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https://www.readbyqxmd.com/read/29892493/recurrence-of-critical-limb-ischemia-after-endovascular-intervention-in-patients-with-diabetic-foot-ulcers
#1
Marco Meloni, Valentina Izzo, Laura Giurato, Costantino Del Giudice, Valerio Da Ros, Valerio Cervelli, Roberto Gandini, Luigi Uccioli
Objective: To establish the rate of clinical recurrence of critical limb ischemia (CLI) in diabetic patients with ischemic foot ulcers (DFUs) treated by percutaneous transluminal angioplasty (PTA). Approach: The study group was composed of 304 patients with ischemic DFUs treated by PTA. We evaluated the rate of clinical recurrence of CLI requiring a second PTA (repeated PTA [rePTA]), the factors related to CLI relapse, and the outcomes of rePTA patients. The follow-up was 12.5 ± 6.6 months. Results: Seventy-four of 304 patients (24...
June 1, 2018: Advances in Wound Care
https://www.readbyqxmd.com/read/29886205/reinterventions-following-endovascular-revascularization-in-elderly-with-critical-limb-ischemia-an-observational-study
#2
S Klaphake, K de Leur, W Thijsse, G H Ho, H G W De Groot, E J Veen, H A W Haans, L van der Laan
BACKGROUND: Endovascular first strategy for critical limb ischemia is widely accepted, because of the increasing patency rates and minimal invasive character, especially in elderly patients. Nonetheless, the impact of reinterventions because of endovascular treatment failure in this population is not well known. The aim of this study is to evaluate the reintervention rate and outcome following reinterventions. MATERIALS AND METHODS: Patients aged >70 years with critical limb ischemia as a result of aortoiliac, femoropopliteal and/or crural disease, treated by 'endovascular first strategy' between 2006 and 2013, were retrospectively analyzed...
June 7, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29859367/mechanical-response-of-human-subclavian-and-iliac-arteries-to-extension-inflation-and-torsion
#3
Gerhard Sommer, Christoph Benedikt, Justyna A Niestrawska, Gloria Hohenberger, Christian Viertler, Peter Regitnig, Tina U Cohnert, Gerhard A Holzapfel
Peripheral vascular trauma due to injuries of the upper and lower limbs are life-threatening, and their treatment require rapid diagnosis and highly-qualified surgical procedures. Experienced surgeons have recognized that subclavian arteries, affected by injuries of the upper limbs, require a more careful handling due to fragility than common iliac arteries, which are may be affected by injures of the lower limbs. We investigated these two artery types with comparable diameter to evaluate the differences in the biomechanical properties between subclavian and iliac arteries...
May 30, 2018: Acta Biomaterialia
https://www.readbyqxmd.com/read/29850426/complications-of-endovascular-aneurysm-repair-of-the-thoracic-and-abdominal-aorta-evaluation-and-management
#4
REVIEW
Dania Daye, T Gregory Walker
In recent decades, endovascular aneurysm repair or endovascular aortic repair (EVAR) has become an acceptable alternative to open surgery for the treatment of thoracic and abdominal aortic aneurysms and other aortic pathologies such as the acute aortic syndromes (e.g., penetrating aortic ulcer, intramural hematoma, dissection). Available data suggest that endovascular repair is associated with lower perioperative 30-day all-cause mortality as well as a significant reduction in perioperative morbidity when compared to open surgery...
April 2018: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/29801560/a-systematic-review-of-the-efficacy-of-aspirin-monotherapy-versus-other-antiplatelet-therapy-regimens-in-peripheral-arterial-disease
#5
REVIEW
Ashlei C Beiswenger, Alice Jo, Karem Harth, Norman H Kumins, Mehdi H Shishehbor, Vikram S Kashyap
BACKGROUND: Dual antiplatelet therapy (DAPT) usually refers to the administration of aspirin plus a platelet P2Y12 receptor blocker. This combination is commonly prescribed after revascularization procedures in patients with peripheral arterial disease (PAD) to prevent failure of the intervention. However, there is not a consensus among peripheral vascular specialists regarding whether the optimal treatment regimen for their patients is mono antiplatelet therapy (MAPT) or DAPT. Furthermore, there is no consensus regarding the optimal duration of DAPT...
June 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29796277/facial-flushing-on-upper-limb-exertion-a-rare-presentation-of-superior-vena-cava-obstruction
#6
Michael Plunkett, James Wethasinghe, Brendon O'Donoghue, Nigel Lever, Conroy Wong
Infection remains a significant problem for patients with cardiac-implantable electronic devices (CIEDs) but can be difficult to diagnose. We describe an unusual presentation of CIED infection in a patient with abandoned pacemaker leads. A 27-year-old male presented with facial flushing on upper but not lower limb exertion due to superior vena cava (SVC) obstruction, as well as pleuritic chest pain due to septic emboli. This was successfully treated with antibiotics and complete endovascular extraction of the pacemaker leads...
April 2018: Respirology Case Reports
https://www.readbyqxmd.com/read/29793677/efficacy-of-cord-blood-platelet-gel-application-for-enhancing-diabetic-foot-ulcer-healing-after-lower-limb-revascularization
#7
Pietro Volpe, Daniela Marcuccio, Giuseppe Stilo, Antonino Alberti, Giovanni Foti, Alberto Volpe, Domenica Princi, Rosangela Surace, Giulia Pucci, Mafalda Massara
The efficacy of umbilical cord blood platelet gel (CBPG) application on healing foot ulcers was analyzed in 10 diabetic patients treated for critical lower limb ischemia by surgical or endovascular arterial revascularization. During a 9-month period, 20 diabetic patients affected by critical lower limb ischemia with tissue loss were enrolled in this nonblinded, consecutive series, randomized clinical trial. After clinical evaluation, patients underwent endovascular or surgical revascularization of the affected limb, followed by minor amputations or surgical debridement of ischemic lesions...
December 2017: Seminars in Vascular Surgery
https://www.readbyqxmd.com/read/29792018/predictive-factors-of-a-poor-outcome-following-revascularization-for-critical-limb-ischemia-implications-for-practice
#8
Mireia Martínez, Claudia Sosa, Alina Velescu, Carme Llort, Roberto Elosua, Albert Clarà
BACKGROUND/OBJECTIVE: Advancements in open and endovascular techniques have brought a widespread indication of revascularization in the majority of patients with critical limb ischemia (CLI). However, some cases still have a dismal short-term outcome. Identifying preoperative variables that characterize these patients could be important to prevent futile decisions. The aim of this study was to define predictive risk factors of mortality and/or major amputation after revascularization for CLI...
May 23, 2018: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/29787536/a-meta-analysis-of-the-incidence-of-complications-associated-with-groin-access-after-the-use-of-resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-trauma-patients
#9
Ramiro Manzano-Nunez, Claudia P Orlas, Juan P Herrera-Escobar, Samuel Galvagno, Joseph DuBose, Juan J Melendez, Jose J Serna, Alexander Salcedo, Camilo A Peña, Edison Angamarca, Tal Horer, Camilo J Salazar, Valeria Lopez-Castilla, Juan Ruiz-Yucuma, Fernando Rodriguez, Michael W Parra, Carlos A Ordoñez
BACKGROUND: Serious complications related to groin access have been reported with the use of resuscitative endovascular balloon occlusion of the aorta (REBOA). We performed a systematic review and meta-analysis to estimate the incidence of complications related to groin access from the use of REBOA in adult trauma patients. METHODS: We identified articles in MEDLINE and EMBASE. We reviewed all studies that involved adult trauma patients that underwent the placement of a REBOA and included only those that reported the incidence of complications related to groin access...
May 21, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29786682/-the-implementation-of-the-method-of-enhanced-external-counter-pulsation-for-the-treatment-of-cardiovascular-diseases
#10
V A Badtieva, D N Voroshilova
The cardiovascular diseases occupy a leading place in the structure of overall morbidity affecting the population not only of Russia but also of the majority of the developed countries throughout the world; they thus impose the heavy social and economic burden on both the public healthcare services and the modern society in general. At the same time, systemic atherosclerosis is considered to be one of the most common, severe, and life-threatening condition. Despite the presence of a large number of pharmaceutical and surgical methods for the treatment of this pathology, they are not infrequently lacking the desired effectiveness...
May 21, 2018: Voprosy Kurortologii, Fizioterapii, i Lechebnoĭ Fizicheskoĭ Kultury
https://www.readbyqxmd.com/read/29783031/a-unique-all-payer-rate-setting-system-controls-the-cost-but-not-the-racial-disparity-in-lower-extremity-revascularization-procedures
#11
Besma Nejim, Robert J Beaulieu, Husain Alshaikh, Mohammed Hamouda, Joseph Canner, Mahmoud B Malas
BACKGROUND: Patients with peripheral arterial disease (PAD) often have high comorbidity burden that may complicate post-interventional course and drive increased healthcare expenditures. Racial disparity had been observed in lower extremity revascularization (LER) patterns and outcomes. In 2014, Maryland adopted an all-payer rate setting system to limit the rising hospitalization costs. This resulted in an aggregate payment system in which hospital compensation takes place as an overall per capita expenditure for hospital services...
May 18, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29772334/quality-of-life-and-mortality-after-endovascular-surgical-or-conservative-treatment-of-elderly-patients-suffering-from-critical-limb-ischemia
#12
Stijn L Steunenberg, Jolanda de Vries, Jelle W Raats, Willem J Thijsse, Nathalie Verbogt, Paul Lodder, Geert-Jan van Eijck, Eelco J Veen, Hans G W de Groot, Gwan H Ho, Lijckle van der Laan
INTRODUCTION: Revascularisation to relieve ischemic pain and prevent limb loss is the cornerstone of critical limb ischemia (CLI) treatment, however not all elderly patients are deemed fit for revascularisation. Patient related outcome measurements are important in these patients. Quality of Life (QoL) results regarding the effect of endovascular, surgical, and conservative treatment on the quality of life (QoL) in the elderly are scarce in current literature. Goal of this study is to explore the outcome of the different treatment modalities in elderly patients suffering from CLI, with a specific focus on QoL...
May 14, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29756521/cost-analysis-of-initial-treatment-with-endovascular-revascularization-open-surgery-or-primary-major-amputation-in-patients-with-peripheral-artery-disease
#13
Linda Tang, Sharath C V Paravastu, Shannon D Thomas, Elaine Tan, Eric Farmer, Ramon L Varcoe
PURPOSE: To compare the total initial treatment costs for open surgery, endovascular revascularization, and primary major amputation within a single-payer healthcare system. METHODS: A multicenter, retrospective analysis was undertaken to evaluate 1138 patients with symptomatic peripheral artery disease (PAD) who underwent 1017 endovascular procedures, 86 open surgeries, and 35 major amputations between 2013 and 2016. A cost-mix analysis was performed on individual patient data generated for selected diagnosis-related groups...
May 1, 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29754671/rationale-and-design-for-the-vascular-outcomes-study-of-asa-along-with-rivaroxaban-in-endovascular-or-surgical-limb-revascularization-for-peripheral-artery-disease-voyager-pad
#14
Warren H Capell, Marc P Bonaca, Mark R Nehler, Edmond Chen, John M Kittelson, Sonia S Anand, Scott D Berkowitz, Eike Sebastian Debus, Fabrizio Fanelli, Lloyd Haskell, Manesh R Patel, Rupert Bauersachs, William R Hiatt
BACKGROUND: Patients with peripheral artery disease (PAD) undergoing a lower-extremity revascularization are at heightened risk for ischemic cardiac and limb events. Although intensification of antithrombotic therapy after revascularization has demonstrated benefit in coronary disease populations, this approach has not been well studied or shown consistent benefit in PAD. Recent trial evidence demonstrated that a treatment strategy of rivaroxaban added to background antiplatelet therapy reduced ischemic risk in patients following recent acute coronary syndromes, as well as in patients with stable atherosclerotic vascular disease...
May 2018: American Heart Journal
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
#15
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/29730375/12-month-results-from-the-first-in-human-randomized-study-of-the-ranger-paclitaxel-coated-balloon-for-femoropopliteal-treatment
#16
Sabine Steiner, Andrea Willfort-Ehringer, Horst Sievert, Volker Geist, Michael Lichtenberg, Costantino Del Giudice, Antoine Sauguet, Juan Diaz-Cartelle, Claudia Marx, Armin Ströbel, Ingolf Schult, Dierk Scheinert
OBJECTIVES: The authors sought to evaluate the performance of the Ranger paclitaxel-coated balloon versus uncoated balloon angioplasty for femoropopliteal lesions at 12 months. BACKGROUND: Drug-coated balloons (DCBs) are a promising endovascular treatment option for peripheral artery disease of the femoropopliteal segment, and each unique device requires dedicated clinical study. METHODS: The prospective, randomized RANGER SFA (Comparison of the Ranger™ Paclitaxel-Coated PTA Balloon Catheter and Uncoated PTA Balloons in Femoropopliteal Arteries) study (NCT02013193) enrolled 105 patients with symptomatic lower limb ischemia (Rutherford category 2 to 4) and stenotic lesions in the nonstented femoropopliteal segment at 10 European centers...
May 28, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29721632/acute-lower-limb-ischemia-and-intestinal-necrosis-due-to-arterial-tumor-embolism-from-advanced-lung-cancer-a-case-report-and-literature-review
#17
Sayuri Togo, Terutoshi Yamaoka, Kazutoyo Morita, Kazuomi Iwasa, Yukihiko Aoyagi, Yumi Oshiro, Takatoshi Fujishita, Hideki Yokoyama, Takashi Matsui, Takashi Nishizaki
BACKGROUND: Arterial tumor embolism (ATE) is a rare but life-threating complication. PRESENTATION OF CASE: A 55-year-old man with acute lower-limb ischemia was referred to our hospital after endovascular intervention failed and underwent above-the-knee amputation for severe limb necrosis. On postoperative day 8, he developed small bowel necrosis and underwent resection. Histopathological examination of the resected bowel revealed that the submucosal arterial emboli were positive for the markers of squamous cells...
May 2, 2018: Surgical Case Reports
https://www.readbyqxmd.com/read/29716475/contemporary-management-and-outcome-after-lower-extremity-fasciotomy-in-non-trauma-related-vascular-surgery
#18
Charlotte Wesslén, Carl-Magnus Wahlgren
INTRODUCTION: Acute compartment syndrome (ACS) is a challenging and recognized complication to vascular surgery revascularization. The aim of this study was to investigate the current epidemiology, management, and early outcomes of fasciotomy in vascular surgery. METHODS: Retrospective cohort study of all patients undergoing lower extremity fasciotomy at a single university center between January 2008 and December 2014. Patient demographics, operative techniques, and outcomes were analyzed...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29716473/bursting-fracture-of-balloon-expandable-stent-and-pseudoaneurysm-formation-in-the-left-common-iliac-artery-and-endovascular-treatment-with-graft-stent
#19
Min Kim, Dae In Lee, Ju-Hee Lee, Sang Yeub Lee, Jang-Whan Bae, Kyung-Kuk Hwang, Dong-Woon Kim, Myeong-Chan Cho, Sangmin Kim
PURPOSE: To report successful endovascular treatment of a previously implanted balloon-expandable stent bursting fracture with concomitant large pseudoaneurysm formation in the left common iliac artery (LCIA). CASE REPORT: A 72-year-old man had been previously treated with balloon-expandable stents for severe stenotic lesion in the LCIA and left external iliac artery. Seven years later, the patient complained pain in both lower legs and back. Angiography demonstrated a 3...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29701404/digital-subtraction-angiography-or-computed-tomography-angiography-in-the-preoperative-evaluation-of-lower-limb-peripheral-artery-disease-a-comparative-analysis
#20
Marina Dias-Neto, Catarina Marques, Sérgio Sampaio
INTRODUCTION: For several years, digital subtraction angiography (DSA) was considered the gold standard method for the evaluation of PAD patients. This is an invasive technique and allows a good evaluation of collaterals and the vessel lumen, even in cases with associated calcification. Nevertheless, recent technical development of computed tomography angiography (CTA) has improved its specificity and sensibility, besides the fact that CTA is a fast and non-invasive procedure. OBJECTIVE: To characterize a cohort of lower limb PAD patients and clarify if there are differences among the patients preoperatively evaluated by DSA or CTA...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
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