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Critical limb ischaemia

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https://www.readbyqxmd.com/read/28594805/-survival-of-patients-with-primary-and-secondary-amputations-for-critical-lower-limb-ischaemia
#1
M N Kudykin, R A Deriabin, A N Vasiagin, V V Beschastnov, M G Riabkov, G E Sheĭko, I V Maklakhov
The authors analysed therapeutic outcomes in a total of 171 patients presenting with critical lower limb ischaemia and subjected to amputation at various levels. In so doing, eighty-eight (Group One) patients sustained primary amputation and the remaining eighty-three (Group Two) patients endured secondary amputation after an initially undertaken attempt at revascularization. It was determined that performing primary amputation statistically significantly shortened the lifespan in the postoperative period as compared with secondary amputation performed...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and 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
#2
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/28594443/growth-factors-for-angiogenesis-in-peripheral-arterial-disease
#3
REVIEW
Vitali Gorenoi, Michael U Brehm, Armin Koch, Anja Hagen
BACKGROUND: Peripheral artery disease (PAD) is associated with a high clinical and socioeconomic burden. Treatments to alleviate the symptoms of PAD and decrease the risks of amputation and death are a high societal priority. A number of growth factors have shown a potential to stimulate angiogenesis. Growth factors delivered directly (as recombinant proteins), or indirectly (e.g. by viral vectors or DNA plasmids encoding these factors), have emerged as a promising strategy to treat patients with PAD...
June 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28587797/comparison-of-long-term-outcomes-of-heparin-bonded-polytetrafluoroethylene-and-autologous-vein-below-knee-femoropopliteal-bypasses-in-patients-with-critical-limb-ischaemia
#4
C Uhl, C Grosch, C Hock, I Töpel, M Steinbauer
OBJECTIVE/BACKGROUND: Endovascular first is the preferred therapy approach to critical limb ischaemia (CLI). However, in spite of new endovascular techniques, bypass surgery still plays an important role, especially in patients with complex anatomy in whom endovascular therapy is not considered feasible, or has failed. The goal of this study was to analyse the outcomes of prosthetic or autologous vein for femoropopliteal (P3) bypasses performed under the abovementioned conditions. METHODS: A retrospective analysis of patients who underwent a femoropopliteal (P3) bypass for CLI (March 2007-December 2015) was conducted...
June 3, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28574037/-diagnostic-significance-of-the-color-duplex-scanning-in-estimation-of-the-arteries-state-at-different-stages-of-infrainguinal-reconstructions
#5
I E Timina, I I Piatkova, A E Zotikov, Z A Adyrkhaev
AIM: The study was aimed at assessing diagnostic possibilities of duplex scanning (DS) of lower limb arteries, used as 'ultrasonographic angiography' in patients presenting with critical ischaemia for appropriately planning complicated infrainguinal reconstructions at stages of surgical management, including dynamic follow up in the postoperative period. PATIENTS AND METHODS: We examined a total of 30 patients. Of these, 14 patients composed the control group and 16 patients with critical ischaemia of lower limb arteries who underwent 8 external iliac-tibial and 8 femorotibial bypass graftings with a relieving arteriovenous fistula and application of a venous cuff according to the type of 'St...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28574036/-stimulation-of-angiogenesis-by-bone-marrow-cells-in-experimental-ischaemia-of-lower-limb
#6
B S Sukovatykh, A Iu Orlova
The objective of the study was to experimentally substantiate a possibility of treating lower limb chronic ischaemia by means of administration of bone marrow cells. The study was performed on 100 laboratory 'Wistar' rats subdivided into four groups: intact, control, first and second study groups. The intact group consisted of 10 animals, with the remaining three containing 30 rats each. All animals, except the intact ones, were subjected to modelled critical ischaemia of a hind limb by means of excision of major vessels of the extremity...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28574034/-effect-of-actovegin-and-solcoseryl-on-microcirculation-in-experimental-critical-lower-limb-ischaemia
#7
A Iu Orlova, B S Sukovatykh, E B Artiushkova, M Iu Gordov
The authors examined the effect of actovegin and solcoseryl on microcirculation parameters in treatment of experimental critical lower limb ischaemia. The study included a total of 130 male Wistar albino rats divided into four groups: intact, control, first and second study groups. The intact group consisted of 10 animals used for assessment of the normal indices of microcirculation, with the remaining three groups comprising 40 rats each. All animals, except the intact ones, were subjected to modelled critical ischaemia of a hind limb...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28567433/maggot-debridement-therapy-for-a-patient-with-critical-limb-ischaemia-and-severe-cardiac-dysfunction-possibility-of-limb-salvage
#8
Akio Nishijima, Naoto Yamamoto, Ryuichi Yoshida, Koji Hozawa, Satoshi Yanagibayashi, Megumi Takikawa, Rie Hayasaka, Junko Nishijima, Tadasu Okada, Mitsuru Sekido
Ischaemic skin ulcer occurred on the foot of a 73-year-old man who had a history of fulminant myocarditis with severe cardiac dysfunction. We attempted wound bed preparation by maggot debridement therapy and salvaged his limb. It can be one of the adjuvant treatment strategies for critical limb ischaemia.
2017: Case Reports in Plastic Surgery & Hand Surgery
https://www.readbyqxmd.com/read/28528282/management-options-in-the-treatment-of-femoral-pseudoaneurysms-secondary-to-intravenous-drug-abuse-a-case-series
#9
James Rammell, Nisheeth Kansal, Vish Bhattacharya
INTRODUCTION: Infected femoral pseudoaneurysms are a common presentation in intravenous drug users with little consensus as to the optimum management of these patients. Whilst emergency revascularisation options are available, excision and ligation of the femoral artery remains the most common operative intervention but risks leaving the patient with critical ischaemia or intermittent claudication. This case series reviewed the outcomes of 4 patients who underwent excision-ligation without revascularisation of an infected femoral pseudoaneurysm at a district general hospital...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28463077/rationale-and-design-of-the-recording-courses-of-vascular-diseases-registry-reccord-registry
#10
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/28448207/gender-differences-in-endovascular-treatment-of-infrainguinal-peripheral-artery-disease
#11
Henrik Christian Rieß, Eike Sebastian Debus, Franziska Heidemann, Konstanze Stoberock, Reinhart T Grundmann, Christian-Alexander Behrendt
BACKGROUND: Despite ongoing research concerning comorbidities and clinical presentation of peripheral arterial disease (PAD), the issue of gender associated differences in treatment is far from being settled. PATIENTS AND METHODS: This was a prospective, non-randomized multicentre study design. All patients suffering from intermittent claudication (IC) or critical limb ischaemia (CLI) were included. RESULTS: A total of 2,798 procedures for symptomatic PAD in the infrainguinal region were recorded, with 1,696 (61...
April 27, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28386401/the-efficacy-and-safety-of-intravenous-lidocaine-for-analgesia-in-the-older-adult-a-literature-review
#12
REVIEW
Harriet Daykin
Opioids remain the mainstay of analgesia for the treatment of moderate to severe acute pain. Even in the young, the use of opioids can be associated with an increased incidence of post-operative complications such as respiratory depression, vomiting, pruritus, excessive sedation, slowing of gastrointestinal function, and urinary retention. The need to manage acute pain in the older patient is becoming more common as the population ages, and increasingly older patients are undergoing more major surgery. Medical conditions are more common in older people and can result in the requirement of systemic analgesia for fractures, malignancy, nociceptive or neuropathic pain and peripheral vascular disease...
February 2017: British Journal of Pain
https://www.readbyqxmd.com/read/28368090/bypass-surgery-for-chronic-lower-limb-ischaemia
#13
REVIEW
George A Antoniou, George S Georgiadis, Stavros A Antoniou, Ragai R Makar, Jonathan D Smout, Francesco Torella
BACKGROUND: Bypass surgery is one of the mainstay treatments for patients with critical lower limb ischaemia (CLI). This is the second update of the review first published in 2000. OBJECTIVES: To assess the effects of bypass surgery in patients with chronic lower limb ischaemia. SEARCH METHODS: For this update, the Cochrane Vascular Group searched its trials register (last searched October 2016) and the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library (last searched Issue 9, 2016)...
April 3, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28358245/changes-in-the-demographics-of-intravenous-drug-users-with-mycotic-common-femoral-artery-pseudoaneurysm-as-a-consequence-of-self-injection-does-not-influence-outcome-following-emergency-ligation
#14
Richard P Stevenson, Catriona Semple, Keith Hussey, Josh McGovern, Wesley P Stuart, David B Kingsmore
Objectives The reported annual incidence of mycotic pseudoaneurysm of the common femoral artery in intravenous drug users has been estimated at 0.03%. Over the past 5 years in Scotland, the proportion of people receiving specialist attention for heroin use over the age of 40 years has increased from 15 to 22%. Although routinely managed with arterial ligation (without reconstruction), some series have reported rates of major limb amputation of up to 10%. We sought to define whether this management strategy was still acceptable in an older population...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28275827/intraprocedural-distal-embolization-after-femoropopliteal-angioplasty-is-there-a-role-for-below-the-knee-stents
#15
Miltiadis Krokidis, Tariq Ali, Nicholas Hilliard, Nadeem Shaida, Andrew Winterbottom, Brendan Koo, Teik Choon See
PURPOSE: Intraprocedural distal embolization is an accepted complication of femoropopliteal angioplasty. The purpose of this study is to assess the use of below-the-knee stents in the "bail-out" of conventional methods. MATERIALS AND METHODS: We retrospectively reviewed 1485 of femoropopliteal angioplasties that were performed in our centre in a 4-year period and analysed 12 cases (<1%) where distal embolization that required further intervention occurred. In all cases lesions were chronic and 75% suffered from critical limb ischaemia...
March 8, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28271745/very-distal-vein-bypass-in-patients-with-thromboangiitis-obliterans
#16
Achim Neufang, Carolina Vargas-Gomez, Patrick Ewald, Nicolaos Vitolianos, Tolga Coskun, Nael Abu-Salim, Rainer Schmiedel, Peter von Flotow, Savvas Savvidis
BACKGROUND: Surgical revascularization for chronic critical limb ischaemia in patients with thromboangiitis obliterans (TAO) still remains controversial. Generally, besides cessation of smoking, conservative treatment supported by intravenous administration of vasoactive agents is regarded as the treatment of choice, in combination with local wound therapy or minor amputation. PATIENTS AND METHODS: In four male patients (42-47 years) surgical revascularization was chosen as therapy for established gangrene or non-healing ulceration after unsuccessful conservative treatment and cessation of smoking...
March 8, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28245882/development-of-a-surrogate-potency-assay-to-determine-the-angiogenic-activity-of-stempeucel%C3%A2-a-pooled-ex-vivo-expanded-allogeneic-human-bone-marrow-mesenchymal-stromal-cell-product
#17
Charan Thej, Balamurugan Ramadasse, Ankita Walvekar, Anish S Majumdar, Sudha Balasubramanian
BACKGROUND: Mesenchymal stromal cells (MSCs) have emerged as a more beneficial alternative to conventional therapy and may offer a potential cure for unmet medical needs. MSCs are known to possess strong immunomodulatory and anti-inflammatory properties. Moreover, they promote angiogenesis and tissue regeneration through the secretion of trophic factors. For these reasons, the past decade witnessed a sharp increase in the number of clinical trials conducted with stem cells for various vascular diseases requiring angiogenesis...
February 28, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28245772/structure-of-atherosclerotic-plaques-in-different-vascular-territories-clinical-relevance
#18
Pavel Poredos, Peter Poredos, Mateja Kaja Jezovnik
Atherosclerosis is a systemic disease with different faces. Despite similar, or even identical, risk factors and pathogenesis, atherosclerotic lesions and their clinical manifestations vary in different parts of the vasculature. Peripheral arterial disease (PAD) in the superficial femoral artery (SFA) represents a frequent clinical manifestations of atherosclerotic disease. The pathohistological characteristics of plaques in PAD differ from lesions in the coronary arteries. Plaques in the SFA have more fibrotic elements with less lipid and degenerative tissue elements; this makes them more stable and less prone to rupture...
February 26, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28215512/angiosome-targeted-pta-is-more-important-in-endovascular-revascularisation-than-in-surgical-revascularisation-analysis-of-545-patients-with-ischaemic-tissue-lesions
#19
K Špillerová, N Settembre, F Biancari, A Albäck, M Venermo
INTRODUCTION: This study aimed to evaluate the impact of angiosome targeted (direct) revascularisation according to revascularisation method in patients with diabetes. MATERIALS AND METHODS: This retrospective study cohort comprised 545 diabetic patients with critical limb ischaemia and tissue loss (Rutherford 5, 6). All patients underwent infrapopliteal endovascular (PTA) or open surgical revascularisation between January 2008 and December 2013. Differences in the outcome after direct revascularisation, bypass surgery, and PTA were investigated by means of Cox proportional hazards analysis...
February 16, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28131538/dual-antiplatelet-therapy-safe-but-still-unsettled-for-endovascular-femoropopliteal-stenting-commentary-on-dual-antiplatelet-therapy-improves-outcome-in-diabetic-patients-undergoing-endovascular-femoropopliteal-stenting-for-critical-limb-ischaemia
#20
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