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Lower limb endovascular

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https://www.readbyqxmd.com/read/28527930/outcomes-of-open-and-endovascular-lower-extremity-revascularization-in-active-smokers-with-advanced-peripheral-arterial-disease
#1
Samuel L Chen, Matthew D Whealon, Nii-Kabu Kabutey, Isabella J Kuo, Michael D Sgroi, Roy M Fujitani
OBJECTIVE: Concern over perioperative and long-term durability of lower extremity revascularizations among active smokers is a frequent deterrent for vascular surgeons to perform elective lower extremity revascularization. In this study, we examined perioperative outcomes of lower extremity endovascular (LEE) revascularization and open lower extremity bypass (LEB) in active smokers with intermittent claudication (IC) and critical limb ischemia (CLI). METHODS: Active smokers undergoing LEE or LEB from 2011 to 2014 were identified in the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) targeted vascular data set...
June 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28526046/balloon-versus-stenting-in-severe-ischaemia-of-the-leg-3-basil-3-study-protocol-for-a-randomised-controlled-trial
#2
Benjamin D Hunt, Matthew A Popplewell, Huw Davies, Lewis Meecham, Hugh Jarrett, Gareth Bate, Margaret Grant, Smitaa Patel, Catherine Hewitt, Lazaros Andronis, Jonathan J Deeks, Andrew Bradbury
BACKGROUND: Severe limb ischaemia (SLI) is defined as the presence of rest pain and/or tissue loss secondary to lower extremity atherosclerotic peripheral arterial disease. The superficial femoral and popliteal arteries are the most commonly diseased vessels in such patients and are being increasingly treated using endovascular revascularisation techniques. However, it is currently unknown whether drug-eluting stents and drug-coated balloons confer additional clinical benefits over more established techniques using plain balloons and bare metal stents, or whether they represent a cost-effective use of NHS resources...
May 19, 2017: Trials
https://www.readbyqxmd.com/read/28508349/the-contemporary-role-of-stents-and-angioplasty-for-the-treatment-of-infrapopliteal-disease-in-critical-limb-ischemia
#3
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/28506476/adherence-to-lipid-management-guidelines-is-associated-with-lower-mortality-and-major-adverse-limb-events-in-patients-undergoing-revascularization-for-chronic-limb-threatening-ischemia
#4
Thomas F X O'Donnell, Sarah E Deery, Jeremy D Darling, Katie E Shean, Murray A Mittleman, Gabrielle N Yee, Matthew R Dernbach, Marc L Schermerhorn
OBJECTIVE: The 2013 American College of Cardiology/American Heart Association lipid management guidelines recommend high-intensity statins for all patients ≤75 years old with chronic limb-threatening ischemia (CLTI) and moderate-intensity statins for CLTI patients >75 years old without contraindications or on dialysis, but these recommendations are based primarily on coronary and stroke data. We aimed to validate these guidelines in patients with CLTI and to assess current adherence to these recommendations...
May 12, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28502550/lower-extremity-computed-tomography-angiography-can-help-predict-technical-success-of-endovascular-revascularization-in-the-superficial-femoral-and-popliteal-artery
#5
Nathan K Itoga, Tanner Kim, Anna M Sailer, Dominik Fleischmann, Matthew W Mell
OBJECTIVE: Preprocedural computed tomography angiography (CTA) assists in evaluating vascular morphology and disease distribution and in treatment planning for patients with lower extremity peripheral artery disease (PAD). The aim of the study was to determine the predictive value of radiographic findings on CTA and technical success of endovascular revascularization of occlusions in the superficial femoral artery-popliteal (SFA-pop) region. METHODS: Medical records and available imaging studies were reviewed for patients undergoing endovascular intervention for PAD between January 2013 and December 2015 at a single academic institution...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28501955/a-case-of-arteriovenous-fistula-of-the-cauda-equina-fed-by-the-proximal-radicular-artery-anatomical-features-and-treatment-precautions
#6
Satoru Tanioka, Naoki Toma, Hiroshi Sakaida, Yasuyuki Umeda, Hidenori Suzuki
PURPOSE: Arteriovenous fistula (AVF) of the cauda equina (CE) fed by the proximal radicular artery (PRA) is very rare, and the differentiation from that of the filum terminale (FT) is important to avoid treatment-related injury to the CE when endovascular treatment is selected. The authors describe a case of AVF of the CE fed by the PRA, demonstrate the anatomical features and discuss the treatment precautions. METHODS: A 69-year-old man presented with a transient weakness of lower limbs...
May 13, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28501130/collateral-artery-pathways-of-the-femoral-and-popliteal-artery
#7
Rombout R Kruse, Denise E Doomernik, Kasper V Maltha, Jan G M Kooloos, Tamas L Kozicz, Michel M P J Reijnen
BACKGROUND: The role of collateral artery circulation in the lower limb is under debate but clinically relevant, particularly when using covered stents for occlusive disease. Covered stents seem to outperform nitinol stents in extensive disease, but collaterals could be essential in case of acute thrombosis. In the present study, we describe the collateral pathways of the deep and superficial femoral artery (DFA, SFA) and the popliteal artery (PA), observed in human cadavers. METHODS: Ten fresh frozen cadaver legs were selected...
May 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28496017/comparison-of-the-incidence-of-complications-and-secondary-surgical-interventions-necessary-in-patients-with-chronic-lower-limb-ischemia-treated-by-both-open-and-endovascular-surgeries
#8
Dariusz Janczak, Maciej Malinowski, Wojciech Bąkowski, Katarzyna Krakowska, Karol Marschollek, Paweł Marschollek, Mariusz Chabowski
BACKGROUND: Peripheral arterial disease (PAD) affects 3%-10% of the population before the age of 70 years and 15%-20% after that age.The aim of the study was to compare the incidence of complications and secondary interventions in patients who underwent each type of treatment. METHODS: We analyzed 734 medical records of the Department of Surgery at the 4th Military Teaching Hospital in Wroclaw, In total, 394 were operated on with open surgery; an endarterectomy (59...
May 11, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28486843/emergent-endovascular-repair-of-challenging-aortocaval-fistula-with-hostile-anatomy
#9
Yuewei Wang, Wenjuan Yu, Yongxin Li, Haofu Wang
Aortocaval fistula (ACF) is a rare complication. Endovascular repair is an option for this fatal condition. However, endoleak and persistent fistula may occur and lead to technical failure. We performed endovascular repair for 3 cases of challenging ACF with hostile anatomy. Patient 1 was an 80-year-old man who complained of abdominal distension and lower limb edema for 15 days. He had renal and cardiac dysfunction. Computed tomography angiography (CTA) showed an ACF and extreme tortuosity of right iliac artery...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28483618/perigraft-seroma-after-extra-anatomic-bypass-case-series-and-review-of-the-literature
#10
REVIEW
Daniele Bissacco, Maurizio Domanin, Silvia Romagnoli, Livio Gabrielli
AIM: extra-anatomic bypass (EAB) remains a viable alternative for lower limbs revascularization if aorto-bifemoral bypass and endovascular therapy are contraindicated. Among EAB, periprosthetic seroma (PS) occurs in about 4% of cases. Diagnostic and therapeutic management, as well as standardized treatment paradigm, are still not well defined. The aim of this study is to report 5 PS cases in EAB and to review literature about similar cases. METHODS: We retrospectively reviewed EAB performed during the period 2002-2015...
May 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28483615/severe-mesenteric-ischemia-in-a-pregnant-woman-with-antiphospholipid-syndrome
#11
Andrea Padricelli, Anna Maria Giribono, Doriana Ferrara, Flavia Spalla, Umberto Bracale, Luca Del Guercio, Giuseppe Servillo, Carlo Ruotolo, Umberto Marcello Bracale
The antiphospholipid syndrome (APS), either primary or secondary form, is considered an autoimmune disease with presence of at least one clinical and one laboratory abnormalities as defined by The Sydney criteria. Clinical criteria include vascular thrombosis of venous, artery, small vessel in any organ and recurrent pregnancy pathologies. Mesenteric ischemia is a rare and threatening manifestation of APS. We herein report a case of 34-years old pregnant woman referred to our Emergency Room with thoracic and abdominal acute pain...
May 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28479456/contrast-induced-nephropathy-fact-or-fiction-in-lower-limb-revascularisation
#12
Carlos Martínez-Rico, Xavier Martí-Mestre, Antonio Romera-Villegas, Emma Espinar-Garcia, Elena Iborra-Ortega, Ramón Vila-Coll
INTRODUCTION: Contrast-induced nephropathy (CIN) is defined as a increase >25% of serum creatinine from baseline, occurring in 24-48 hours after exposure to contrast, while alternative explanations for renal impairment have been excluded. The volume administered directly relates to risk, increasing by 12% per 100ml of contrast. According to the series, its incidence varies between 3.3-8% in patients without renal damage and 12-50% in patients with chronic kidney disease (CKD) and/or diabetes mellitus (DM)...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28479434/giant-infrarenal-aortic-aneurysm-rupture-preceded-by-left-lower-limb-motor-deficit
#13
Sasarman Vasile Aurelian, Molnar Adrian, Andercou Aurel, Schjoth Bruno, Oprea Alexandru, Trifan Catalin, Bindea Dan
This report presents the surgical repair and postsurgical outcomes following a ruptured infrarenal aortic aneurysm with a maximum transverse diameter of 20 cm. Its association with acute lower limb motor deficit is rare. Open surgery of giant abdominal aortic aneurysms is often the only available treatment, favored over an endovascular approach in the presence of increased aneurysm size with dislodged abdominal organs, adhesions, and short and angled proximal infrarenal aortic neck, presenting significant additional surgical and anesthesiological challenges...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28479421/outcomes-of-isolated-tibial-endovascular-intervention-for-rest-pain-in-patients-on-dialysis
#14
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 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. Patients with claudication (Rutherford1 to 3) and Tissue Loss (Rutherford 5 and 6) were excluded...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28471523/laparoscopic-surgery-for-elective-abdominal-aortic-aneurysm-repair
#15
REVIEW
Lindsay Robertson, Sandip Nandhra
BACKGROUND: Abdominal aortic aneurysm (AAA) is an abnormal dilatation of the infradiaphragmatic aorta that is equal to or greater than 30 mm or a local dilatation of equal to or greater than 50% compared to the expected normal diameter of the artery. AAAs rarely occur in individuals under 50 years of age, but thereafter the prevalence dramatically increases with age, with men at a six-fold greater risk of developing an AAA than women. Prevalence of AAA has been reported to range from 1...
May 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28466753/non-compressible-abis-are-associated-with-an-increased-risk-of-major-amputation-and-major-adverse-cardiovascular-events-in-patients-with-critical-limb-ischemia
#16
Gagan D Singh, Ehrin J Armstrong, Stephen W Waldo, Bejan Alvandi, Ellen Brinza, Justin Hildebrand, Ezra A Amsterdam, Misty D Humphries, John R Laird
Ankle-brachial indices (ABIs) are important for the assessment of disease burden among patients with peripheral artery disease. Although low values have been associated with adverse clinical outcomes, the association between non-compressible ABI (ncABI) and clinical outcome has not been evaluated among patients with critical limb ischemia (CLI). The present study sought to compare the clinical characteristics, angiographic findings and clinical outcomes of those with compressible (cABI) and ncABI among patients with CLI...
March 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28466410/the-distribution-of-calcified-nodule-and-plaque-rupture-in-patients-with-peripheral-artery-disease-an-intravascular-ultrasound-analysis
#17
Tetsuo Horimatsu, Kenichi Fujii, Masashi Fukunaga, Kojiro Miki, Machiko Nishimura, Yoshiro Naito, Masahiko Shibuya, Takahiro Imanaka, Kenji Kawai, Hiroto Tamaru, Akinori Sumiyoshi, Ten Saita, Tohru Masuyama, Masaharu Ishihara
In addition to plaque rupture (PR), calcified nodule (CN) may also have the potential to develop into arterial thrombus in the peripheral arteries. This study evaluated the distribution of plaque ruptures and calcified nodules in the peripheral arteries and their impact on the outcome of endovascular therapy (EVT). Consecutive 159 patients who underwent EVT with intravascular ultrasound guidance were enrolled. The position of CNs and PRs were assigned to any of common iliac artery, external iliac artery, common femoral artery, and superficial femoral artery...
May 2, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28463463/transradial-versus-transfemoral-ancillary-approach-in-complex-structural-coronary-and-peripheral-interventions-results-from-the-multicenter-ancillary-registry-a-study-of-the-italian-radial-club
#18
Bernardo Cortese, Stefano Rigattieri, Tiziana C Aranzulla, Filippo Russo, Azeem Latib, Francesco Burzotta, Pierfrancesco Agostoni, Alfonso Ielasi, Fabio Tarantino, Alessandro Sticchi, Gaetano Di Palma, Mauro de Benedictis, Carlo Trani, Roberto Boccaletti, Rosa Miccoli, Orazio Valsecchi, Antonio Colombo
OBJECTIVES: to understand the role of a transradial (TR) secondary approach during complex percutaneous interventions. BACKGROUND: The value of the TR route for ancillary vascular approach has not been adequately validated in this setting, and there is scant data on its role in reducing bleeding complications. METHODS: In the present study we retrospectively included patients undergoing the following interventions requiring two vascular approaches at nine high-volume centers in Italy: structural cardiac interventions, complex PCI, endovascular aortic repair (EVAR) and complex lower limb angioplasty...
May 2, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28463077/rationale-and-design-of-the-recording-courses-of-vascular-diseases-registry-reccord-registry
#19
Nasser M Malyar, Jürgen Stausberg, Wulf D Ito, Heinz Kölble, Ralf Langhoff, Holger Lawall, Michael Lichtenberg, Jens Stegemann, Marcus Treitl, Norbert Weiss, Ulrich Hoffmann
BACKGROUND: The prevalence of peripheral artery disease (PAD) is increasing worldwide. Revascularization procedures constitute a cornerstone of the therapy in PAD, not only in critical limb ischaemia but increasingly also in patients with intermittent claudication. The German Society of Angiology - Society for Vascular Medicine is establishing a nationwide, prospective, multicentre registry to address the lack of contemporary real life data regarding current practice of medical and interventional care in vascular patients and its subsequent long-term outcome...
May 2, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28458517/a-comparative-study-on-endovascular-treatment-of-sub-acute-critical-limb-ischemia-mechanical-thrombectomy-vs-thrombolysis
#20
Mariya Kronlage, Ilka Printz, Britta Vogel, Erwin Blessing, Oliver J Müller, Hugo A Katus, Christian Erbel
OBJECTIVE: The aim of this study was to compare different interventional methods for treatment of (sub)acute limb ischemia upon thrombotic occlusions of the lower extremity in terms of their safety and efficacy in a tertiary hospital setting. DESIGN: This is a retrospective, single-center study of non-randomized data. METHODS: A total of 202 patients, including 26 critically ill patients, underwent rotational thrombectomy (Rotarex(®)), local thrombolysis (recombinant tissue plasminogen activator), or combination of both at the University Hospital Heidelberg (2006-2015)...
2017: Drug Design, Development and Therapy
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