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Diabetic foot endovascular

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https://www.readbyqxmd.com/read/28697694/midterm-outcomes-from-a-pilot-study-of-percutaneous-deep-vein-arterialization-for-the-treatment-of-no-option-critical-limb-ischemia
#1
Steven Kum, Yih Kai Tan, Michiel A Schreve, Roberto Ferraresi, Ramon L Varcoe, Andrej Schmidt, Dierk Scheinert, Jihad A Mustapha, Darryl M Lim, Derek Ho, Tjun Y Tang, Vlad-Adrian Alexandrescu, Pramook Mutirangura
PURPOSE: To report the initial clinical experience with percutaneous deep vein arterialization (PDVA) to treat critical limb ischemia (CLI) via the creation of an arteriovenous fistula. METHODS: Seven patients (median age 85 years; 5 women) with CLI and no traditional endovascular or surgical revascularization options (no-option CLI) were recruited in a pilot study to determine the safety of PDVA. All patients were diabetic; 4 had Rutherford category 6 ischemia...
July 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28674266/pilot-cohort-study-assessing-the-efficacy-of-endovascular-revascularization-in-the-restoration-of-peripheral-sensory-disturbance-in-patients-with-critical-limb-ischemia
#2
Kentaro Jujo, Katsumi Saito, Issei Ishida, Yuho Furuki, Eiji Shibahashi, Kensuke Shimazaki, Haruki Sekiguchi, Yuichiro Minami, Junichi Yamaguchi, Hiroshi Ogawa, Nobuhisa Hagiwara
BACKGROUND: Sensory disturbance (SD) is a common consequence of peripheral nerve damage associated with diabetes and severe ischemia. Progression of SD places patients at high risk for lower extremity ulcers and amputations. SD has been thought to be progressive and irreversible, and possibly caused by microvascular dysfunction. The aim of this study was to determine whether endovascular revascularization (EVR) induces quantifiable changes in SD in chronic critical limb ischemia (CLI) patients with neuropathy...
July 1, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28584901/endovascular-treatment-of-diabetic-peripheral-arterial-disease-in-older-and-oldest-old-patients-a-retrospective-study
#3
Cristina Gatti, Sara Cecchini, Paolo Fabbietti, Fabio Romagnoli, Stefano Ricci
BACKGROUND: Peripheral arterial disease (PAD) is frequent among older diabetic patients, but the evidence about endovascular revascularization is very limited. METHOD: We retrospectively analyzed data collected from 120 diabetic patients consecutively admitted to a Diabetic Foot Clinic, including 64 patients aged 65-79 years and 56 patients aged 80 or more. RESULTS: Percutaneous transluminal angioplasty (PTA) was followed by technical success in 82...
June 3, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28541016/pedal-arch-patency-and-not-direct-angiosome-revascularization-predicts-outcomes-of-endovascular-interventions-in-diabetic-patients-with-critical-limb-ischemia
#4
Nicola Troisi, Filippo Turini, Emiliano Chisci, Leonardo Ercolini, Pierfrancesco Frosini, Renzo Lombardi, Francesca Falciani, Cristiana Baggiore, Roberto Anichini, Stefano Michelagnoli
BACKGROUND: Aim of this study was to evaluate the impact of pedal arch status and direct-angiosome revascularization (DAR) on clinical outcomes in diabetic patients with foot wounds undergoing endovascular revascularization. METHODS: Between January 2014 and June 2015 93 diabetic patients with foot wounds underwent endovascular revascularization of at least one below-the-knee vessel. Patients were divided into three groups according to the pedal arch status: complete pedal arch (CPA), incomplete pedal arch (IPA) and absent pedal arch (APA)...
May 24, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28480283/using-nuclear-medicine-imaging-wisely-in-diagnosing-infectious-diseases
#5
REVIEW
Andrea Censullo, Tara Vijayan
In recent years, there has been an increasing emphasis on efficient and accurate diagnostic testing, exemplified by the American Board of Internal Medicine's "Choosing Wisely" campaign. Nuclear imaging studies can provide early and accurate diagnoses of many infectious disease syndromes, particularly in complex cases where the differential remains broad. This review paper offers clinicians a rational, evidence-based guide to approaching nuclear medicine tests, using an example case of methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia in a patient with multiple potential sources...
2017: Open Forum Infectious Diseases
https://www.readbyqxmd.com/read/28349710/endovascular-devices-and-revascularization-techniques-for-limb-threatening-ischemia-in-individuals-with-diabetes
#6
Jayer Chung
Diabetes mellitus (DM) is a rapidly worsening global epidemic over the last thirty-five years. The increased prevalence of DM has changed the phenotypic expression of atherosclerotic limb threatening ischemia (LTI), resulting in an increase in lesions in the tibial vessels. These patients are also afflicted with peripheral neuropathy, foot deformities, and medial calcification of the vasculature. In response to the evolving phenotype of atherosclerosis, newer minimally invasive tools and techniques have been developed to improve the blood supply in LTI...
March 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28166662/-ischemic-origin-of-diabetic-foot-disease-epidemiology-difficulties-of-diagnosis-options-for-prevention-and-revascularization
#7
Endre Kolossváry, Zoltán Bánsághi, Gábor Viktor Szabó, Zoltán Járai, Katalin Farkas
"Diabetic foot" as definition covers a multifactorial clinical condition. According to the recent epidemiological data, the role of lower limb ischemia is getting more influential over other pathological causes, like neuropathy, infections and bone or soft tissue deformity. In diabetes, vascular disease leads to increased risk for leg ulcers and minor or major amputations. The traditional diagnostic tools for recognition of peripheral arterial disease have limited value because of diabetes specific clinical manifestations...
February 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/27935900/-thromboangiitis-obliterans-buerger-s-disease-state-of-the-art
#8
REVIEW
D D Zerbino, E A Zimba, N N Bagry
Thromboangiitis obliterans (Buerger's disease) is systemic vasculitis with predominant development of thrombotic occlusions of small-to-medium diameter arteries of distal portions of both upper and lower limbs. A distinctive feature of Buerger's disease from other vasculitides is the involvement of the venous bed into the pathological process in the form of migrating thrombophlebitis. The disease is encountered more often in young adult males, predominantly tobacco smokers. The clinical pattern is presented by symptoms of increasing insufficiency of blood supply of tissues of extremities...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/27667151/elevated-serum-phosphate-levels-are-associated-with-decreased-amputation-free-survival-after-interventions-for-critical-limb-ischemia
#9
Sara L Zettervall, Peter A Soden, Klaas H J Ultee, Crystal Seldon, Jinhee Oh, Kevin McGann, Marc L Schermerhorn, Raul J Guzman
OBJECTIVE: Elevated serum phosphate levels have been associated with increased risks of cardiovascular events and death in several patient populations. The effects of serum phosphate on outcomes in patients with critical limb ischemia (CLI) have not been evaluated. In this study, we assessed the effect of abnormal phosphate levels on mortality and major limb events after surgical intervention for CLI. METHODS: A retrospective review was undertaken to identify all patients at a single institution who underwent a first-time open or endovascular intervention for CLI between 2005 and 2014...
February 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27565588/the-financial-burden-of-surgical-and-endovascular-treatment-of-diabetic-foot-wounds
#10
Maximilian O Joret, Anastasia Dean, Colin Cao, Joanna Stewart, Venu Bhamidipaty
OBJECTIVE: The cost of treating diabetes-related disease in New Zealand is increasing and is expected to reach New Zealand dollars (NZD) 1.8 billion in 2021. The financial burden attached to the treatment of diabetic foot wounds is difficult to quantify and reported costs of treatment vary greatly in the literature. As of yet, no study has captured the true total cost of treating a diabetic foot wound. In this study, we investigate the total minimum cost of treating a diabetic foot ulcer at a tertiary institution...
September 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27428500/determinants-of-decreasing-major-amputation-rates-in-germany
#11
Carolin Pütter, Jürgen Stausberg, Olga von Beckerath, Holger Reinecke, Erika Schäfer, Knut Kröger
BACKGROUND: We analysed a potential association between the decrease in major amputations in Germany and the number of doctors, prescribed podologic foot care (PFC) and antidiabetic drugs, and performed percutaneous endoluminal angioplasties (PTA). PATIENTS AND METHODS: Data of all lower limb major amputations between 2007 and 2011, the cases hospitalised with an additional diagnosis of diabetes mellitus, and the numbers of PTAs, and the number of doctors in private practices and in hospitals were obtained from the Federal Statistical Office...
2016: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/27321326/long-term-outcomes-of-diabetic-haemodialysis-patients-with-critical-limb-ischemia-and-foot-ulcer
#12
Marco Meloni, Laura Giurato, Valentina Izzo, Matteo Stefanini, Enrico Pampana, Roberto Gandini, Luigi Uccioli
AIM: To evaluate the outcomes of diabetic dialysis patients with critical limb ischemia and foot ulcer. METHODS: The study group included 599 diabetic, 99 dialyzed (Ds) (16.5%) and 500 not dialyzed (NDs) (83%) patients with critical limb ischemia and foot ulcers identified as stage C (ischemia) or D (ischemia plus infection) of Texas Wound Classification. All patients were treated by endovascular revascularization. Outcomes were expressed as healing, major amputation, death and non healing after 12months...
June 2016: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/27219884/clinical-evaluation-of-human-umbilical-cord-mesenchymal-stem-cell-transplantation-after-angioplasty-for-diabetic-foot
#13
H L Qin, X H Zhu, B Zhang, L Zhou, W Y Wang
Aims: The multilineage differentiation potential of human umbilical cord mesenchymal stem cells (HUCMSCs) holds therapeutic promise for non-healing ulcers and tissue regeneration. The present study evaluated the effects of HUCMSC transplantation after angioplasty for treatment of diabetic foot. Methods: Included in the study were 53 patients (72 limbs) with severe symptoms of Fontaine II-IV diabetic foot accompanied by varying degrees of lower extremity arterial disease. The patients were randomly apportioned to a control group (25 patients; 38 limbs) or an experimental group (28 patients; 34 limbs)...
September 2016: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/27065215/using-noncontact-infrared-thermography-for-long-term-monitoring-of-foot-temperatures-in-a-patient-with-diabetes-mellitus
#14
Erik Staffa, Vladan Bernard, Luboš Kubíček, Robert Vlachovský, Daniel Vlk, Vojtěch Mornstein, Robert Staffa
Foot complications in persons with diabetes mellitus (DM) are associated with substantial costs and loss of quality of life. Increasing evidence suggests changes in skin temperature, measured using an infrared thermographic system (IRT), may be a predictor of foot ulcer development in patients with DM. The purpose of this case study is to describe the long-term IRT findings and overall clinical outcomes of a patient with DM and peripheral vascular disease. Foot temperature measurements using IRT were obtained slightly more than 1 year before and immediately following endovascular treatment of a 76-year-old man, a nonsmoker with type 2 DM, hypertension, and ischemic heart disease with cardiac arrhythmia...
April 2016: Ostomy/wound Management
https://www.readbyqxmd.com/read/27036309/society-for-vascular-surgery-limb-stage-and-patient-risk-correlate-with-outcomes-in-an-amputation-prevention-program
#15
Marlin W Causey, Ayman Ahmed, Bian Wu, Warren J Gasper, Alex Reyzelman, Shant M Vartanian, Jade S Hiramoto, Michael S Conte
OBJECTIVE: Clinical decision making and accurate outcomes comparisons in advanced limb ischemia require improved staging systems. The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System (Wound extent, Ischemia, and foot Infection [WIfI]) was designed to stratify limb outcomes based on three major factors-wound extent, ischemia, and foot infection. The Project or Ex-Vivo vein graft Engineering via Transfection III (PREVENT) III (PIII) risk score was developed to stratify patients by expected amputation-free survival (AFS) after surgical revascularization...
June 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27015337/combination-of-vascular-intervention-surgery-and-free-tissue-transfer-for-critical-diabetic-limb-salvage
#16
Chieh Chou, Pao-Jen Kuo, Yen-Chou Chen, Shu-Hung Huang, Chih-Hau Chang, Yi-Chia Wu, Su-Shin Lee, Cheng-Sheng Lai, Sin-Daw Lin, Kao-Ping Chang, Yur-Ren Kuo
BACKGROUND: Complex, nontraumatic diabetic foot ulcers with peripheral vascular compromise often lead to extensive lower-limb amputation. The aim of this study is to determine the outcome of combined vascular intervention and free tissue transfer for critical diabetic limb salvage. MATERIALS AND METHODS: A total of 26 consecutive diabetic patients with 28 legs with diabetic foot ulcers who underwent limb salvage with a combination of revascularization (bypass surgery or endovascular angioplasty) and free flap transfers were reviewed...
February 2016: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/26994958/validation-of-the-wound-ischemia-foot-infection-wifi-classification-system-in-nondiabetic-patients-treated-by-endovascular-means-for-critical-limb-ischemia
#17
Efthymios Beropoulis, Konstantinos Stavroulakis, Arne Schwindt, Arne Stachmann, Giovanni Torsello, Theodosios Bisdas
BACKGROUND: The Society for Vascular Surgery Lower Extremity Guidelines Committee developed the Wound, Ischemia, foot Infection (WIfI) a classification system to predict the amputation risk in patients with critical limb ischemia (CLI). A number of published studies have already evaluated its prognostic value. However, most of the included patients were diabetic, and the validation was done independent of the revascularization procedure. This single-center study evaluated the prognostic value of WIfI stages in nondiabetic patients treated by endovascular means...
July 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/26927956/collagen-implant-with-gentamicin-sulphate-as-an-option-to-treat-a-neuroischaemic-diabetic-foot-ulcer-case-report
#18
C E Costa Almeida
INTRODUCTION: The ischaemic diabetic foot is associated with a faster evolving atherosclerosis affecting preferentially the bellow knee arteries. This distal ischemia associated with a wide distribution of multiple stenosis and occlusions throughout lower limb arteries, makes revascularization very hard or even impossible. This represents a major factor responsible for non-healing diabetic foot ulcer. In these cases all efforts should be made to find treatment alternatives that can promote ulcer healing...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/26804367/the-management-of-diabetic-foot-a-clinical-practice-guideline-by-the-society-for-vascular-surgery-in-collaboration-with-the-american-podiatric-medical-association-and-the-society-for-vascular-medicine
#19
Anil Hingorani, Glenn M LaMuraglia, Peter Henke, Mark H Meissner, Lorraine Loretz, Kathya M Zinszer, Vickie R Driver, Robert Frykberg, Teresa L Carman, William Marston, Joseph L Mills, Mohammad Hassan Murad
BACKGROUND: Diabetes mellitus continues to grow in global prevalence and to consume an increasing amount of health care resources. One of the key areas of morbidity associated with diabetes is the diabetic foot. To improve the care of patients with diabetic foot and to provide an evidence-based multidisciplinary management approach, the Society for Vascular Surgery in collaboration with the American Podiatric Medical Association and the Society for Vascular Medicine developed this clinical practice guideline...
February 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/26802295/the-use-of-the-angiosome-concept-for-treating-infrapopliteal-critical-limb-ischemia-through-interventional-therapy-and-determining-the-clinical-significance-of-collateral-vessels
#20
MULTICENTER STUDY
Xiang-Tao Zheng, Rui-Chao Zeng, Jing-Yong Huang, Le-Men Pan, Xiang Su, Zi-Heng Wu, Guan-Feng Yu
BACKGROUND: The purpose of this study was to evaluate the clinical significance of the involvement of collateral vessels in interventional therapy based on the angiosome concept for infrapopliteal critical limb ischemia (CLI). METHODS: We enrolled 486 patients with unilateral infrapopliteal CLI (Rutherford Stage 5 or 6) treated at 2 hospitals from January 2005 to December 2014. Using the angiosome concept, the patients were categorized into 3 groups: the direct revascularization (DR) group, the indirect revascularization through collaterals (IR-tc) group, and the indirect revascularization without collaterals (IR-wc) group...
April 2016: Annals of Vascular Surgery
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