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Lower limb claudication

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https://www.readbyqxmd.com/read/28440113/major-limb-outcomes-following-lower-extremity-endovascular-revascularization-in-patients-with-and-without-diabetes-mellitus
#1
Andrew N Shammas, Haekyung Jeon-Slaughter, Shirling Tsai, Houman Khalili, Mujtaba Ali, Hao Xu, Gerardo Rodriguez, Ian Cawich, Ehrin J Armstrong, Emmanouil S Brilakis, Subhash Banerjee
PURPOSE: To determine whether diabetes mellitus has an independent impact on major limb outcomes at 1 year after endovascular treatment of lower extremity peripheral artery disease (PAD). METHODS: The study involved 1906 consecutive patients (mean age 66 years; 1469 men) enrolled in the observational Excellence in Peripheral Artery Disease (XLPAD) registry ( ClinicalTrials.gov identifier NCT01904851) between January 2005 and October 2015 after undergoing index endovascular procedures in 2426 limbs for arterial occlusive disease...
April 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28432883/sagittal-plane-joint-kinetics-during-stair-ascent-in-patients-with-peripheral-arterial-disease-and-intermittent-claudication
#2
Stephanie L King, Natalie Vanicek, Thomas D O'Brien
Stair negotiation poses a substantial physical demand on the musculoskeletal system and this challenging task can place individuals at risk of falls. Peripheral arterial disease (PAD) can cause intermittent claudication (IC) pain in the calf and results in altered gait mechanics during level walking. However, whether those with PAD-IC adopt alternate strategies to climb stairs is unknown. Twelve participants with PAD-IC (six bilateral and six unilateral) and 10 healthy controls were recruited and instructed to ascend a five-step staircase whilst 3D kinematic data of the lower-limbs were recorded synchronously with kinetic data from force plates embedded into the staircase on steps two and three...
March 28, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28407473/trimodal-rescue-of-hind-limb-ischemia-with-growth-factors-cells-and-nanocarriers-fundamentals-to-clinical-trials
#3
Rajesh Laksmanan, Gopi Ukani, Muhammad Tipu Rishi, Nilanjana Maulik
Peripheral Artery Disease is a severe medical condition commonly characterized by critical or acute limb ischemia. Gradual accumulation of thrombotic plaques in peripheral arteries of the lower limb may lead to intermittent claudication or ischemia in muscle tissue. Ischemic muscle tissue with lesions may become infected, resulting in a non-healing wound. Stable progression of the non-healing wound associated with severe ischemia might lead to functional deterioration of the limb, which, depending on the severity, can result in amputation...
April 13, 2017: Canadian Journal of Physiology and Pharmacology
https://www.readbyqxmd.com/read/28400218/outcomes-of-the-japanese-multicenter-viabahn-trial-of-endovascular-stent-grafting-for-superficial-femoral-artery-lesions
#4
Takao Ohki, Kimihiko Kichikawa, Hiroyoshi Yokoi, Masaaki Uematsu, Terutoshi Yamaoka, Koji Maeda, Yuji Kanaoka
OBJECTIVE: The objective of this study was to assess 1-year safety, efficacy, and invasiveness outcomes of endovascular stent grafting of symptomatic long lesions (≥10 cm) in the superficial femoral artery (SFA) as a substitute for above-knee open bypass surgery. METHODS: This prospective, multicenter (15 hospitals) study assessed heparin-coated stent grafts for the treatment of long SFA lesions in Japanese subjects with peripheral arterial disease. Inclusion criteria were Rutherford category 2 to 5 symptoms (grade 5 without active infection), ankle-brachial index ≤0...
April 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28368090/bypass-surgery-for-chronic-lower-limb-ischaemia
#5
REVIEW
George A Antoniou, George S Georgiadis, Stavros A Antoniou, Ragai R Makar, Jonathan D Smout, Francesco Torella
BACKGROUND: Bypass surgery is one of the mainstay treatments for patients with critical lower limb ischaemia (CLI). This is the second update of the review first published in 2000. OBJECTIVES: To assess the effects of bypass surgery in patients with chronic lower limb ischaemia. SEARCH METHODS: For this update, the Cochrane Vascular Group searched its trials register (last searched October 2016) and the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library (last searched Issue 9, 2016)...
April 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28366300/distal-embolization-during-lower-extremity-endovascular-interventions
#6
Cassius I Ochoa Chaar, Fatma Shebl, Bauer Sumpio, Alan Dardik, Jeffrey Indes, Timur Sarac
OBJECTIVE: Distal embolization (DE) during peripheral arterial endovascular interventions is a well-known complication that is poorly studied. The goal of this study was to determine the incidence, risk factors, and effect of DE on the outcomes of lower extremity endovascular interventions (LEIs). METHODS: All LEIs between 2010 and 2014 in the Vascular Study Group of New England (VSGNE) database were reviewed. Patient characteristics were analyzed to determine predictors of DE...
March 30, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28366299/unplanned-return-to-operating-room-after-lower-extremity-endovascular-intervention-is-an-independent-predictor-for-hospital-readmission
#7
Tarik Z Ali, Erik B Lehman, Faisal Aziz
OBJECTIVE: Hospital readmissions after surgical operations are preventable and are now counted as a quality metric. Patients with peripheral arterial disease often have several serious medical comorbidities. With advancements in endovascular technology and increasing comfort level of vascular surgeons, more and more patients with peripheral arterial disease are being treated with endovascular therapy. Most of these interventions are done as same-day operations. This study retrospectively reviewed the factors associated with hospital readmission after lower extremity endovascular interventions...
March 30, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28347511/-an-unusal-cause-of-lower-limb-claudication
#8
P Charles, B Boura, P Validire, J-F Paul
No abstract text is available yet for this article.
March 24, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28292886/optical-probing-of-gastrocnemius-in-patients-with-peripheral-artery-disease-characterizes-myopathic-biochemical-alterations-and-correlates-with-stage-of-disease
#9
Ryan A Becker, Kim Cluff, Nithyanandhi Duraisamy, Hootan Mehraein, Hussam Farhoud, Tracie Collins, George P Casale, Iraklis I Pipinos, Jeyamkondan Subbiah
Peripheral artery disease (PAD) is a condition caused by atherosclerotic blockages in the arteries supplying the lower limbs and is characterized by ischemia of the leg, progressive myopathy, and increased risk of limb loss. The affected leg muscles undergo significant changes of their biochemistry and metabolism including variations in the levels of many key proteins, lipids, and nucleotides. The mechanisms behind these changes are poorly understood. The objective of this study was to correlate the severity of the PAD disease stage and associated hemodynamic limitation (determined by the ankle brachial index, ABI) in the legs of the patients with alterations in the biochemistry of chronically ischemic leg muscle as determined by ATR-Fourier transform infrared micro-spectroscopy...
March 2017: Physiological Reports
https://www.readbyqxmd.com/read/28273223/endovascular-therapeutic-options-for-the-treatment-of-aortoiliac-aneurysms
#10
Bernardo Massière, Arno VON-Ristow, Alberto Vescovi, Daniel Leal, Lea Mirian Barbosa Fonseca
About 20% of patients with abdominal aortic aneurysms have associated iliac aneurysms. Distal sealing during the endovascular treatment of aortic-iliac aneurysms is a challenge that has led to the emergence of several technical options to achieve this goal over the years. Internal iliac artery embolization is associated with the risk of ischemic complications, such as gluteal necrosis, lower limb neurological deficit, colonic ischemia, impotence and gluteal claudication. This article summarizes the technical options for endovascular treatment of aortoiliac aneurysms with different approaches to preserving the patency of internal iliac arteries...
December 2016: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28264725/extracorporeal-shockwave-therapy-for-the-treatment-of-lower-limb-intermittent-claudication-study-protocol-for-a-randomised-controlled-trial-the-shockwave-1-trial
#11
Thomas Cayton, Amy E Harwood, George E Smith, Joshua P Totty, Daniel Carradice, Ian C Chetter
BACKGROUND: Peripheral arterial disease (PAD) has a population prevalence of 4.6% with intermittent claudication (IC) presenting as one of the earliest and most common symptoms. PAD has detrimental effects on patients' walking ability in terms of maximum walking distance (MWD) and pain-free walking distance (PFWD). Research has suggested extracorporeal shockwave therapy (ESWT) may induce angiogenesis in treated tissue; therefore, our objective is to assess the tolerability and efficacy of ESWT as a novel treatment of intermittent claudication...
March 6, 2017: Trials
https://www.readbyqxmd.com/read/28259568/chloroquine-improves-the-response-to-ischemic-muscle-injury-and-increases-hmgb1-after-arterial-ligation
#12
Jun Xu, Xiangdong Cui, Jiehua Li, Panagiotis Koutakis, Iraklis Pipinos, Edith Tzeng, Alex Chen, Ulka Sachdev
OBJECTIVE: We have previously shown that exogenous administration of the nuclear protein high mobility group box 1 (HMGB1) improves angiogenesis after tissue ischemia. Antagonizing HMGB1 prolongs muscle necrosis and deters regeneration. In this study, we evaluated HMGB1 expression in peripheral arterial disease (PAD) and the mechanisms that promote its release in a murine model of hindlimb ischemia. Specifically, we investigated how chloroquine (CQ), a commonly employed disease-modifying antirheumatic drug, promotes HMGB1 release from muscle...
March 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28245772/structure-of-atherosclerotic-plaques-in-different-vascular-territories-clinical-relevance
#13
Pavel Poredos, Peter Poredos, Mateja Kaja Jezovnik
Atherosclerosis is a systemic disease with different faces. Despite similar, or even identical, risk factors and pathogenesis, atherosclerotic lesions and their clinical manifestations vary in different parts of the vasculature. Peripheral arterial disease (PAD) in the superficial femoral artery (SFA) represents a frequent clinical manifestations of atherosclerotic disease. The pathohistological characteristics of plaques in PAD differ from lesions in the coronary arteries. Plaques in the SFA have more fibrotic elements with less lipid and degenerative tissue elements; this makes them more stable and less prone to rupture...
February 26, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28239949/temporal-trends-in-peripheral-arterial-interventions-observations-from-the-blue-cross-blue-shield-of-michigan-cardiovascular-consortium-bmc2-pvi
#14
Michael P Thomas, Yeo Jung Park, Scott Grey, Theodore L Schreiber, Hitinder S Gurm, Dale Leffler, Thomas P Davis, Peter Henke, Paul Michael Grossman
OBJECTIVES: The aim is to examine trends in procedural indication, arterial beds treated, and device usage in peripheral arterial interventions (PVIs). BACKGROUND: There is little data on indication, vascular beds treated and devices utilized for peripheral arterial interventions. METHODS: We used data from 43 hospitals participating in the BMC2 VIC registry. PVIs were separated by year and divided by arterial segment. Lower extremity PVIs were subclassified as having been performed for claudication or critical limb ischemia (CLI)...
February 27, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28228325/prognostic-factors-associated-with-the-surgical-indication-for-lumbar-spinal-stenosis-patients-less-responsive-to-conservative-treatments-an-investigator-initiated-observational-cohort-study
#15
Masayoshi Fukushima, Hiroyuki Oka, Nobuhiro Hara, Yasushi Oshima, Hirotaka Chikuda, Sakae Tanaka, Katsushi Takeshita, Ko Matsudaira
BACKGROUND: A few cohort studies have determined which patients with lumbar spinal stenosis are likely to need surgery because of the deterioration of symptoms. However, there are still insufficient data regarding the management of lumbar spinal stenosis due to lack of prognostic factors associated with the need for surgery. The purpose of this study was to identify the prognostic factors associated with the need for surgical treatment in patients with lumbar spinal stenosis. METHODS: Patients with lumbar spinal stenosis from our hospital and related facilities were enrolled...
February 19, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28203578/supersized-atheroma-causing-acquired-coarctation-of-aorta-leading-to-heart-failure
#16
Sajin Karakattu, Ghulam Murtaza, Sharma Dinesh, Kamesh Sivagnanam, Jeffrey Schoondyke, Timir Paul
Calcified atheromatous aortic lesion causing significant narrowing of the aorta is an uncommon clinical entity. This calcified atheroma leads to obstruction of the lumen of the aorta simulating acquired coarctation of aorta causing impaired perfusion of lower limbs, visceral ischemia, and hypertension. We report a case of 58-year-old patient who presented with dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea, 25-lb weight gain, lower extremity edema, and chest pain. Extensive workup including computed tomography and magnetic resonance imaging revealed a large calcific mass in the aortic arch causing his presenting symptoms...
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28194186/safety-and-effectiveness-of-bone-marrow-cell-concentrate-in-the-treatment-of-chronic-critical-limb-ischemia-utilizing-a-rapid-point-of-care-system
#17
Venkatesh Ponemone, Saniya Gupta, Dalip Sethi, Manish Suthar, Monika Sharma, Richard J Powell, Kenneth Lee Harris, Nungshi Jungla, Priyadarshini Arambam, Upendra Kaul, Ashok Seth, Suhail Bukhari
Critical limb ischemia (CLI) is the end stage of lower extremity peripheral vascular disease (PVD) in which severe obstruction of blood flow results in ischemic rest pain, ulcers and/or gangrene, and a significant risk of limb loss. This open-label, single-arm feasibility study evaluated the safety and therapeutic effectiveness of autologous bone marrow cell (aBMC) concentrate in revascularization of CLI patients utilizing a rapid point-of-care device. Seventeen (17) no-option CLI patients with ischemic rest pain were enrolled in the study...
2017: Stem Cells International
https://www.readbyqxmd.com/read/28151868/impact-of-betablockers-on-general-and-local-outcome-in-patients-hospitalized-for-lower-extremity-peripheral-artery-disease-the-copart-registry
#18
MULTICENTER STUDY
Tristan Mirault, Alexandre Galloula, Jean-Pierre Cambou, Philippe Lacroix, Victor Aboyans, Carine Boulon, Joel Constans, Alessandra Bura-Riviere, Emmanuel Messas
Lower extremity peripheral artery disease (PAD) is one manifestation of atherosclerosis. Patients with PAD have an increased rate of mortality due to concurrent coronary artery disease and hypertension. Betablockers (BB) may, therefore, be prescribed, especially in case of heart failure. However, BB safety in PAD is controversial, because of presumed peripheral hemodynamic consequences of BB that could lead to worsening of symptoms in patients with PAD. In this context, we aimed to determine the impact of BB on all-cause and cardiovascular mortality and amputation rate at 1 year after hospitalization for PAD from the COPART Registry population...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28128018/german-guideline-on-the-diagnosis-and-treatment-of-peripheral-artery-disease-a-comprehensive-update-2016
#19
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/28126175/risk-factors-for-30-day-unplanned-readmission-following-infrainguinal-endovascular-interventions
#20
Thomas C F Bodewes, Peter A Soden, Klaas H J Ultee, Sara L Zettervall, Alexander B Pothof, Sarah E Deery, Frans L Moll, Marc L Schermerhorn
OBJECTIVE: Unplanned hospital readmissions following surgical interventions are associated with adverse events and contribute to increasing health care costs. Despite numerous studies defining risk factors following lower extremity bypass surgery, evidence regarding readmission after endovascular interventions is limited. This study aimed to identify predictors of 30-day unplanned readmission following infrainguinal endovascular interventions. METHODS: We identified all patients undergoing an infrainguinal endovascular intervention in the targeted vascular module of the American College of Surgeons National Surgical Quality Improvement Program between 2012 and 2014...
February 2017: Journal of Vascular Surgery
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