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Critical leg ischemia

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https://www.readbyqxmd.com/read/29248242/plasma-microbiome-modulated-indole-and-phenyl-derived-metabolites-associate-with-advanced-atherosclerosis-and-postoperative-outcomes
#1
Cori A Cason, Kyle T Dolan, Gaurav Sharma, Ming Tao, Rohan Kulkarni, Irene B Helenowski, Brendan M Doane, Michael J Avram, Mary M McDermott, Eugene B Chang, C Keith Ozaki, Karen J Ho
OBJECTIVE: Multiple studies have shown that gut microbes contribute to atherosclerosis, and there is mounting evidence that microbial metabolism of dietary nutrients influences pathophysiology. We hypothesized that indole- and phenyl-derived metabolites that originate solely or in part from bacterial sources would differ between patients with advanced atherosclerosis and age- and sex-matched controls without clinically apparent atherosclerosis. METHODS: Plasma from the advanced atherosclerosis cohort (n = 100) was from patients who underwent carotid endarterectomy, open infrainguinal leg revascularization, or major leg amputation for critical limb ischemia...
December 13, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29200838/mortality-after-major-amputation-in-elderly-patients-with-critical-limb-ischemia
#2
Sanne Klaphake, Kevin de Leur, Paul Gh Mulder, Gwan H Ho, Hans G de Groot, Eelco J Veen, Hence Jm Verhagen, Lijckle van der Laan
Background: Owing to the aging population, the number of elderly patients with critical limb ischemia (CLI) has increased. The consequence of amputation is immense. However, at the moment, information about the mortality after amputation in the elderly vascular patients is unknown. For this reason, this study evaluated mortality rates and patient-related factors associated with mortality after a major amputation in elderly patients with CLI. Methods: From 2006 to 2013, we included patients aged >70 years who were treated for chronic CLI by primary or secondary major amputation within or after 3 months of initial therapy (revascularization or conservative management)...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29193492/perfusion-measures-for-symptom-severity-and-differential-outcome-of-revascularization-in-limb-ischemia-preliminary-results-with-arterial-spin-labeling-reactive-hyperemia
#3
Hou-Jen Chen, Trisha L Roy, Graham A Wright
BACKGROUND: Previously, a theoretical model based on microvascular physiology was established to facilitate the interpretation of calf perfusion dynamics recorded by arterial spin labeling (ASL). PURPOSE: To investigate the clinical relevance of novel perfusion indices by comparing them to the symptoms, response to revascularization, and short-term functional outcome in patients with peripheral arterial disease (PAD). STUDY TYPE: Prospective cohort study...
November 28, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28965800/short-and-long-term-readmission-rates-after-infrainguinal-bypass-in-a-safety-net-hospital-are-higher-than-expected
#4
Brianna M Krafcik, Sevan Komshian, Kimberly Lu, Lauren Roberts, Alik Farber, Jeffrey A Kalish, Denis Rybin, Jeffrey J Siracuse
OBJECTIVE: Readmission rates are expected to have an increasing effect on both the hospital bottom line and physician reimbursements. Safety net hospitals may be most vulnerable. We examined readmissions at 30 days, 90 days, and 1 year in a large safety net hospital to determine the magnitude and effect of short- and long-term readmission rates after lower extremity infrainguinal bypass in this setting. METHODS: All nonemergent extremity infrainguinal bypass performed at a large safety net hospital between 2008 and 2016 were identified...
December 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28883255/critical-leg-ischemia-following-abdominal-aortic-aneurysm-occlusion
#5
Shun-Ichi Kawarai, Keisuke Kanda, Masaharu Hatakeyama, Koichi Nagaya
No abstract text is available yet for this article.
October 1, 2017: Internal Medicine
https://www.readbyqxmd.com/read/28819879/lower-extremity-bypass-using-bovine-carotid-artery-graft-artegraft-an-analysis-of-124-cases-with-long-term-results
#6
Philip Lindsey, Angela Echeverria, Mathew Cheung, Elias Kfoury, Carlos F Bechara, Peter H Lin
INTRODUCTION: Although biological grafts have been utilized as a vascular conduit in leg bypass for many years, reports of a bovine carotid artery graft (BCAG) in lower extremity revascularization have been scarce. This study analyzed the outcome of lower leg bypass using BCAG. METHODS: A retrospective review of a prospectively collected database of all patients undergoing lower extremity bypass using BCAG from 2002 to 2017 was performed. Clinical outcomes including graft patency and limb salvage were evaluated...
August 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28767168/the-possibility-of-free-tissue-transfer-as-a-nutrient-flap-for-critical-ischemic-foot-a-case-report
#7
Kentaro Tanaka, Kimihiro Igari, Mitsuhiro Kishino, Satoshi Usami, Tsutomu Homma, Takahiro Toyofuku, Yoshinori Inoue, Mutsumi Okazaki
Microsurgical procedure of free tissue transfer in critical limb ischemia patients with large ulceration has already been established. The nutrient flap concept was that transferred tissue functioned not only to cover the skin defect but also as a supplementary blood supply to the ischemic lower leg. This report showed the justification for this concept, which was rarely discussed. A 58-year-old male patient with progressive forefoot gangrene caused by arteriosclerosis obliterans was presented. The distal bypass procedure was performed as revascularization surgery, and a latissimus dorsi (LD) myocutaneous flap was transplanted to cover ulceration...
August 2, 2017: Microsurgery
https://www.readbyqxmd.com/read/28741197/axillobifemoral-bypasses-reappraisal-of-an-extra-anatomic-bypass-by-analysis-of-results-and-prognostic-factors
#8
D Dickas, F Verrel, J Kalff, A Koscielny
BACKGROUND: Axillobifemoral bypass (AFB) is method of second choice. It is reserved for patients at high operative risk or to bypass infected vessels or grafts. In this study, we analyzed prognostic factors for AFB patency and limb salvage rate to facilitate the choice of procedure. METHODS: Between Jan 2006 and Aug 2013, 45 patients underwent AFB surgery in our department, 24 for critical limb ischemia (CLI) and 23 for infection. Endpoints of study were graft occlusion, graft infection, amputation and patient's death...
July 24, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28689942/life-expectancy-and-outcome-of-different-treatment-strategies-for-critical-limb-ischemia-in-the-elderly-patient
#9
S Klaphake, K de Leur, P G H Mulder, G H Ho, H G W Groot, E J Veen, L van der Laan
BACKGROUND: Treatment of critical limb ischemia (CLI) in the elderly patients is challenging because of the comorbidity and fragility of these patients. We analysed survival in relation to different treatment options, and estimated life expectancy of our study group by age and gender. METHODS: All patients aged ≥70 years, presenting with chronic CLI, between 2006 to 2013 were included. Treatment was conservative, endovascular, surgical or by primary major amputation...
July 6, 2017: Annals of Vascular Surgery
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
#10
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/28508349/the-contemporary-role-of-stents-and-angioplasty-for-the-treatment-of-infrapopliteal-disease-in-critical-limb-ischemia
#11
REVIEW
Tarek A Hammad, Anand Prasad
PURPOSE OF REVIEW: Critical limb ischemia (CLI) is associated with significant morbidity, mortality, and increased health care expenses. Revascularization has a central role in the treatment of CLI. Following publication of BASIL (bypass versus angioplasty in severe ischemia of the leg) trial a decade ago, an "endovascular first" approach had gained momentum and the technologies available for endovascular therapy have exponentially increased. Both the development of technology and technique, highlighted in this review, have allowed operators to treat complex infrapopliteal lesions which are central to CLI pathology...
July 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28502548/lifelong-limb-preservation-a-patient-centered-description-of-lower-extremity-arterial-reconstruction-outcomes
#12
Katie E Shean, Peter A Soden, Marc L Schermerhorn, Sara L Zettervall, Sarah E Deery, Jeremy D Darling, Allen Hamdan, Frank W LoGerfo
BACKGROUND: Life expectancy is short for patients with critical limb ischemia (CLI), many of whom may fear amputation more than death. In light of the reduced life expectancy of these patients, the traditional 5-year freedom from amputation (FFA) statistic may not accurately address their concern. We developed a more relevant patient-centered calculation of major amputation risk during a patient's remaining lifetime to better answer the question, Will I ever lose my leg? METHODS: We identified all limbs undergoing first-time intervention for CLI in a large institutional database from 2005 to 2013...
October 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28502546/cryopreserved-saphenous-vein-as-a-last-ditch-conduit-for-limb-salvage
#13
Leigh Ann O'Banion, Bian Wu, Charles M Eichler, Linda M Reilly, Michael S Conte, Jade S Hiramoto
OBJECTIVE: In patients lacking autogenous vein suitable for infrainguinal bypass, cryopreserved saphenous vein (CSV) allograft (CryoLife, Inc, Kennesaw, Ga) may be an acceptable alternative. The purpose of this study was to examine outcomes of CSV conduit for infrainguinal revascularization. METHODS: Between February 2008 and August 2015, 70 patients underwent infrainguinal bypass grafts in 73 limbs using CSV. All patients lacked suitable arm or leg vein. Demographic data and patient outcomes were retrospectively collected using electronic medical records...
September 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28488306/physician-initiated-first-in-human-clinical-study-using-a-novel-angiogenic-peptide-ag30-5c-for-patients-with-severe-limb-ulcers
#14
Hironori Nakagami, Toshifumi Yamaoka, Misa Hayashi, Atsushi Tanemura, Yasushi Takeya, Hitomi Kurinami, Ken Sugimoto, Ayumi Nakamura, Kazunori Tomono, Katsuto Tamai, Ichiro Katayama, Hiromi Rakugi, Yasufumi Kaneda
AIM: In patients with diabetes or ischemia, angiogenesis and infection control are required for chronic leg ulcers, which substantially impair patients' quality of life. We developed a novel functional peptide, named AG30/5C, with angiogenic and anti-microbial properties. Treatment with AG30/5C significantly accelerated the wound healing of full-thickness defects in mice. To evaluate the safety of AG30/5C in the treatment of leg ulcers, a physician-initiated clinical study was carried out...
May 10, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28479452/cumulative-number-of-treatment-interventions-predicts-health-related-quality-of-life-in-patients-with-critical-limb-ischemia
#15
Matthew A Corriere, Matthew P Goldman, Ryan Barnard, Santiago Saldana, Jeanette M Stafford, Douglas Easterling, Edward H Ip, Gregory L Burke
BACKGROUND: Health-related quality of life (QOL) is usually assessed after a defined interval following a single intervention, but critical limb ischemia (CLI) is a chronic condition where multiple interventions are often required over a patient's lifetime. We hypothesized that the impact of CLI treatment interventions on QOL is diminished in the setting of multiple previous interventions. To test this hypothesis, we performed a cross-sectional study evaluating associations between cumulative number of previous peripheral artery disease (PAD) treatment interventions and QOL adjusting for both comorbidity and disease severity...
October 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28479421/outcomes-of-isolated-tibial-endovascular-intervention-for-rest-pain-in-patients-on-dialysis
#16
Hallie E Baer-Bositis, Taylor D Hicks, Georges M Haidar, Matthew J Sideman, Lori L Pounds, Mark G Davies
BACKGROUND: Tibial interventions for critical limb ischemia are frequent in patients with end-stage renal disease (ESRD) presenting with critical ischemia. The aim of this study was to examine impact of ESRD on the patient-centered outcomes following tibial endovascular Intervention for rest pain. METHODS: A database of patients undergoing lower extremity endovascular interventions between 2006 and 2016 was retrospectively queried. Patients with rest pain (Rutherford 4) were identified...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28408447/getting-a-leg-up-on-cell-therapy-for-critical-limb-ischemia
#17
EDITORIAL
S Keisin Wang, Michael P Murphy
No abstract text is available yet for this article.
April 14, 2017: Circulation Research
https://www.readbyqxmd.com/read/28295963/a-multicenter-study-of-the-impella-device-for-mechanical-support-of-the-systemic-circulation-in-pediatric-and-adolescent-patients
#18
V Vivian Dimas, Brian H Morray, Dennis W Kim, Christopher S Almond, Shabana Shahanavaz, Sebastian C Tume, Lynn F Peng, Doff B McElhinney, Henri Justino
OBJECTIVES: The objective was to review the use of Impella devices (Abiomed Inc, Danvers, MA) for temporary circulatory support in pediatric and adolescent patients (age ≤ 21 yrs). BACKGROUND: Options for minimally invasive circulatory support in children are limited, and published data are confined to case reports and small case series. METHODS: This was a retrospective, multicenter review of Impella implants in pediatric and adolescent patients from 2009-15, using standardized data collection and INTERMACS definitions...
July 2017: Catheterization and Cardiovascular Interventions
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
#19
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/28287292/-long-term-results-after-invasive-treatment-of-critical-limb-ischemia
#20
Zoltán Ruzsa, Ferenc Kuti, Balázs Berta, Károly Tóth, Zoltán Bánsághi, Zoltán Vámosi, Kálmán Hüttl
INTRODUCTION AND AIM: Surgical tibial bypass for critical limb ischemia is associated with significant morbidity, mortality, and graft failure, whereas percutaneous angioplasty and stenting has promising results. The objective of this study was the investigation of the long term results of below-knee percutaneous angioplasty for restoring straight inline arterial flow in patients with critical limb ischemia. METHOD: The clinical and angiographic data of 281 consecutive patients with critical limb ischemia treated by PTA between 2008 and 2011 was evaluated in a prospective register...
March 2017: Orvosi Hetilap
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