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Lower limb endovascular

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/28549963/the-role-of-the-profundoplasty-in-the-modern-management-of-patient-with-peripheral-vascular-disease
#9
Maurizio Taurino, Francesca Persiani, Roberta Ficarelli, Federico Filippi, Raffaele Dito, Luigi Rizzo
OBJECTIVE: The occlusion of superficial femoris artery (SFA), is a common feature in peripheral vascular disease, so the profunda femoris artery (PFA) is a crucial collateral pathway for the perfusion of the lower limb. The purpose of this study is to discuss the safety, clinical and hemodynamic efficacy of profundoplasty on the basis of limb salvage, patency and freedom from reintervention rates. Furthermore this study aims to identify the risk factors linked to the failure of the procedure...
May 23, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28541861/trends-and-outcomes-in-the-operative-management-of-traumatic-vascular-injuries-a-comparison-of-open-versus-endovascular-approaches
#10
Bryan K Richmond, Rudy Judhan, William Sherrill, Michael Yacoub, Ali F AbuRahma, Kimball Knackstedt, Julton T Chumbe, Damayanti Samanta, Stephanie N Thompson
Controversy exists in vascular trauma regarding the best method of treatment-open versus endovascular techniques. Little has been published on this complex topic. Patients from 2005 to 2013 at a Level I trauma center with vascular injuries were identified via a prospectively trauma registry. Patient data, injury type/severity, treatment, and 30-day outcomes were obtained from the trauma registry and the chart review. Adverse events (limb loss, major disability, and death) were outcomes of interest. Univariate analysis and multivariate logistic regression were used to identify predictors of adverse events...
May 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28527930/outcomes-of-open-and-endovascular-lower-extremity-revascularization-in-active-smokers-with-advanced-peripheral-arterial-disease
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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