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Lower limb claudication

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28123169/pathophysiology-of-intermittent-claudication-in-peripheral-artery-disease
#7
Naomi M Hamburg, Mark A Creager
Peripheral artery disease (PAD) affects more than 200 million adults worldwide. Patients with lower extremity PAD have a heightened risk for cardiovascular events because of the systemic nature of atherosclerosis, and benefit from treatment with risk factor-modifying therapies. Limb symptoms in PAD include intermittent claudication and diminished walking ability. Arterial obstruction from atherosclerotic lesions initiates limb ischemia; however, decreased perfusion incompletely determines the clinical expression of PAD and its response to therapy...
January 26, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28065441/clinimetric-evaluation-of-the-vascular-quality-of-life-questionnaire-in-patients-with-lower-limb-ischaemia
#8
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/28050885/results-of-an-international-postmarketing-surveillance-study-of-pl-vegf165-safety-and-efficacy-in-210-patients-with-peripheral-arterial-disease
#9
Roman Deev, Igor Plaksa, Ilia Bozo, Artur Isaev
INTRODUCTION: The effective treatment of chronic lower limb ischemia is one of the most challenging issues confronting vascular surgeons. Current pharmacological therapies play an auxiliary role and cannot prevent disease progression, and new treatment methods are needed. pl-VEGF165, a gene therapy drug, was approved in Russia for the treatment of atherosclerotic peripheral arterial disease (PAD) after clinical studies in 2011. The study drug is an original gene construction in which pl-VEGF165 1...
January 3, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28041804/endovascular-treatment-of-the-common-femoral-artery-in-the-vascular-quality-initiative
#10
Jeffrey J Siracuse, Kathryn Van Orden, Jeffrey A Kalish, Mohammad H Eslami, Marc L Schermerhorn, Virendra I Patel, Denis Rybin, Alik Farber
OBJECTIVE: Endovascular interventions of the common femoral (CFA) and deep (DFA) femoral arteries are becoming more common. However, there is very little published data for guidance. Our objective was to analyze practice patterns and outcomes from these interventions. METHODS: The Vascular Quality Initiative (2010-2015) was queried for all endovascular interventions of the CFA and DFA. Cases that were emergent or for acute limb ischemia were excluded. Those with isolated CFA with or without DFA treatment were analyzed...
December 29, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28003211/lower-limb-hot-water-immersion-acutely-induces-beneficial-hemodynamic-and-cardiovascular-responses-in-peripheral-arterial-disease-and-healthy-elderly-controls
#11
Kate N Thomas, Andre Marie van Rij, Samuel J E Lucas, James D Cotter
Passive heat induces beneficial perfusion profiles, provides substantive cardiovascular strain and reduces blood pressure, thereby holding potential for healthy and cardiovascular disease populations. The aim of this study was to assess acute responses to passive heat via lower-limb hot-water immersion in patients with peripheral arterial disease (PAD) and healthy, elderly controls. Eleven patients with PAD (age 71±6 y, 7 male) and ten Controls (age 72±7 y, 8 male) underwent hot-water immersion (30 min waist-level immersion in 42...
December 21, 2016: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/27998051/follow-up-and-surveillance-of-vein-grafts-when-and-how-to-intervene-to-prevent-complications
#12
Olivia M McBride, Roderick T Chalmers
Despite advances in endovascular strategies, surgical infrainguinal lower limb revascularization remains the gold standard treatment for critical lower limb ischemia and disabling claudication.1 Maintaining patency of infrainguinal vein bypass grafts has been a challenging task for vascular surgeons as they are prone to developing stenosis which may precipitate failure of the bypass.2,3 Duplex ultrasound scanning has evolved as the investigation of choice to identify vein graft lesions but graft surveillance programs using this technique remain controversial...
December 19, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27994881/endovascular-treatment-of-spontaneous-isolated-abdominal-aortic-dissection
#13
Anna Maria Giribono, Doriana Ferrara, Flavia Spalla, Donatella Narese, Umberto Bracale, Felice Pecoraro, Renata Bracale, Luca Del Guercio, Umberto Marcello Bracale
Isolated abdominal aortic dissection is a rare clinical disease representing only 1.3% of all dissections. There are a few case series reported in the literature. The causes of this pathology can be spontaneous, iatrogenic, or traumatic. Most patients are asymptomatic and symptoms are usually abdominal or back pain, while claudication and lower limb ischemia are rare. Surgical and endovascular treatment are two valid options with acceptable results. We herein describe nine cases of symptomatic spontaneous isolated abdominal aortic dissection, out of which four successfully were treated with an endovascular approach between July 2003 and July 2013...
December 2016: Acta Radiologica Open
https://www.readbyqxmd.com/read/27986482/high-dose-rate-brachytherapy-for-the-treatment-of-lower-extremity-in-stent-restenosis
#14
Karen J Ho, Phillip M Devlin, Arin L Madenci, Marcus E Semel, Edwin C Gravereaux, Louis L Nguyen, Michael Belkin, Matthew T Menard
OBJECTIVE: Historically, edge stenosis and late thrombosis limited the effectiveness of adjunctive endovascular brachytherapy (EVBT) for in-stent restenosis (ISR) after percutaneous transluminal angioplasty (PTA) and stenting. We evaluated an updated protocol of PTA and EVBT for ISR among patients with lower extremity occlusive disease. METHODS: This is a retrospective, single-center review of patients treated with PTA and EVBT for ISR in the iliac and femoropopliteal segments between 2004 and 2012...
December 13, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27959717/ticagrelor-versus-clopidogrel-in-symptomatic-peripheral-artery-disease
#15
RANDOMIZED CONTROLLED TRIAL
William R Hiatt, F Gerry R Fowkes, Gretchen Heizer, Jeffrey S Berger, Iris Baumgartner, Peter Held, Brian G Katona, Kenneth W Mahaffey, Lars Norgren, W Schuyler Jones, Juuso Blomster, Marcus Millegård, Craig Reist, Manesh R Patel
Background Peripheral artery disease is considered to be a manifestation of systemic atherosclerosis with associated adverse cardiovascular and limb events. Data from previous trials have suggested that patients receiving clopidogrel monotherapy had a lower risk of cardiovascular events than those receiving aspirin. We wanted to compare clopidogrel with ticagrelor, a potent antiplatelet agent, in patients with peripheral artery disease. Methods In this double-blind, event-driven trial, we randomly assigned 13,885 patients with symptomatic peripheral artery disease to receive monotherapy with ticagrelor (90 mg twice daily) or clopidogrel (75 mg once daily)...
5, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/27956404/percutaneous-therapies-for-peripheral-artery-disease
#16
Mehdi H Shishehbor, Michael R Jaff
Percutaneous therapies for peripheral artery disease continue to evolve with new techniques and devices. Although guidelines-recommended therapies have impacted cardiovascular morbidity and mortality, endovascular interventions have been shown to reduce limb pain, improve quality of life, and prolong walking distance for those with claudication and to reduce amputation rates among those with critical limb ischemia. Novel devices such as drug-eluting stents and drug-coated balloons have improved patency for moderate-length lesions, whereas others allow treatment of heavily calcified and tortuous segments...
December 13, 2016: Circulation
https://www.readbyqxmd.com/read/27921154/peripheral-stent-thrombosis-leading-to-acute-limb-ischemia-and-major-amputation-incidence-and-risk-factors-in-the-aortoiliac-and-femoropopliteal-arteries
#17
Konstantinos Katsanos, Said A M Al-Lamki, Aneeta Parthipun, Stavros Spiliopoulos, Sanjay Dhanji Patel, Ioannis Paraskevopoulos, Hany Zayed, Athanasios Diamantopoulos
PURPOSE: To report the real-world incidence and risk factors of stent thrombosis in the aortoiliac and femoropopliteal arteries in case of bare nitinol stent (BNS) or covered nitinol stent (CNS) placement from a single-centre retrospective audit. MATERIALS AND METHODS: Medical records of consecutive patients treated with peripheral stent placement for claudication or critical limb ischemia were audited for definite stent thrombosis defined as imaging confirmed stent thrombosis that presented as acute limb-threatening ischemia...
March 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27908823/subintimal-recanalization-of-an-occluded-common-iliac-stent-a-case-report
#18
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-year-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 restenting after failed intraluminal approach. The postoperative computed tomography scan showed that the restented 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
#19
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
#20
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
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