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Diabetic foot endovascular

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https://www.readbyqxmd.com/read/29733065/impacto-de-la-revascularizaci%C3%A3-n-y-factores-asociados-en-el-salvamento-de-la-extremidad-en-pacientes-con-pie-diab%C3%A3-tico
#1
Carlos A Hinojosa, Estefanía Boyer-Duck, Javier E Anaya-Ayala, Ana E Núñez-Salgado, Hugo Laparra-Escareno, René Lizola
Introducción: El pie diabético es causa frecuente de hospitalización. Objetivo: Examinar el impacto de la revascularización en la preservación de los miembros inferiores. Método: Estudio retrospectivo de pacientes diabéticos con úlceras en el pie. Se evaluó extensión del tejido perdido conforme las clasificaciones PEDIS y de Wagner, así como indicaciones y técnicas de revascularización. Los factores involucrados en la amputación mayor y el salvamento de la extremidad fueron evaluados por pruebas Fisher y chi cuadrado...
2018: Gaceta Médica de México
https://www.readbyqxmd.com/read/29679687/a-novel-technique-indocyanine-green-angiography-to-prognosticate-healing-of-foot-ulcer-in-critical-limb-ischemia
#2
Hiten M Patel, Shahzad S Bulsara, Shubhabrata Banerjee, Tapish Sahu, Virender K Sheorain, Tarun Grover, Rajiv Parakh
BACKGROUND: To predict wound healing in patients with critical limb ischemia(CLI) is ongoing issue. Currents methods like ankle-brachial index (ABI), color doppler and transcutaneous oxygen pressure (TCPO2 ), CT angiography are lacking in demonstrating regional perfusion. Indocyanine green angiography (ICGA) has the potential to provide regional perfusion information lacking in other methods. To demonstrate successes of revascularization procedure in CLI patients based on ICGA data this study was conducted...
April 18, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29501595/heel-wounds-predict-mortality-but-not-amputation-after-infrapopliteal-revascularization
#3
Abhisekh Mohapatra, Jon C Henry, Efthimios D Avgerinos, Rabih A Chaer, Steven A Leers, Aureline Boitet, Michael J Singh, Eric S Hager
BACKGROUND: Ischemic heel ulcerations are generally thought to carry a poor prognosis for limb salvage. We hypothesized that patients undergoing infrapopliteal revascularization for heel wounds, either bypass or endovascular intervention, would have lower wound healing rates and amputation-free survival (AFS) than patients with forefoot wounds. METHODS: A retrospective chart review was performed on patients who presented between 2006 and 2013 to our institution with ischemic foot wounds and infrapopliteal arterial disease and underwent either pedal bypass or endovascular tibial artery intervention...
March 6, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29428535/diabetic-foot-limb-salvage-a-series-of-809-attempts-and-predictors-for-endovascular-limb-salvage-failure
#4
Zhiwen Joseph Lo, Zhimin Lin, Uei Pua, Lawrence Han Hwee Quek, Bien Ping Tan, Sundeep Punamiya, Glenn Wei Leong Tan, Sriram Narayanan, Sadhana Chandrasekar
BACKGROUND: To review patient characteristics and outcomes of in-patient diabetic foot limb salvage and identify risk factors predicting for endovascular limb salvage failure. METHODS: Retrospective study of limb salvage attempts in 809 patients between August 2013 and July 2015. RESULTS: Sixty-eight percent of our study population were male with mean age at 65 years and 73% presented with Rutherford grade 6 critical limb ischemia, with the remaining 27% Rutherford grade 5...
February 9, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29422826/role-of-plasma-growth-factor-in-the-healing-of-chronic-ulcers-of-the-lower-legs-and-foot-due-to-ischaemia-in-diabetic-patients
#5
Tomasz Miłek, Krzysztof Baranowski, Piotr Zydlewski, Piotr Ciostek, Krzysztof Mlosek, Wojciech Olszewski
Introduction: It has been demonstrated that plasma growth factor (PGF) responsible for proliferation of smooth muscle cells and fibroblasts significantly shortens treatment duration. Aim: To determine the role of human growth factor in the healing of ulcers due to ischaemic diabetic foot syndrome (DFS) following previous angioplasty of the blood vessels of the lower leg and foot. Material and methods: The study group included 50 patients with ischaemic diabetic foot complicated by lower leg ulcers in which angioplasty of the stenotic arteries in the distal lower leg and foot was performed...
December 2017: Postȩpy Dermatologii i Alergologii
https://www.readbyqxmd.com/read/29353999/impact-of-pedal-arch-patency-on-tissue-loss-and-time-to-healing-in-diabetic-patients-with-foot-wounds-undergoing-infrainguinal-endovascular-revascularization
#6
Nicola Troisi, Filippo Turini, Emiliano Chisci, Leonardo Ercolini, Pierfrancesco Frosini, Renzo Lombardi, Francesca Falciani, Cristiana Baggiore, Roberto Anichini, Stefano Michelagnoli
Objective: To retrospectively evaluate the impact of pedal arch quality on tissue loss and time to healing in diabetic patients with foot wounds undergoing infrainguinal endovascular revascularization. Materials and Methods: Between January 2014 and June 2015, 137 consecutive diabetic patients with foot wounds underwent infrainguinal endovascular revascularization (femoro-popliteal or below-the-knee, arteries). Postprocedural angiography of the foot was used to divide the patients into the following three groups according to the pedal arch status: complete pedal arch (CPA), incomplete pedal arch (IPA), and absent pedal arch (APA)...
January 2018: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/29246911/three-year-outcomes-of-surgical-versus-endovascular-revascularization-for-critical-limb-ischemia-the-spinach-study-surgical-reconstruction-versus-peripheral-intervention-in-patients-with-critical-limb-ischemia
#7
Osamu Iida, Mitsuyoshi Takahara, Yoshimitsu Soga, Akio Kodama, Hiroto Terashi, Nobuyoshi Azuma
BACKGROUND: The aim of this study was to compare clinical outcomes between surgical reconstruction and endovascular therapy (EVT) for critical limb ischemia (CLI) in today's real-world settings. METHODS AND RESULTS: This multicenter, prospective, observational study registered and followed 548 Japanese CLI patients. The registration was in advance of revascularization; 197 patients were scheduled to receive surgical reconstruction, and the remaining 351 were scheduled to receive EVT...
December 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29138198/norwegian-trends-in-numbers-of-lower-extremity-revascularisations-and-amputations-including-regional-trends-in-endovascular-treatments-for-peripheral-arterial-disease-a-retrospective-cross-sectional-registry-study-from-2001-to-2014
#8
Kjersti Wendt, Ronny Kristiansen, Kirsten Krohg-Sørensen, Fredrik Alexander Gregersen, Erik Fosse
OBJECTIVE: The numbers of lower extremity revascularisations and amputations are insufficiently reported in Norway. To support future policy decisions regarding the provision of vascular treatment, knowledge of such trends is important. METHODS: This retrospective cross-sectional study from 2001 to 2014 used data from the Norwegian Patient Registry. The revascularisation treatments were categorised in multilevel, aortoiliac, femoral to popliteal and popliteal to foot levels and sorted as open, endovascular and hybrid...
November 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28980181/outcome-of-intra-arterial-thrombolysis-in-patients-with-diabetes-and-acute-lower-limb-ischemia-a-propensity-score-adjusted-analysis
#9
Talha Butt, Anders Gottsäter, Jan Apelqvist, Gunnar Engström, Stefan Acosta
The presence of diabetes mellitus is rarely addressed in acute lower limb ischaemia (ALLI). The aim of this study was to evaluate the outcome of local intra-arterial thrombolysis for ALLI in patients with diabetes mellitus (DM). Outcome of all thrombolytic events performed in an endovascular first-strategy centre during a 13-year period between 2001 and 2013 in patients with ALLI were followed to January 2017. A propensity score adjusted analysis was performed to evaluate results in patients with (n = 83) versus without (n = 316) DM...
November 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28951878/the-effect-of-charcot-neuroarthropathy-on-limb-preservation-in-diabetic-patients-with-foot-wound-and-critical-limb-ischemia-after-balloon-angioplasty
#10
Mehmet Burak Çildağ, Ömer Faruk Kutsi Köseoğlu
OBJECTIVE: The aim of this article is to investigate one-year limb preservation rates after below-the-knee angioplasty in patients with diabetic foot wound who only have critical limb ischemia (CLI) and those who have Charchot neuroarthropathy (CN) accompanied by CLI. METHODS: This single-center, retrospective study consists of 63 patients with diabetic foot wound who had undergone lower extremity balloon angioplasty of at least 1 below-the-knee (BTK) vessel. Only those patients with postprocedural technical success of 100% were selected from the database...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28865844/factors-affecting-lifespan-following-below-knee-amputation-in-diabetic-patients
#11
S Beyaz, Ü Ö Guler, G Ş Bagir
INTRODUCTION: Untreatable foot problems in diabetics may require lower extremity amputation, which has a high level of patient mortality. This high mortality rate is worse than most malignancies. The present study aimed to identify parameters that can be used to estimate survival in DM patients undergoing below-knee amputations for diabetic foot problems. MATERIALS AND METHODS: A total of 470 patients (299 males, 171 females) with a mean age of 64.32 years who underwent below-knee amputation for diabetic foot problems between 2004 and 2014 were enrolled in the study...
August 30, 2017: Acta Orthopaedica et Traumatologica Turcica
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
#12
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
#13
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...
November 24, 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
#14
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...
February 2018: 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
#15
Nicola Troisi, Filippo Turini, Emiliano Chisci, Leonardo Ercolini, Pierfrancesco Frosini, Renzo Lombardi, Francesca Falciani, Cristiana Baggiore, Roberto Anichini, Stefano Michelagnoli
BACKGROUND: The 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)...
October 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
#16
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
#17
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...
September 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
#18
REVIEW
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
#19
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
#20
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
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