491392/validation-of-the-correlation-between-angiosome-based-target-arterial-path-mid-term-limb-based-patency-and-the-global-limb-anatomical-staging-system
#31
JOURNAL ARTICLE
Takehiro Yamada, Taro Shibahara, Masaru Nagase, Daiju Ono, Gen Tanabe, Keita Suzuki, Makoto Yamaura, Takahisa Ido, Takashi Nakashima, Shigekiyo Takahashi, Takuma Aoyama
This study aimed to validate the correlation between the Global Limb Anatomical Staging System (GLASS) and limb-based patency (LBP) and angiosome-based target arterial path (TAP) and to detect the predictors of LBP loss. After the publication of the Global Vascular Guidelines in 2019, the evaluation of GLASS and identification of TAP have been recommended. However, there are few reports regarding GLASS. Eighty-three patients with chronic limb-threatening ischemia (CLTI) and tissue loss from 2016 to 2020 were evaluated...
March 2022: Heart and Vessels
https://read.qxmd.com/read/34029036/-primary-retrograde-distal-access-for-endovascular-interventions-in-patients-with-lower-limb-ischemia
#32
JOURNAL ARTICLE
S A Platonov, V V Zavatsky, V N Zhigalo, M A Kiselev, K Sh Isaev, I A Khomchuk, D V Kandyba, V N Sidorov, I P Dudanov
OBJECTIVE: To evaluate safety and technical efficiency of primary retrograde distal access for endovascular interventions in patients with lower limb ischemia. MATERIAL AND METHODS: A prospective analysis included 25 endovascular procedures via primary retrograde distal access in 23 patients with chronic obliterating diseases of lower limb arteries. Occlusive lesion of femoral-popliteal segment was observed in 68% of cases, occlusion of at least one tibial artery was also found in 68% of cases...
2021: Khirurgiia
https://read.qxmd.com/read/33856650/an-advanced-ultrasound-application-used-to-assess-peripheral-vascular-diseases-superb-microvascular-imaging
#33
REVIEW
Wakana Sato, Yuta Suto, Takayuki Yamanaka, Hiroyuki Watanabe
Over the past several years, a novel ultrasound imaging modality termed superb microvascular imaging (SMI) has enabled visualization of microvessels. SMI ultrasound studies of peripheral artery diseases have significantly extended our knowledge of tissue microcirculation and the arterial microenvironments of atherosclerotic lesions. We here present an overview of current knowledge on the utility of SMI assessment of vascular diseases and highlight certain peripheral microcirculation disorders for which SMI is particularly valuable...
September 2021: Journal of Echocardiography
https://read.qxmd.com/read/33778231/fluorescent-angiography-used-as-a-tool-to-guide-angiosome-directed-endovascular-therapy-for-diabetic-foot-ulcers
#34
Marshall Dworak, Elizabeth A Andraska, S Michael Gharacholou, Melissa Myers, Scott C Chapman
Angiosome-directed endovascular therapy for the treatment of chronic limb-threatening ischemia (CLTI) remains controversial owing to the overlap of wound angiosomes. Angiographic grading of success has limitations and translesional pressure assessments are seldom performed in the infrapopliteal vessels. Objective criteria to determine revascularization success in tibiopedal vessels have not been well described. Quantifying perfusion to a wound bed after establishing direct or indirect (via collateral) flow after revascularization is an important component for treating CLTI patients yet is seldom performed...
March 2021: Journal of Vascular Surgery Cases and Innovative Techniques
https://read.qxmd.com/read/33777352/steal-syndrome-from-a-superficial-circumflex-iliac-perforator-artery-flap-in-a-patient-with-a-hypoplastic-posterior-tibial-artery-and-severe-diabetic-peripheral-artery-disease
#35
Grant A Murphy, Rajinder P Singh-Moon, Vincent L Rowe, Ketan M Patel, Amaan Mazhar, David J Cuccia, David G Armstrong
The use of free flaps in lower extremity reconstructive surgery has seen growing adoption for treating tissue loss in patients with diabetes mellitus and peripheral artery disease as a means for limb preservation. The superficial circumflex iliac perforator artery (SCIP) flap is one of the most commonly utilized flaps in foot reconstruction and has demonstrated benefits over amputation. Patients with impaired vascular and neurologic function are predisposed to complications following lower extremity reconstructive surgery, particularly ischemia in the angiosomes of the arteries used for flap anastomosis...
March 2021: Journal of Surgical Case Reports
https://read.qxmd.com/read/33691547/bifurcated-bypass-in-severe-chronic-limb-threatening-ischaemia
#36
JOURNAL ARTICLE
Daniele Adami, Michele Marconi, Alberto Piaggesi, Davide M Mocellin, Raffaella N Berchiolli, Mauro Ferrari
OBJECTIVES: Revascularization according to the angiosome concept is of proven importance for limb salvage in chronic limb threatening ischaemia but it is not always practicable. Bifurcated bypasses could be considered as an option when an endovascular approach is not feasible or has already failed and a single bypass would not allow direct revascularization of the ischaemic area. Bifurcated bypasses are characterized by landing on two different arteries, the main artery (in direct continuity with the foot vessels) and the secondary one (perfusing the angiosome district)...
February 2022: Vascular
https://read.qxmd.com/read/33533936/effect-of-direct-endovascular-revascularization-based-on-the-angiosome-model-on-risk-of-major-amputations-and-life-expectancy-in-type-2-diabetic-patients-with-critical-limb-ischemia-and-foot-ulceration
#37
JOURNAL ARTICLE
Elisabetta Iacopi, Alberto Coppelli, Chiara Goretti, Irene Bargellini, Antonio Cicorelli, Roberto Cioni, Alberto Piaggesi
BACKGROUND: We evaluated whether direct or indirect endovascular revascularization based on the angiosome model affects outcomes in type 2 diabetes and critical limb ischemia. METHODS: From 2010 to 2015, 603 patients with type 2 diabetes were admitted for critical limb ischemia and submitted to endovascular revascularization. Among these patients, 314 (52%) underwent direct and 123 (20%) indirect revascularization, depending on whether the flow to the artery directly feeding the site of ulceration, according to the angiosome model, was successfully acquired; 166 patients (28%) were judged unable to be revascularized...
July 1, 2021: Journal of the American Podiatric Medical Association
https://read.qxmd.com/read/33398615/effect-of-660-850-nm-led-on-the-microcirculation-of-the-foot-neurovascular-biphasic-reflex
#38
JOURNAL ARTICLE
Claudia Maria Duarte de Sá
Phototherapy (LED) can be used to stimulate the healing of chronic ulcers of the lower limb, as it affects healing cells and neurons. In this way, this study has sought to know if the heat stimulus of the 660-/850-nm contact LED is sufficient to trigger the response in the peripheral sympathetic nervous system of normal volunteers. The LED was applied on the right foot of forty-two normal volunteers followed by serial infrared images. After the stimulus, a biphasic hyperthermia curve was observed synchronously in both feet, in the right and left halluxes, while hyperthermia was attributed to the redistribution of postural blood flow in the plantar region, which may indicate independent neurovascular mechanisms...
December 2021: Lasers in Medical Science
https://read.qxmd.com/read/33280321/pedal-acceleration-time-a-new-method-of-diagnosis-and-prognosis-in-peripheral-arteriopathy
#39
JOURNAL ARTICLE
Andreia Pinelo, Luís Loureiro, Sérgio Teixeira, João Castro, Carlos Veterano, Inês Antunes, Carlos Veiga, Daniel Mendes, Henrique Rocha, Rui Almeida
Introduction It is well recognized that the Ankle-Arm Index is unreliable in the diagnosis and prognosis of peripheral arteriopathy in patients with incompressible vessels, such as diabetics and chronic kidney patients. It is therefore important to define alternative strategies for assessing distal perfusion in this population. Arterial Doppler, a non-invasive technique available in any vascular laboratory, can be used to directly assess foot perfusion by interrogating the plantar arch and its nourishing arteries...
October 2020: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://read.qxmd.com/read/33221224/prognostic-value-of-radiotracer-based-perfusion-imaging-in-critical-limb-ischemia-patients-undergoing-lower-extremity-revascularization
#40
JOURNAL ARTICLE
Ting-Heng Chou, Jessica L Alvelo, Sarah Janse, Xenophon Papademetris, Bauer E Sumpio, Carlos Mena-Hurtado, Albert J Sinusas, Mitchel R Stacy
OBJECTIVES: The purpose of this study was to evaluate the prognostic value of single-photon emission computed tomography (SPECT)/computed tomography (CT) imaging of angiosome foot perfusion for predicting amputation outcomes in patients with critical limb ischemia (CLI) and diabetes mellitus (DM). BACKGROUND: Radiotracer imaging can assess microvascular foot perfusion and identify regional perfusion abnormalities in patients with critical limb ischemia CLI and DM, but the relationship between perfusion response to revascularization and subsequent clinical outcomes has not been evaluated...
August 2021: JACC. Cardiovascular Imaging
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