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Lower limb claudication

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https://www.readbyqxmd.com/read/27908823/subintimal-recanalization-of-an-occluded-common-iliac-stent-a-case-report
#1
Giuseppe Asciutto, Roberta M Brambilla, Ioannis Bountouris, Martin Malina, Nuno V Dias
The purpose of this report is to describe a minimally invasive alternative endovascular technique for the treatment of chronically occluded stents when it is not possible to cross them endoluminally. A 71-years-old patient with recurrent severe lower limb claudication due to occlusion of a stent placed in the common iliac artery 5 years earlier underwent subintimal recanalization of the stented segment and re-stenting after failed intraluminal approach. The postoperative CT scan showed that the re-stented segment was patent with a flattening of the previous stent...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27896226/use-of-the-directional-atherectomy-for-the-treatment-of-femoro-popliteal-lesions-in-patients-with-critical-lower-limb-ischemia
#2
Umberto Marcello Bracale, Gaetano Vitale, Guido Bajardi, Donatella Narese, Ettore Dinoto, Anna Maria Giribono, Doriana Ferrara, Luca Del Guercio, Massimo Midiri, Felice Pecoraro
: Femoro-popliteal PTA for the treatment of critical limb ischemia is frequently associated with unsatisfactory procedural success rates while directional atherectomy (DCA) has improved success rate since claudicant patients undergoing percutaneous treatment of femoro-popliteal obstructive disease. The aim of this prospective study is to evaluate the safety, efficacy and procedural success of DCA, at one year, in the percutaneous treatment of femoro-popliteal obstructive disease in patients with critical limb ischemia...
November 2016: Translational Medicine @ UniSa
https://www.readbyqxmd.com/read/27866700/angiopoietin-related-growth-factor-is-independently-associated-with-lower-extremity-peripheral-arterial-disease
#3
Hao Nie, Yue Liang, Hong-Xia Wang, Hua-Liang Ren, Yue-Wei Wang, Fang-Da Li, Yue-Hong Zheng
AIMS: The present study investigated the association of serum levels of angiopoietin-related growth factor (AGF) with lower extremity peripheral arterial disease (LEPAD). METHODS: The study group is comprised of 105 patients with lower extremity peripheral arterial disease. The control group consisted of 80 individuals without lower extremity peripheral arterial disease. Serum AGF concentrations were determined by enzyme-linked immunosorbent assay. The relationship between AGF and clinical and biochemical parameters was studied...
October 27, 2016: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/27853042/polyarteritis-nodosa-presenting-as-peripheral-vascular-disease-and-acute-limb-ischemia
#4
A Shukla, A Aggarwal
Acute limb ischemia and peripheral vascular disease (PVD) are unusual presentations of polyarteritis nodosa (PAN). Here, we present a case with PVD of both lower limbs leading to foot claudication. Digital subtraction angiography showed narrowing, irregularity, and occlusion of both lower limb arteries with no involvement of the abdomen visceral arteries. Based on significant weight loss, diastolic blood pressure >90 mmHg, myalgia, testicular pain, and angiographic abnormalities in medium-sized arteries, he was diagnosed as having PAN...
November 16, 2016: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/27833919/the-impact-of-walking-exercises-and-resistance-training-upon-the-walking-distance-in-patients-with-chronic-lower-limb-ischaemia
#5
Maria Szymczak, Grzegorz Oszkinis, Marian Majchrzycki
Objective. The objective of this paper is to compare the impact of supervised walking and resistance training upon the walking distance in PAD patients. Materials and Methods. The examination involved 50 PAD patients at the 2nd stage of the disease according to Fontaine's scale. The participants were randomly allocated to two groups: one exercising on the treadmill (n = 24) and one performing resistance exercises of lower limbs (n = 26). Results. The 12-week program of supervised rehabilitation led to a significant increase in the intermittent claudication distance measured both on the treadmill and during the 6-minute walking test...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27829449/efficacy-of-brief-behavioral-counselling-by-allied-health-professionals-to-promote-physical-activity-in-people-with-peripheral-arterial-disease-bipp-study-protocol-for-a-multi-center-randomized-controlled-trial
#6
Nicola W Burton, Zanfina Ademi, Stuart Best, Maria A Fiatarone Singh, Jason S Jenkins, Kenny D Lawson, Anthony S Leicht, Yorgi Mavros, Yian Noble, Paul Norman, Richard Norman, Belinda J Parmenter, Jenna Pinchbeck, Christopher M Reid, Sophie E Rowbotham, Lisan Yip, Jonathan Golledge
BACKGROUND: Physical activity is recommended for people with peripheral arterial disease (PAD), and can improve walking capacity and quality of life; and reduce pain, requirement for surgery and cardiovascular events. This trial will assess the efficacy of a brief behavioral counselling intervention delivered by allied health professionals to improve physical activity in people with PAD. METHODS: This is a multi-center randomised controlled trial in four cities across Australia...
November 9, 2016: BMC Public Health
https://www.readbyqxmd.com/read/27763293/outcomes-of-open-and-endovascular-lower-extremity-revascularization-in-current-smokers-with-intermittent-claudication-and-critical-limb-ischemia
#7
Samuel L Chen, Matthew D Whealon, Nii-Kabu Kabutey, Isabella J Kuo, Roy M Fujitani
No abstract text is available yet for this article.
August 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27751735/a-multi-institutional-experience-in-adventitial-cystic-disease
#8
Raghu L Motaganahalli, Matthew R Smeds, Michael P Harlander-Locke, Peter F Lawrence, Naoki Fujimura, Randall R DeMartino, Giovanni De Caridi, Alberto Munoz, Sherene Shalhub, Susanna H Shin, Kwame S Amankwah, Hugh A Gelabert, David A Rigberg, Jeffrey J Siracuse, Alik Farber, E Sebastian Debus, Christian Behrendt, Jin H Joh, Naveed U Saqib, Kristofer M Charlton-Ouw, Catherine M Wittgen
BACKGROUND: Adventitial cystic disease (ACD) is an unusual arteriopathy; case reports and small series constitute the available literature regarding treatment. We sought to examine the presentation, contemporary management, and long-term outcomes using a multi-institutional database. METHODS: Using a standardized database, 14 institutions retrospectively collected demographics, comorbidities, presentation/symptoms, imaging, treatment, and follow-up data on consecutive patients treated for ACD during a 10-year period, using Society for Vascular Surgery reporting standards for limb ischemia...
October 14, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27749546/high-prevalence-of-known-and-unknown-pulmonary-diseases-in-patients-with-claudication-during-exercise-oximetry-a-retrospective-analysis
#9
Christophe Colas-Ribas, Isabelle Signolet, Samir Henni, Mathieu Feuillloy, Frédéric Gagnadoux, Pierre Abraham
The prevalence of pulmonary disease in patients with peripheral artery disease (PAD) has not been extensively studied. Recent evidence has shown that ∼20% of the patients have an atypical chest transcutaneous oxygen pressure (TcpO2) pattern during exercise, which suggests walking-induced hypoxemia. The main objectives of this study were to: (1) describe in a retrospective way the characteristics of the patients suffering from claudication, who attended a treadmill testing in our laboratory, (2) assess the prevalence of known or unknown pulmonary disease...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27692467/regional-variation-in-patient-selection-and-treatment-for-lower-extremity-vascular-disease-in-the-vascular-quality-initiative
#10
Peter A Soden, Sara L Zettervall, Thomas Curran, Ageliki G Vouyouka, Philip P Goodney, Joseph L Mills, John W Hallett, Marc L Schermerhorn
OBJECTIVE: Prior studies on the cause and effect of surgical variation have been limited by utilization of administrative data. The Vascular Quality Initiative (VQI), a robust national clinical registry, provides anatomic and perioperative details allowing a more robust analysis of variation in surgical practice. METHODS: The VQI was used to identify all patients undergoing infrainguinal open bypass or endovascular intervention from 2009 to 2014. Asymptomatic patients were excluded...
September 27, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27692118/rehabilitation-therapy-in-peripheral-arterial-disease
#11
Sandeep Aggarwal, Randy D Moore, Ross Arena, Brenda Marra, Amanda McBride, Brea Lamb, Billie-Jean Martin, James Stone
Peripheral arterial disease (PAD) is the result of atherosclerosis in the lower limb arteries, which can give rise to intermittent claudication (IC), limb ulceration, infections, and, in some circumstances, amputation. As a result of PAD, patients are frequently limited in both walking duration and speed. These ambulatory deficits impact both functional capacity and quality of life. The prevalence of PAD is increasing, and patients with this diagnosis have high cardiovascular morbidity and mortality. A comprehensive approach is required to improve outcomes in patients with PAD and include tobacco cessation, pharmacologic management of metabolic fitness, risk-factor modification, and exercise training...
October 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27633168/the-effect-of-supervised-exercise-therapy-for-intermittent-claudication-on-lower-limb-lean-mass
#12
Simon Vui Vun, Michelle D Miller, Christopher L Delaney, Richard B Allan, J Ian Spark
OBJECTIVE: Supervised exercise is currently recommended for the first-line treatment of intermittent claudication based on improvement in walking capacity. However, the promotion of skeletal muscle atrophy by repetitive ischemia-reperfusion caused by treadmill-based programs remains a concern. Because preservation of skeletal muscle mass (SMM) and lean mass (LM) is integral to functional capacity and longevity, this study measured the effect of standard treadmill-based supervised exercise on SMM and regional lower limb LM in patients with intermittent claudication...
September 12, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27633166/effect-of-adjunct-femoral-endarterectomy-in-lower-extremity-bypass-on-perioperative-and-1-year-outcomes
#13
Peter A Soden, Sara L Zettervall, Katie E Shean, Sarah E Deery, Jeffrey A Kalish, Christopher T Healey, Nikhil Kansal, Marc L Schermerhorn
BACKGROUND: Isolated common femoral endarterectomy was recently reported to have a 30-day mortality of 3.4%. The effect of adjunctive femoral endarterectomy at the time of lower extremity bypass is not well described, and therefore, the purpose of this study was to determine its associated perioperative and long-term risk. METHODS: Vascular Study Group of New England registry data were used to identify patients undergoing initial lower extremity bypass from 2003 to 2015...
September 12, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27629349/lower-limb-magnetic-resonance-angiography-performance-of-extracellular-contrast-agents-versus-blood-pool-contrast-agent-for-both-dynamic-and-high-spatial-resolution-imaging-in-extended-phase
#14
G Roditi, A Christie, S Chandramohan
AIM: To prospectively compare the performance of extracellular space contrast agents (ECSCAs) versus a blood-pool contrast agent (BPCA) for a comprehensive lower-limb magnetic resonance angiography (MRA) protocol in patients with either claudication or critical ischaemia. MATERIALS AND METHODS: Thirty patients with claudication underwent lower-limb magnetic resonance angiography (MRA) (dynamic crural, three-station bolus chase, and infra-inguinal high resolution) using a triphasic injection method with both a ECSCA and BPCA to allow intra-individual comparison, and 30 patients with critical ischaemia were scanned with either a ECSCA or BPCA...
September 11, 2016: Clinical Radiology
https://www.readbyqxmd.com/read/27623758/ankle-brachial-index-for-the-diagnosis-of-lower-limb-peripheral-arterial-disease
#15
Fay Crawford, Karen Welch, Alina Andras, Francesca M Chappell
BACKGROUND: Peripheral arterial disease (PAD) of the lower limb is common, with prevalence of both symptomatic and asymptomatic disease estimated at 13% in the over 50 age group. Symptomatic PAD affects about 5% of individuals in Western populations between the ages of 55 and 74 years. The most common initial symptom of PAD is muscle pain on exercise that is relieved by rest and is attributed to reduced lower limb blood flow due to atherosclerotic disease (intermittent claudication). The ankle brachial index (ABI) is widely used by a variety of healthcare professionals, including specialist nurses, physicians, surgeons and podiatrists working in primary and secondary care settings, to assess signs and symptoms of PAD...
September 14, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27594393/surgical-and-endovascular-hybrid-approach-in-peripheral-arterial-disease-of-the-lower-limbs
#16
Anouk Grandjean, Katia Iglesias, Céline Dubuis, Sébastien Déglise, Jean-Marc Corpataux, François Saucy
BACKGROUND: Multilevel peripheral arterial disease is frequently observed in patients with intermittent claudication or critical limb ischemia. This report evaluates the efficacy of one-stage hybrid revascularization in patients with multilevel arterial peripheral disease. PATIENTS AND METHODS: A retrospective analysis of a prospective database included all consecutive patients treated by a hybrid approach for a multilevel arterial peripheral disease. The primary outcome was the patency rate at 6 months and 1 year...
September 2016: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/27575814/dual-antiplatelet-therapy-is-associated-with-prolonged-survival-after-lower-extremity-revascularization
#17
Peter A Soden, Sara L Zettervall, Klaas H J Ultee, Bruce E Landon, A James O'Malley, Philip P Goodney, Randall R DeMartino, Shipra Arya, Marc L Schermerhorn
BACKGROUND: Dual antiplatelet therapy (DAPT) after coronary stenting prolongs survival by preventing both in-stent thrombosis and other cardiovascular atherothrombotic events. Patients with peripheral artery disease (PAD) typically have a heavy burden of unrevascularized coronary artery disease and also stand to benefit from increased atherothrombotic protection with DAPT. The potential benefit of DAPT compared with aspirin alone in patients with PAD is not well described. METHODS: We identified all patients undergoing an initial elective lower extremity revascularization (bypass or endovascular) from 2003 to 2016 in the Vascular Quality Initiative registry discharged on aspirin or aspirin plus a thienopyridine antiplatelet agent (DAPT)...
August 26, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27558463/tibiopedal-access-for-crossing-of-infrainguinal-artery-occlusions-a-prospective-multicenter-observational-study
#18
Craig M Walker, Jihad Mustapha, Thomas Zeller, Andrej Schmidt, Miguel Montero-Baker, Aravinda Nanjundappa, Marco Manzi, Luis Mariano Palena, Nelson Bernardo, Yazan Khatib, Robert Beasley, Luis Leon, Fadi A Saab, Adam R Shields, George L Adams
PURPOSE: To report a prospective, multicenter, observational study (ClinicalTrials.gov identifier NCT01609621) of the safety and effectiveness of tibiopedal access and retrograde crossing in the treatment of infrainguinal chronic total occlusions (CTOs). METHODS: Twelve sites around the world prospectively enrolled 197 patients (mean age 71±11 years, range 41-93; 129 men) from May 2012 to July 2013 who met the inclusion criterion of at least one CTO for which a retrograde crossing procedure was planned or became necessary...
August 24, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27558461/comparison-of-transradial-vs-transfemoral-access-for-aortoiliac-and-femoropopliteal-interventions-a-single-center-experience
#19
Andrew K Roy, Phillipe Garot, Yves Louvard, Antoinette Neylon, Marco Spaziano, Fadi J Sawaya, Leticia Fernandez, Yann Roux, Raphael Blanc, Michel Piotin, Stephane Champagne, Oscar Tavolaro, Hakim Benamer, Thomas Hovasse, Bernard Chevalier, Thierry Lefèvre, Thierry Unterseeh
PURPOSE: To compare the procedure and safety outcomes of the transradial approach (TRA) with the femoral approach (FA) for treating aortoiliac and femoropopliteal stenoses and occlusions. METHODS: A single-center retrospective study was conducted involving 188 patients (mean age 66.4±10.8 years; 116 men) with lower limb claudication or critical limb ischemia who underwent aortoiliac (131, 62.4%) or femoropopliteal (79, 37.6%) interventions on 210 lesions over a 3-year period...
August 24, 2016: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/27490003/drug-eluting-balloon-angioplasty-versus-uncoated-balloon-angioplasty-for-peripheral-arterial-disease-of-the-lower-limbs
#20
REVIEW
Ahmed Kayssi, Talal Al-Atassi, George Oreopoulos, Graham Roche-Nagle, Kong Teng Tan, Dheeraj K Rajan
BACKGROUND: Atherosclerotic peripheral arterial disease (PAD) can lead to disabling ischemia and limb loss. Treatment modalities have included risk factor optimization through life-style modifications and medications, or operative approaches using both open and minimally invasive techniques, such as balloon angioplasty. Drug-eluting balloon (DEB) angioplasty has emerged as a promising alternative to uncoated balloon angioplasty for the treatment of this difficult disease process. By ballooning and coating the inside of atherosclerotic vessels with cytotoxic agents, such as paclitaxel, cellular mechanisms responsible for atherosclerosis and neointimal hyperplasia are inhibited and its devastating complications are prevented or postponed...
August 4, 2016: Cochrane Database of Systematic Reviews
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