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Lower limb endovascular

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https://www.readbyqxmd.com/read/28716775/acute-rehabilitation-after-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-major-trauma
#1
Jessica Anne Rich, Julia Coleman, Camille Devaux, Karen Hoffman
We report a 23-year-old woman admitted post cyclist versus heavy goods vehicle accident in December 2014. This was the second case the life-saving procedure, that is, resuscitative endovascular balloon occlusion of the aorta (REBOA) was performed on at the roadside. This advanced procedure was performed due to the extensive haemorrhage from this patient's complex pelvic fracture . As a result of REBOA, the patient consequently lost her left lower limb and underwent a variety of complex pelvic and lower limb surgeries...
July 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28705403/symptomatic-lower-limb-giant-cell-arteritis-characteristics-management-and-long-term-outcome
#2
C Le Hello, L Auboire, L Berger, D Gouicem, M T Barrellier, S Duthois
OBJECTIVE: To describe characteristics and long-term outcomes of the rare symptomatic lower-limb giant-cell arteritis (LL-GCA). METHODS: Retrospective analysis of 8 patients (6 women; mean±SD age, 63.6±10.9 years; follow-up, 137.3±57.3 months). RESULTS: Four patients satisfied≥3 American College of Rheumatology (ACR) GCA-classification criteria; 4 had<3 criteria and histological LL-GCA proof or associated typical upper-limb involvement...
May 2017: J Med Vasc
https://www.readbyqxmd.com/read/28701057/treatment-of-serious-complications-following-endovascular-aortic-repair-for-type-b-thoracic-aortic-dissection
#3
Zhao Liu, Yepeng Zhang, Chen Liu, Dian Huang, Ming Zhang, Feng Ran, Wei Wang, Tao Shang, Tong Qiao, Min Zhou, Changjian Liu
Objective This study aimed to describe treatment of serious complications after primary thoracic endovascular aortic repair (TEVAR) in type B aortic dissection. Methods From June 2008 to March 2016, serious complications occurred in 58 patients without Marfan syndrome who received TEVAR for type B aortic dissection. Results Complications included endoleak, distal true lumen collapse, retrograde dissection, stroke, stent-graft (SG) migration and mistaken deployment, lower limb ischaemia, and SG fracture. Treatment included endovascular repair, surgical procedures, or conservative medication...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28697942/outcomes-for-concomitant-common-iliac-artery-aneurysms-after-endovascular-abdominal-aortic-aneurysm-repair
#4
Mohsen Bannazadeh, Christina Jenkins, Andrew Forsyth, Jason Kramer, Ankur Aggarwal, Amy E Somerset, Paul G Bove, Graham W Long
OBJECTIVE: This study evaluated the morbidity of endovascular abdominal aortic aneurysm repair (EVAR) in patients with concomitant common iliac artery aneurysm (CCIAA). METHODS: This was a retrospective review of all patients who underwent elective EVAR from June 2006 through June 2012 at a single institution. Demographics, comorbidities, preoperative presentation, intraoperative details, and postoperative complications were tabulated. Patients with CCIAA were categorized into three groups according to the distal extent of their iliac limb: iliac limb extension into the external iliac artery with internal iliac artery coil embolization (EE); flared iliac limb ≥20 mm in diameter to the iliac bifurcation (FL); and iliac limb ≤20 mm ending proximal to the CCIAA (no-FL)...
July 8, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28697938/outcomes-of-endovascular-recanalization-versus-autogenous-venous-bypass-for-thromboangiitis-obliterans-patients-with-critical-limb-ischemia-due-to-tibioperoneal-arterial-occlusion
#5
Kaichuang Ye, Huihua Shi, Jinbao Qin, Minyi Yin, Xiaobing Liu, Weimin Li, Mi'er Jiang, Xinwu Lu
OBJECTIVE: This study sought to compare the outcomes of endovascular recanalization (ER) vs autogenous venous bypass (AVB) for tibioperoneal arterial occlusion in thromboangiitis obliterans patients with critical lower limb ischemia. METHODS: A total of 90 limbs in 75 patients, successfully treated with ER (ER group, 35 patients, 43 limbs) and AVB (AVB group, 40 patients, 47 limbs) for tibioperoneal arterial occlusions from January 2009 to December 2015 in a single institution, were retrospectively analyzed...
July 8, 2017: Journal 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
#6
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/28662928/surveillance-after-endovascular-aortic-repair
#7
Feras Zaiem, Jehad Almasri, Mouaffaa Tello, Larry J Prokop, Elliot L Chaikof, Mohammad Hassan Murad
OBJECTIVE: The objective of this systematic review and meta-analysis was to evaluate the optimal modality and frequency of surveillance after endovascular aortic repair (EVAR) in adult patients with abdominal aortic aneurysms. METHODS: We searched for studies of post-EVAR surveillance in MEDLINE In-Process & Other Non-Indexed Citations, MEDLINE, Embase, Cochrane Database of Systematic Reviews, and Scopus through May 10, 2016. The outcomes of interest were endoleaks, mortality, limb ischemia, renal complications, late rupture, and aneurysm-related mortality...
June 26, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28662927/endovascular-treatment-of-abdominal-aortic-aneurysms-with-narrow-aortic-bifurcation-using-excluder-bifurcated-stent-grafts
#8
Pablo Marques De Marino, Isaac Martinez Lopez, Ferran Pla Sanchez, Iñaki Cernuda Artero, Maday Cabrero Fernandez, Oscar Ucles Cabeza, Francisco Javier Serrano Hernando
OBJECTIVE: This study investigated the influence of the aortic bifurcation anatomy on the endovascular treatment of abdominal aortic aneurysms using Excluder (W. L. Gore & Associates, Flagstaff, Ariz) bifurcated stent grafts. METHODS: This was a retrospective single-center study of patients treated with the Excluder stent graft. Analysis included anatomical factors of the aortic bifurcation (aortic bifurcation diameter [ABD], calcification, thrombus), characteristics of the stent graft limbs (sum of stent graft limbs diameters [SLD]), and the SLD/ABD ratio...
June 26, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28655549/lower-extremity-bypass-for-critical-limb-ischemia-decreases-major-adverse-limb-events-with-equivalent-cardiac-risk-compared-with-endovascular-intervention
#9
J Hunter Mehaffey, Robert B Hawkins, Anna Fashandi, Kenneth J Cherry, John A Kern, Irving L Kron, Gilbert R Upchurch, William P Robinson
OBJECTIVE: Lower extremity bypass (LEB) has traditionally been the "gold standard" in the treatment of critical limb ischemia (CLI). Infrainguinal endovascular intervention (IEI) has become more commonly performed than LEB, but comparative outcomes are limited. We sought to compare rates of major adverse limb events (MALEs) and major adverse cardiovascular events (MACEs) after LEB and IEI in a propensity score-matched, national cohort of patients with CLI. METHODS: The National Surgical Quality Improvement Program (NSQIP) vascular targeted files (2011-2014) for LEB and IEI were merged...
June 24, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28648651/the-impact-of-functional-status-on-the-outcomes-of-endovascular-lower-extremity-revascularization-for-critical-limb-ischemia-in-the-elderly
#10
Isidore Dinga Madou, Martin D Slade, Kristine C Orion, Timur Sarac, Cassius Iyad Ochoa Chaar
INTRODUCTION: Functional status is an important predictor of outcomes after infrainguinal bypass surgery. There is little data on the effect of functional status on the outcomes of endovascular LE interventions, especially in the elderly frail population. METHODS: This is a retrospective analysis of the American College of Surgeons - National Surgical Quality Improvement Program (ACS-NSQIP) files for the years 2011-2013 to assess the impact of functional status on outcome after endovascular intervention for critical limb ischemia...
June 22, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28647640/bypass-surgery-after-endovascular-therapy-for-infrapopliteal-lesion-is-not-a-poor-outcome-compared-with-initial-bypass-surgery-by-vascular-surgeons
#11
Koichi Morisaki, Terutoshi Yamaoka, Kazuomi Iwasa, Takahiro Ohmine
PURPOSE: It is unclear whether prior endovascular therapy (EVT) adversely affects bypass surgery. The aim of this study is to investigate treatment outcomes between initial bypass (bypass-first) and bypass surgery after EVT (EVT-first). METHODS: We conducted a retrospective analysis of critical limb ischemia patients undergoing infrapopliteal bypass between November 2006 and December 2015. Graft patency, limb salvage (LS), amputation-free survival (AFS), and overall survival (OS) were examined between bypass-first and EVT-first groups...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28642109/neoaortic-xenoprosthetic-grafts-for-treatment-of-mycotic-aneurysms-and-infected-aortic-grafts
#12
Chukwudubem Anibueze, Visesh Sankaran, Umar Sadat, Kelvin Tan, Yvonne G Wilson, Robert E Brightwell, Michael S Delbridge, Philip W Stather
BACKGROUND: There is no international consensus regarding the optimum management of infected aortae (mycotic aneurysms, infected aortic grafts). Neoaortoiliac reconstruction has advantages over extra-anatomical bypass grafting; however, the use of autologous vein is associated with venous hypertension and compartment syndrome, alternatively cadaveric homografts are associated with high rates of perianastomotic hemorrhage, limb occlusion, and pseudoaneurysm. Arterial repair using xenoprosthetic patches is associated with lower infection rates compared to the use of prosthetic material...
June 20, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28630267/a-structured-review-of-antithrombotic-therapy-in-peripheral-artery-disease-with-a-focus-on-revascularization-a-tasc-intersociety-consensus-for-the-management-of-peripheral-artery-disease-initiative
#13
REVIEW
Connie N Hess, Lars Norgren, Gary M Ansel, Warren H Capell, John P Fletcher, F Gerry R Fowkes, Anders Gottsäter, Kerry Hitos, Michael R Jaff, Joakim Nordanstig, William R Hiatt
Peripheral artery disease affects >200 million people worldwide and is associated with significant limb and cardiovascular morbidity and mortality. Limb revascularization is recommended to improve function and quality of life for symptomatic patients with peripheral artery disease with intermittent claudication who have not responded to medical treatment. For patients with critical limb ischemia, the goals of revascularization are to relieve pain, help wound healing, and prevent limb loss. The baseline risk of cardiovascular and limb-related events demonstrated among patients with stable peripheral artery disease is elevated after revascularization and related to atherothrombosis and restenosis...
June 20, 2017: Circulation
https://www.readbyqxmd.com/read/28622743/endovascular-treatment-for-chronic-lower-extremity-ischaemia-with-sub-acute-deterioration
#14
Liangxi Yuan, Songlin Guo, Jian Dong, Jian Zhou, Qingsheng Lu, Junmin Bao, Zaiping Jing
OBJECTIVES: The purpose of this study is to report the efficacy of endovascular treatment for patients with sub-acute (14-day to 2-month) deterioration of chronic lower extremity ischaemia. MATERIALS AND METHODS: Between June 2013 and May 2015, 26 consecutive patients (22 men, 4 women; mean age, 68.6 years; range, 50-86 years) were treated for sub-acute deterioration of chronic lower extremity ischaemia in our hospital. All patients were treated with catheter-directed thrombolysis initially and then adjunctive percutaneous transluminal angioplasty and/or stenting was performed to correct underlying lesions...
July 2017: Diabetes & Vascular Disease Research
https://www.readbyqxmd.com/read/28605479/collapsed-stent-graft-and-severe-malperfusion-2%C3%A2-years-after-endovascular-aortic-repair
#15
Yoshihiro Goto, Soh Hosoba, Shinji Ogawa, Yoshihisa Kinoshita
Late collapsing of a stent graft is an extremely rare event, with one existing report describing this phenomenon. A 65-year-old man with a history of endovascular aortic repair for an abdominal aortic aneurysm presented with paraplegia and bilateral lower limb ischaemia. Contrast-enhanced computed tomography showed a dissection of the descending thoracic aorta and a collapsed stent graft, resulting in bilateral lower limb ischaemia. Subsequent axillo-bifemoral bypass resolved his lower extremity functions. The patient required haemodialysis due to acute kidney failure...
June 10, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28602903/major-lower-limb-amputation-outcomes-are-improving
#16
David A Kelly, Stephanie Pedersen, Patrik Tosenovsky, Kishore Sieunarine
INTRODUCTION: Outcomes following major lower limb amputation (MLLA) between 2000 and 2002 from the department of vascular surgery at Royal Perth Hospital (RPH) have been published; mean postoperative length of stay 20 days, inpatient complication rate 54% and 30-day mortality 10%. The last decade has seen increasing endovascular revascularization techniques, increased focus on MLLA patients and general improvements in the model of care. The aim of this study is to compare outcomes between 2000-2002 and 2010-2012...
June 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28600023/contrast-enhanced-ultrasound-in-vascular-surgery-review-and-update
#17
REVIEW
K Bredahl, X M Mestre, R V Coll, Q M Ghulam, H Sillesen, J Eiberg
Accurate imaging methods associated with minimum patient risk are important tools for clinical decision-making in vascular surgery. Today, traditional imaging methods, such as computed tomography angiography, magnetic resonance angiography and digital subtraction angiography are the preferred modalities. Ultrasound has only challenged these methods in assessment of carotid disease, aortic aneurysms, venous insufficiency and thromboembolism and in surveillance of in-situ bypasses. These practice patterns may change with the introduction of second generation ultrasound contrast agents which are easy to use, manageable and safe...
June 6, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28594792/-assessment-of-functional-state-of-microcirculatory-bed-of-the-foot-in-patients-with-lower-limb-critical-ischaemia
#18
S A Platonov, V V Zavatskiĭ, M A Kiselev, A I Avramenko, A S Novitskiĭ, I A Alimkhadzhiev, D V Kandyba, V E Savello, I P Dudanov
The authors assessed perfusion of the foot in patients presenting with lower limb critical ischaemia before and after endovascular revascularization, as well as analysed the interrelationship between the change of perfusion and the clinical result of treatment. The study includes a total of 15 patients presenting with ulcerative-necrotic defects of the foot. All patients underwent study of 2D-perfusion of the foot before and after the endovascular intervention. The '2D-perfusion' package was used within the framework of an angiographic examination, and required neither increase in the volume of the contrast medium nor radiation load...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28593656/clinical-outcome-and-its-predictors-in-hemodialysis-patients-with-critical-limb-ischemia-undergoing-endovascular-therapy
#19
Shohei Kataoka, Junichi Yamaguchi, Masashi Nakao, Kentaro Jujo, Nobuhisa Hagiwara
OBJECTIVES: This study aimed to examine prognosis and causes of death in hemodialysis (HD) patients with critical limb ischemia (CLI) after endovascular therapy (EVT). BACKGROUND: EVT is becoming a first-line treatment in patients with CLI. Nonetheless, only a few studies have examined prognosis and its predictors in HD patients with CLI undergoing EVT, who are known to be at high-risk. Moreover, causes of death in this population are not clarified to date. METHODS: We examined 175 consecutive patients who underwent EVT for CLI between March 2009 and March 2014...
June 8, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28571881/radial-artery-access-for-peripheral-endovascular-procedures
#20
Avnee J Kumar, Lauren E Jones, Kenneth R Kollmeyer, Robert W Feldtman, Craig A Ferrara, Michelle N Moe, Julia F Chen, Jasmine L Richmond, Sam S Ahn
OBJECTIVE: The radial artery is often used for coronary angiography, with a demonstrated decrease in local complications and an increase in postoperative mobility of the patient. Data on radial artery access for peripheral endovascular procedures, however, are limited. We describe our experience with radial artery access for diagnostic and endovascular interventions. METHODS: Between February 2012 and March 2015, there were 95 endovascular procedures performed using radial artery access in 80 unique patients...
May 29, 2017: Journal of Vascular Surgery
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