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Lower limb endovascular

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https://www.readbyqxmd.com/read/27909207/below-knee-amputation-failure-and-poor-functional-outcomes-are-higher-than-predicted-in-contemporary-practice
#1
Jesse A Columbo, Brian W Nolan, Ryland S Stucke, Eva M Rzucidlo, Karen L Walker, Richard J Powell, Bjoern D Suckow, David H Stone
OBJECTIVE: The perceived functional benefit of below-knee amputation (BKA) must be carefully weighed against the need for potential reinterventions. This study sought to examine the contemporary clinical and functional outcomes of patients undergoing BKA in the endovascular era. METHODS: All patients who underwent BKA from January 2008 to December 2014 at a single tertiary medical center were retrospectively reviewed. Demographics, comorbidities, ambulation status, and transcutaneous oximetry (TcPO2) values were recorded...
November 30, 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27908823/subintimal-recanalization-of-an-occluded-common-iliac-stent-a-case-report
#2
Giuseppe Asciutto, Roberta M Brambilla, Ioannis Bountouris, Martin Malina, Nuno V Dias
The purpose of this report is to describe a minimally invasive alternative endovascular technique for the treatment of chronically occluded stents when it is not possible to cross them endoluminally. A 71-years-old patient with recurrent severe lower limb claudication due to occlusion of a stent placed in the common iliac artery 5 years earlier underwent subintimal recanalization of the stented segment and re-stenting after failed intraluminal approach. The postoperative CT scan showed that the re-stented segment was patent with a flattening of the previous stent...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27896226/use-of-the-directional-atherectomy-for-the-treatment-of-femoro-popliteal-lesions-in-patients-with-critical-lower-limb-ischemia
#3
Umberto Marcello Bracale, Gaetano Vitale, Guido Bajardi, Donatella Narese, Ettore Dinoto, Anna Maria Giribono, Doriana Ferrara, Luca Del Guercio, Massimo Midiri, Felice Pecoraro
: Femoro-popliteal PTA for the treatment of critical limb ischemia is frequently associated with unsatisfactory procedural success rates while directional atherectomy (DCA) has improved success rate since claudicant patients undergoing percutaneous treatment of femoro-popliteal obstructive disease. The aim of this prospective study is to evaluate the safety, efficacy and procedural success of DCA, at one year, in the percutaneous treatment of femoro-popliteal obstructive disease in patients with critical limb ischemia...
November 2016: Translational Medicine @ UniSa
https://www.readbyqxmd.com/read/27884944/ruptured-abdominal-aortic-aneurysm-after-endovascular-aortic-aneurysm-repair-thrombosis
#4
Jesse Victory, Syed Ali Rizvi, Enrico Ascher, Anil Hingorani
BACKGROUND: Complete thrombosis of an aortic endograft after an endovascular aortic aneurysm repair is a rare complication. The majority of thrombotic events occur in the iliac limbs. CASE PRESENTATION: We present the case of a patient who presented with acute limb ischemia as the result of a thrombosed infra-renal aortic endograft. After restoration of blood flow to the lower extremities with an axillary to bi-femoral artery bypass, the patient was lost to follow-up...
November 24, 2016: Vascular
https://www.readbyqxmd.com/read/27884710/predisposing-factors-for-re-interventions-with-additional-iliac-stent-grafts-after-endovascular-aortic-repair
#5
H Roos, C Sandström, G Koutouzi, A Jeppsson, M Falkenberg
BACKGROUND: Endoleaks of type Ib and III are relatively common causes of re-intervention after EVAR. The aim was to determine underlying causes and identify anatomical factors associated with these re-interventions. METHODS: A total of 444 patients with standard bifurcated stent grafts were included in a retrospective observational study. Patients requiring additional iliac stent grafts (n = 24) were compared to those who did not (n = 420). Pre- and post-operative CT examinations were reviewed in patients with additional iliac stents...
November 21, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27884360/cost-effectiveness-of-endovascular-femoropopliteal-intervention-using-drug-coated-balloons%C3%A2-versus-standard-percutaneous-transluminal-angioplasty-results-from-the-in-pact%C3%A2-sfa-ii-trial
#6
Adam C Salisbury, Haiyan Li, Katherine R Vilain, Michael R Jaff, Peter A Schneider, John R Laird, David J Cohen
OBJECTIVES: The aim of this study was to evaluate the cost-effectiveness of drug-coated balloon (DCB) angioplasty versus standard percutaneous transluminal angioplasty (PTA). BACKGROUND: Recent trials have reported lower rates of target lesion revascularization with DCB angioplasty versus standard PTA. However, the cost-effectiveness of DCB angioplasty is unknown. METHODS: A prospective economic study was performed alongside the IN.PACT SFA II (IN...
November 28, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27879958/evaluation-of-a-6-year-old-multicentric-standard-endovascular-treatment-of-critical-limb-ischemia-in-the-drug-eluting-era
#7
Vincenzo Brizzi, Caroline Caradu, Xavier Berard, Gerard Sassoust, Dominique Midy, Eric Ducasse
BACKGROUND: There has been increasing evidence to support the endovascular- first approach in the treatment of below the knee (BTK) lesions. Plain Old Balloon Angioplasty (POBA), with bailout bare-metal stent scaffolding in case of flow limiting dissection or recoil, have been considered the standard treatment of choice but industries are continually developing innovative equipment and dedicated technologies, such as drug-eluting platforms whose use is increasingly extended, despite significant costs and lack of high-quality evidence to support a well- established strategy...
November 23, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27878794/varicosities-of-the-lower-extremity-new-approaches-cosmetic-or-therapeutic-needs
#8
Luca Spinedi, Heiko Uthoff, Sasan Partovi, Daniel Staub
Varicose veins of the lower extremity (VVLE) are a frequently encountered vascular disorder in the general population. The general view that VVLE are a non-serious disease with primarily aesthetic impact is a common misconception, as the disease can have a significant negative impact on generic and disease-specific quality of life. Further, VVLE may be associated with potentially threatening clinical conditions, such as chronic venous ulceration, venous thromboembolism and haemorrhage from ruptured varicose veins...
2016: Swiss Medical Weekly
https://www.readbyqxmd.com/read/27871503/statin-use-in-patients-with-peripheral-arterial-disease
#9
Sheena K Harris, Matt G Roos, Gregory J Landry
BACKGROUND: Statins are recommended for use in patients with peripheral arterial disease (PAD) to reduce cardiovascular events and mortality. However, much of the data regarding benefits of statins stem from the cardiovascular literature. Here, we review the literature regarding statin use specifically in patients with PAD regarding its effects on cardiovascular events and mortality, limb-related outcomes, statin use after endovascular interventions, statin dosing, and concerns about statins...
December 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27871493/diabetes-does-not-worsen-outcomes-following-infrageniculate-bypass-or-endovascular-intervention-for-patients-with-critical-limb-ischemia
#10
Caitlin W Hicks, Alireza Najafian, Alik Farber, Matthew T Menard, Mahmoud B Malas, James H Black, Christopher J Abularrage
OBJECTIVE: Both open surgery and endovascular peripheral interventions have been shown to effectively improve outcomes in patients with peripheral arterial disease, but minimal data exist comparing outcomes performed at and below the knee among patients with diabetes (DM) specifically. The purpose of this study is to compare outcomes following open bypass (lower extremity bypass [LEB]) and peripheral vascular intervention (PVI) at and below the knee in patients with DM vs patients without DM (non-DM) with critical limb ischemia...
December 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27860129/the-postthrombotic-syndrome-current-evidence-and-future-challenges
#11
REVIEW
A Rabinovich, S R Kahn
Post thrombotic syndrome (PTS) is a chronic complication of deep vein thrombosis (DVT), which develops in 20%-50 % of patients. PTS manifests as a spectrum of symptoms and signs of chronic venous insufficiency that can impose significant morbidity and have a negative impact on quality of life. Chronic venous hypertension caused by a combination of residual venous obstruction and valvular reflux is believed to play a major role in the pathophysiology of PTS. The Villalta scale is the most widely applied clinical scale used to diagnose and define PTS...
November 18, 2016: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/27857463/transmural-coil-embolization-alternative-technique-for-management-of-arterial-perforation-during-subintimal-angioplasty
#12
Karthikeyan Damodharan, Amman Bolia
Subintimal angioplasty of lower limb arterial occlusion carries a relatively higher risk of vessel perforation compared to transluminal angioplasty. Vessel perforation is a potentially life threatening complication which requires prompt recognition and management. They are usually managed by endovascular techniques such as low-pressure balloon tamponade, covered stents, and coil embolization of the ruptured artery. We describe a technique of treating vessel perforation following balloon angioplasty. Patient developed a large perforation of the proximal superficial femoral artery (SFA) after balloon inflation during subintimal angioplasty of complete SFA occlusion...
July 2016: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/27844109/endovascular-therapy-research-in-lower-limb-peripheral-arterial-disease-published-over-a-5-year-period-who-is-publishing-and-where
#13
H Asadi, R J Lee, M Sheehan, P Thanaratam, D M Lee, A M Lee, M J Lee
INTRODUCTION: Peripheral arterial disease (PAD) is being increasingly managed by endovascular therapies. In this study, we identified the clinical services publishing research as well as the journals of publication over a 5-year period. METHODS: Twenty keywords and phrases related to endovascular intervention were identified, and a literature search was performed through the PubMed database from January 2009 to January 2014. Inclusion criteria were English language, study population more than five patients, and matching the keyword search...
November 14, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27834057/lower-limb-ischemia-caused-by-resuscitative-balloon-occlusion-of-aorta
#14
Yohei Okada, Hiromichi Narumiya, Wataru Ishi, Iiduka Ryoji
BACKGROUND: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emergency procedure to manage severe hemorrhagic shock from torso injury but can cause severe ischemia of the lower extremities. However, lower extremity ischemia occurring as a complication of REBOA has been rarely reported. We describe the severe lower extremity ischemia caused by REBOA with a 12-Fr sheath in a small-built patient. CASE REPRESENTATION: The patient was a 16-year-old male who developed severe hemorrhagic shock due to abdominal blunt trauma...
December 2016: Surgical Case Reports
https://www.readbyqxmd.com/read/27770080/lower-extremity-revascularization-in-end-stage-renal-disease-which-patients-benefit
#15
Douglas W Jones, Kirsten Dansey, Allen D Hamdan
Patients with end-stage renal disease (ESRD) who present with critical limb ischemia (CLI) have become an increasingly common and complex treatment problem for vascular surgeons. Dialysis patients have high short-term mortality rates regardless of whether revascularization is pursued. ESRD patients with CLI can be managed with: local wound care, endovascular or surgical revascularization, or amputation. Some patients may heal small foot wounds with local wound care alone, even if distal perfusion is marginal, as long as any infectious process has been controlled...
October 20, 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27763293/outcomes-of-open-and-endovascular-lower-extremity-revascularization-in-current-smokers-with-intermittent-claudication-and-critical-limb-ischemia
#16
Samuel L Chen, Matthew D Whealon, Nii-Kabu Kabutey, Isabella J Kuo, Roy M Fujitani
No abstract text is available yet for this article.
August 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27758848/wound-healing-of-critical-limb-ischemia-with-tissue-loss-in-patients-on-hemodialysis
#17
Yohsuke Honda, Keisuke Hirano, Masahiro Yamawaki, Shinsuke Mori, Shigemitsu Shirai, Kenji Makino, Takahiro Tokuda, Takuro Takama, Masakazu Tsutumi, Yasunari Sakamoto, Hideyuki Takimura, Norihiro Kobayashi, Motoharu Araki, Yoshiaki Ito
We assessed wound healing in patients on hemodialysis (HD) with critical limb ischemia (CLI). This study enrolled 267 patients (including 120 patients on HD and 147 patients not on HD) who underwent endovascular therapy (EVT) for CLI. The primary endpoint was wound-healing rate at two years. Secondary endpoints were time to wound healing, wound recurrence rate, and limb salvage at two years. The percentage of male and young patients was higher in the HD patients (p < 0.01). A lower patency of the pedal arch after EVT was observed frequently in HD patients (p < 0...
October 6, 2016: Vascular
https://www.readbyqxmd.com/read/27752169/-control-study-of-total-percutaneous-access-with-preclose-technique-versus-open-femoral-artery-exposure-for-endovascular-aneurysm-repair
#18
J J Jiang, H K Qing, X M Zhang, X M Zhang, W Li, C Y Shen, Q L Li, Y Jiao
OBJECTIVE: To compare total percutaneous access using preclose technique with femoral artery cut-down in endovascular aneurysm repair (EVAR) and assess the safety and feasibility of preclose technique. METHODS: In the study, 81 cases undergoing EVAR from Dec. 2011 to Nov. 2014 in Peking University People's Hospital were retrospectively reviewed. Preoperative CT angiography (CTA) showed presence of infrarenal abdominal aortic aneurysm or descending aortic aneurysm in all the cases...
October 18, 2016: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/27699156/diagnosis-and-treatment-of-lower-extremity-deep-vein-thrombosis-korean-practice-guidelines
#19
Seung-Kee Min, Young Hwan Kim, Jin Hyun Joh, Jin Mo Kang, Ui Jun Park, Hyung-Kee Kim, Jeong-Hwan Chang, Sang Jun Park, Jang Yong Kim, Jae Ik Bae, Sun Young Choi, Chang Won Kim, Sung Il Park, Nam Yeol Yim, Yong Sun Jeon, Hyun-Ki Yoon, Ki Hyuk Park
Lower extremity deep vein thrombosis is a serious medical condition that can result in death or major disability due to pulmonary embolism or post-thrombotic syndrome. Appropriate diagnosis and treatment are required to improve symptoms and salvage the affected limb. Early thrombus clearance rapidly resolves symptoms related to venous obstruction, restores valve function and reduces the incidence of post-thrombotic syndrome. Recently, endovascular treatment has been established as a standard method for early thrombus removal...
September 2016: Vascular Specialist International
https://www.readbyqxmd.com/read/27693605/the-prognostic-significance-of-different-definitions-for-angiosome-targeted-lower-limb-revascularization
#20
Kristýna Špillerová, Fausto Biancari, Nicla Settembre, Anders Albäck, Maarit Venermo
BACKGROUND: The definition of angiosome-targeted revascularization is confusing, especially when a tissue lesion affects several angiosomes. Two different definitions of direct revascularization exist in the literature. The study aim was (1) to compare the 2 definitions of direct revascularization in patients with foot lesions involving more than one angiosome and (2) to evaluate which definition better predicts clinical outcome. METHODS: This study cohort comprises 658 patients with Rutherford 5-6 foot lesions who underwent infrapopliteal endovascular or surgical revascularization between January 2010 and July 2013...
September 29, 2016: Annals of Vascular Surgery
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