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Lower limb claudication

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https://www.readbyqxmd.com/read/29157680/immediate-and-late-outcomes-of-endovascular-therapy-for-lower-extremity-arteries-in-buerger-disease
#1
Dae-Hoon Kim, Young-Guk Ko, Chul-Min Ahn, Dong-Ho Shin, Jung-Sun Kim, Byeong-Keuk Kim, Donghoon Choi, Myeong-Ki Hong, Yangsoo Jang
OBJECTIVE: Buerger disease is a rare inflammatory vasculopathy presenting with severe claudication or critical limb ischemia. In this study, we sought to evaluate the feasibility and clinical outcomes of endovascular therapy for Buerger disease involving arteries in the lower extremities. METHODS: Between January 2006 and May 2016, there were 44 Buerger disease patients (43 men; mean age, 40.4 ± 9.6 years) with 50 target limbs treated by endovascular therapy at the Severance Cardiovascular Hospital...
November 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29133605/low-density-lipoprotein-cholesterol-lowering-with-evolocumab-and-outcomes-in-patients-with-peripheral-artery-disease-insights-from-the-fourier-trial-further-cardiovascular-outcomes-research-with-pcsk9-inhibition-in-subjects-with-elevated-risk
#2
Marc P Bonaca, Patrice Nault, Robert P Giugliano, Anthony C Keech, Armando Lira Pineda, Estella Kanevsky, Julia Kuder, Sabina A Murphy, J Wouter Jukema, Basil S Lewis, Lale Tokgozoglu, Ransi Somaratne, Peter S Sever, Terje R Pedersen, Marc S Sabatine
BACKGROUND : The PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitor evolocumab reduced low-density lipoprotein cholesterol and cardiovascular events in the FOURIER trial (Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk). We investigated the efficacy and safety of evolocumab in patients with peripheral artery disease (PAD) as well as the effect on major adverse limb events. METHODS : FOURIER was a randomized trial of evolocumab versus placebo in 27 564 patients with atherosclerotic disease on statin therapy followed for a median of 2...
November 13, 2017: Circulation
https://www.readbyqxmd.com/read/29132880/rivaroxaban-with-or-without-aspirin-in-patients-with-stable-peripheral-or-carotid-artery-disease-an-international-randomised-double-blind-placebo-controlled-trial
#3
Sonia S Anand, Jackie Bosch, John W Eikelboom, Stuart J Connolly, Rafael Diaz, Peter Widimsky, Victor Aboyans, Marco Alings, Ajay K Kakkar, Katalin Keltai, Aldo P Maggioni, Basil S Lewis, Stefan Störk, Jun Zhu, Patricio Lopez-Jaramillo, Martin O'Donnell, Patrick J Commerford, Dragos Vinereanu, Nana Pogosova, Lars Ryden, Keith A A Fox, Deepak L Bhatt, Frank Misselwitz, John D Varigos, Thomas Vanassche, Alvaro A Avezum, Edmond Chen, Kelley Branch, Darryl P Leong, Shrikant I Bangdiwala, Robert G Hart, Salim Yusuf
BACKGROUND: Patients with peripheral artery disease have an increased risk of cardiovascular morbidity and mortality. Antiplatelet agents are widely used to reduce these complications. METHODS: This was a multicentre, double-blind, randomised placebo-controlled trial for which patients were recruited at 602 hospitals, clinics, or community practices from 33 countries across six continents. Eligible patients had a history of peripheral artery disease of the lower extremities (previous peripheral bypass surgery or angioplasty, limb or foot amputation, intermittent claudication with objective evidence of peripheral artery disease), of the carotid arteries (previous carotid artery revascularisation or asymptomatic carotid artery stenosis of at least 50%), or coronary artery disease with an ankle-brachial index of less than 0·90...
November 10, 2017: Lancet
https://www.readbyqxmd.com/read/29088925/predictive-value-of-underweight-status-for-patients-with-peripheral-artery-disease-with-claudication
#4
Keisuke Senda, Takashi Miura, Masatoshi Minamisawa, Yasushi Ueki, Tomoaki Mochidome, Hidetomo Nomi, Wataru Shoin, Satoko Higuchi, Yasutaka Oguchi, Hitoshi Nishimura, Tatsuya Saigusa, Soichiro Ebisawa, Hirohiko Motoki, Atsushi Izawa, Jun Koyama, Uichi Ikeda, Koichiro Kuwahara
We evaluated whether underweight status is associated with poor prognosis in patients with peripheral artery disease (PAD) with claudication, excluding critical limb ischemia. We identified 441 claudicants hospitalized for cardiovascular disease between 2005 and 2012. Patients were divided into 4 groups according to body mass index (BMI): an underweight group (BMI < 18.5 kg/m(2); n = 48), a normal group (BMI = 18.5-25.0 kg/m(2); n = 286), an overweight group (BMI = 25.0-30.0 kg/m(2); n = 92), and an obese group (BMI ≥ 30...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/29033576/lumbar-spinal-stenosis-attributable-to-tophaceous-gout-case-report-and-review-of-the-literature
#5
Wei Wang, Qingbo Li, Lei Cai, Weijun Liu
OBJECTIVES: Tophaceous gout seldom affects the axial skeleton. Symptoms vary according to the differential localization of urate deposits and the diagnosis is often delayed. Here, we report an unusual case of lumbar spinal stenosis caused by extradural tophaceous deposits. METHODS: We retrospectively reviewed a case of a patient with tophaceous gout of the lumbar spine and reviewed the relevant literature. RESULTS: A 62-year-old man with a 2-year history of lower back pain and a 3-month history of lower limb radiation pain and intermittent claudication was admitted...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28985707/simultaneous-pain-intensity-rating-and-quantification-of-ischemia-throughout-exercise-and-recovery-in-proximal-versus-distal-arterial-claudication
#6
Alban Fouasson-Chailloux, Pierre Abraham, Christophe Colas-Ribas, Mathieu Feuilloy, Bruno Vielle, Samir Henni
Data on simultaneous hemodynamic changes and pain rating estimation in arterial claudication while walking are lacking. This study was conducted to determine if a difference in transcutaneous oxygen pressure (tc pO2) exists between proximal and distal localization at pain appearance (PAINapp), maximal pain (PAINmax) and pain relief (PAINrel) in proximal or distal claudication and if a relationship exists between tc pO2 changes and pain intensity. We analyzed the pain rating (Visual Analog Scale (VAS)) to lower limb ischemia, measured with the decrease from rest of oxygen pressure (DROP) tc pO2 index during constant-load treadmill tests in patients with calf ( n = 41) or buttock ( n = 19) claudication...
October 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28976393/-approach-to-peripheral-arterial-disease-in-the-elderly
#7
Ozan Onur Balkanay, Suat Nail Ömeroğlu
The prevalence of peripheral arterial disease, which usually develops on the basis of atherosclerosis and develops as a result of chronic arterial occlusive pathology, increases with age. Peripheral artery disease in the elderly patient population may be asymptomatic due to restrictive conditions associated with immobilization. Concurrent cerebrovascular disease and coronary artery disease risk and mortality rates are higher in elderly patients with peripheral artery disease. The life expectancy in patients with peripheral arterial disease is worse than in prostate cancer patients...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28974486/combined-dietary-nitrate-and-exercise-intervention-in-peripheral-artery-disease-protocol-rationale-and-design
#8
Mary N Woessner, Mitch D VanBruggen, Carl F Pieper, Erin K O'Reilly, William E Kraus, Jason D Allen
BACKGROUND: Peripheral artery disease (PAD) is caused by atherosclerotic occlusions in the legs. It affects approximately 8-12 million people in the United States alone, one-third of whom suffer from intermittent claudication (IC), defined as ischemic leg pain that occurs with walking and improves with rest. Patients with IC suffer a markedly impaired quality of life and a high perception of disability. Improving pain-free walking time is a primary goal of rehabilitation in this population...
October 3, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28965800/short-and-long-term-readmission-rates-after-infrainguinal-bypass-in-a-safety-net-hospital-are-higher-than-expected
#9
Brianna M Krafcik, Sevan Komshian, Kimberly Lu, Lauren Roberts, Alik Farber, Jeffrey A Kalish, Denis Rybin, Jeffrey J Siracuse
OBJECTIVE: Readmission rates are expected to have an increasing effect on both the hospital bottom line and physician reimbursements. Safety net hospitals may be most vulnerable. We examined readmissions at 30 days, 90 days, and 1 year in a large safety net hospital to determine the magnitude and effect of short and long-term readmission rates after lower extremity infrainguinal bypass in this setting. METHODS: All nonemergent extremity infrainguinal bypass performed at a large safety net hospital between 2008 and 2016 were identified...
September 28, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28938901/validation-of-the-vascular-quality-of-life-questionnaire-6-for-clinical-use-in-patients-with-lower-limb-peripheral-arterial-disease
#10
Anne Sofie F Larsen, Anne Therese Reiersen, Morten B Jacobsen, Nils-Einar Kløw, Joakim Nordanstig, Mark Morgan, Jarlis Wesche
BACKGROUND: The VascuQoL-6 (VQ-6) health-related quality of life questionnaire, a short version of the disease-specific VascuQoL-25, was developed for clinical practice and use in vascular registries. The study purpose was to evaluate the validity and reliability of VQ-6. METHODS: VQ-6 was translated to Norwegian with linguistic validation and face value evaluation, and consecutive patients with intermittent claudication (IC) or critical limb ischemia (CLI) were included...
September 22, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/28905042/social-demographic-and-clinical-characteristics-of-patients-suffering-from-peripheral-vascular-disease-treated-surgically-compared-to-patients-treated-with-endovascular-angioplasty
#11
Renata Piotrkowska, Marek Dobosz, Janina Książek, Grzegorz Halena
INTRODUCTION: Atherosclerosis is the most common cause of chronic lower limb ischaemia. Many factors that have a crucial influence on the development of the disease, its course and prognosis have been identified. The risk factors seem to be subject to interventions due to their susceptibility to changes. It is important to increase the engagement of doctors and nurses performing the screening oriented on risk factors, medical consultation regarding giving up smoking, changing the diet and undertaking physical activity...
2017: Arch Med Sci Atheroscler Dis
https://www.readbyqxmd.com/read/28891401/revascularization-of-the-superficial-femoral-artery-with-paclitaxel-coated-balloon-for-claudication
#12
Celine Deloge, Evelyne Boesmans, Hendrik Van Damme, Jean-Olivier Defraigne
BACKGROUND: Percutaneous angioplasty of the superficial femoral artery (SFA) with paclitaxel-coated balloon, intended to reduce restenosis, has been proven safe and effective in recent randomized controlled trials. OBJECTIVE: To assess outcome results of angioplasty of the SFA with paclitaxel-coated balloon in claudicants in real-world practice of a single center. MATERIAL & METHODS: A continuous prospective cohort study of 53 claudicants (62 lower limbs) from January 2015 to December 2016...
September 11, 2017: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/28870682/association-of-arterial-calcification-with-chronic-limb-ischemia-in-patients-with-peripheral-artery-disease
#13
Sara L Zettervall, Andre P Marshall, Paul Fleser, Raul J Guzman
OBJECTIVE: Arterial calcification is associated with an increased risk of limb events, including amputation. The association between calcification in lower extremity arteries and the severity of ischemia, however, has not been assessed. We thus sought to determine whether the extent of peripheral artery calcification (PAC) was correlated with Rutherford chronic ischemia categories and hypothesized that it could independently contribute to worsening limb status. METHODS: We retrospectively reviewed all patients presenting with symptomatic peripheral artery disease who underwent evaluation by contrast and noncontrast computed tomography scan of the lower extremities as part of their assessment...
September 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28860931/the-effect-of-pentoxifylline-on-l-1-sarcoma-tumor-growth-and-angiogenesis-in-balb-c-mice
#14
Barbara Joanna Bałan, Urszula Demkow, Piotr Skopiński, Małgorzata Bychawska, Ewa Skopińska-Różewska, Sławomir Lewicki, Robert Zdanowski
Methyloxantines are present in many herbs and vegetal foods, among them in tea, coffee and chocolate. Previous studies revealed that theophylline and theobromine have anti-angiogenic properties. Anti-tumor properties of theobromine were also described. Pentoxifylline (3,7-dimethyl-1-(5-oxohexyl)xanthine, PTX) is a synthetic xanthine derivative. It is a phosphodiesterase inhibitor and has various anti-inflammatory abilities. Pentoxifylline is widely used in therapy of inflammatory arterial diseases such as intermittent claudication of upper and lower limbs as well as in coronary heart disease...
2017: Central-European Journal of Immunology
https://www.readbyqxmd.com/read/28844467/patient-selection-and-perioperative-outcomes-of-bypass-and-endovascular-intervention-as-first-revascularization-strategy-for-infrainguinal-arterial-disease
#15
Thomas C F Bodewes, Jeremy D Darling, Sarah E Deery, Thomas F X O'Donnell, Alexander B Pothof, Katie E Shean, Frans L Moll, Marc L Schermerhorn
OBJECTIVE: The optimal initial revascularization strategy remains uncertain for patients with peripheral arterial disease. The purpose of this study was to evaluate current nationwide selection and perioperative outcomes of patients undergoing bypass or endovascular intervention for infrainguinal disease in those with no prior ipsilateral revascularization. METHODS: Patients undergoing nonemergent first-time infrainguinal revascularization were identified in the Targeted Vascular module of the National Surgical Quality Improvement Program (NSQIP) for 2011 to 2014 and stratified by symptom status (chronic limb-threatening ischemia [CLTI] or claudication)...
August 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28838480/self-expanding-versus-balloon-expandable-stents-for-iliac%C3%A2-artery%C3%A2-occlusive-disease-the%C3%A2-randomized-ice-trial
#16
Hans Krankenberg, Thomas Zeller, Maja Ingwersen, Josefin Schmalstieg, Hans Martin Gissler, Sigrid Nikol, Iris Baumgartner, Nicolas Diehm, Estell Nickling, Stefan Müller-Hülsbeck, Rainer Schmiedel, Giovanni Torsello, Willibald Hochholzer, Christian Stelzner, Klaus Brechtel, Wulf Ito, Ralph Kickuth, Erwin Blessing, Marcus Thieme, Jaroslaw Nakonieczny, Thomas Nolte, Ragnar Gareis, Harald Boden, Sebastian Sixt
OBJECTIVES: Atherosclerosis of iliac arteries is widespread. As inflow vessels, they are of great clinical significance and increasingly being treated by endovascular means. Most commonly, stents are implanted. BACKGROUND: So far, due to a lack of comparative data, no guideline recommendations on the preferable stent type, balloon-expandable stent (BE) or self-expanding stent (SE), have been issued. METHODS: In this randomized, multicenter study, patients with moderate to severe claudication from common or external iliac artery occlusive disease were assigned 1:1 to either BE or SE...
August 28, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28819879/lower-extremity-bypass-using-bovine-carotid-artery-graft-artegraft-an-analysis-of-124-cases-with-long-term-results
#17
Philip Lindsey, Angela Echeverria, Mathew Cheung, Elias Kfoury, Carlos F Bechara, Peter H Lin
INTRODUCTION: Although biological grafts have been utilized as a vascular conduit in leg bypass for many years, reports of a bovine carotid artery graft (BCAG) in lower extremity revascularization have been scarce. This study analyzed the outcome of lower leg bypass using BCAG. METHODS: A retrospective review of a prospectively collected database of all patients undergoing lower extremity bypass using BCAG from 2002 to 2017 was performed. Clinical outcomes including graft patency and limb salvage were evaluated...
August 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28818667/endoconduits-with-pave-and-crack-technique-avoid-open-ilio-femoral-conduits-with-sustainable-mid-term-results
#18
G Asciutto, M Aronici, T Resch, B Sonesson, T Kristmundsson, N V Dias
OBJECTIVE/BACKGROUND: The objective was to evaluate the feasibility and mid-term outcomes of endoconduits (EC) with the "pave and crack" technique during endovascular aneurysm repair (EVAR) of varying complexity. METHODS: This was a retrospective study. All patients undergoing EC between July 2009 and October 2015 were included. The primary endpoint was technical success of the EC defined as the ability to successfully deliver the aortic stent graft through the EC without rupture, dissection, or thrombosis of the iliac or femoral arteries, and with the absence of haemodynamically significant blood loss related to the EC...
October 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28797662/amputation-rates-mortality-and-pre-operative-comorbidities-in-patients-revascularised-for-intermittent-claudication-or-critical-limb-ischaemia-a-population-based-study
#19
E Baubeta Fridh, M Andersson, M Thuresson, B Sigvant, B Kragsterman, S Johansson, P Hasvold, M Falkenberg, J Nordanstig
OBJECTIVES: The aims of this population based study were to describe mid- to long-term amputation risk, cumulative incidence of death or amputation, and differences in pre-operative comorbidities in patients revascularised for lower limb peripheral artery disease (PAD). METHODS: This was an observational cohort study. Data from the Swedish National Quality Registry for Vascular Surgery (Swedvasc) were combined with mandatory national health care registries and patient medical records...
October 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28796049/tophaceous-gout-causing-lumbar-stenosis-a-case-report
#20
Huigen Lu, Jianming Sheng, Jiaping Dai, Xuqi Hu
RATIONALE: Gout in the spine is very rare. The clinical symptoms of the spinal gout are various and lack of specificity. The authors report a case of spinal gout causing lumbar stenosis. We never find such wide-invasive spinal gouty lesion in the published studies. PATIENT CONCERNS: A 68-year-old male had low back pain radiating to bilateral lower limbs, accompanying with intermittent claudication that lasted for 3 months and aggravated 5 days ago. DIAGNOSES: Spinal gout, lumbar stenosis...
August 2017: Medicine (Baltimore)
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