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Critical limb ischaemia

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https://www.readbyqxmd.com/read/28902825/-treatment-of-patients-with-critical-lower-limb-ischaemia-endovascular-methods-or-reconstructive-operations
#1
A V Gavrilenko, A A Kravchenko, A É Kotov, D V Shatalova
Presented herein is a review of the literature related to endovascular methods of treatment of patients with critical lower limb ischaemia. This is followed by comparative assessment of the outcomes of endovascular and open surgical interventions. Also covered are problems concerning appropriate therapeutic decision making, taking into consideration peculiarities of lower limb ischaemia and the state at the expense of insufficiency of inflow/outflow.
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28876565/pattern-and-distribution-of-peripheral-arterial-disease-in-diabetic-patients-with-critical-limb-ischemia-rutherford-clinical-category-4-6
#2
M J Motsumi, N G Naidoo
BACKGROUND: This study investigated the pattern and distribution of peripheral arterial disease in diabetic patients with critical limb ischaemia (CLI) and to stratify the findings according to the patients' risk factor profile, gender and age group. METHOD: We conducted a one-year prospective descriptive study (January 2014 to December 2014) at Groote Schuur Hospital, University of Cape Town. The research protocol and the informed consent were approved by the Institutional Review Board, and all subjects included in this study gave an informed consent...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28838085/long-term-survival-and-fate-of-the-leg-in-de-novo-intermittent-claudication
#3
Hisao Kumakura, Hiroyoshi Kanai, Yoshiaki Hojo, Toshiya Iwasaki, Shuichi Ichikawa
Aims: The long-term life expectancy and fate of the leg, including progression rate to critical limb ischaemia (CLI), were analysed in de novo patients with intermittent claudication (IC). Methods and results: A prospective cohort study was performed in 1107 patients with de novo IC. The endpoints were overall survival (OS), freedom from major adverse cardiovascular events (MACE), freedom from major adverse cardiovascular and limb events (MACLE), and fate of the leg...
July 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28835456/systematic-review-of-pharmacological-therapies-for-the-management-of-ischaemic-pain-in-patients-with-non-reconstructable-critical-limb-ischaemia
#4
REVIEW
Áine Ní Laoire, Fliss E M Murtagh
BACKGROUND: Critical limb ischaemia (CLI) is a severe manifestation of peripheral arterial disease, characterised by chronic ischaemic rest pain, ulcers or gangrene. Management of ischaemic pain is challenging in patients with no options for revascularisation and optimal pharmacological therapies have not been established. OBJECTIVES: To identify and evaluate the effectiveness of pharmacological therapies to treat ischaemic pain secondary to non-reconstructable CLI...
August 23, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28832559/critical-limb-ischaemia-artery-repair
#5
David Holmes
No abstract text is available yet for this article.
August 23, 2017: Nature
https://www.readbyqxmd.com/read/28830892/life-threatening-intraoperative-anaphylaxis-as-a-result-of-chlorhexidine-present-in-instillagel
#6
Joshua Totty, James Forsyth, Anthony Mekako, Ian Chetter
A 70-year-old man with left lower limb critical ischaemia was admitted to our vascular unit for a femoral-popliteal bypass. He had experienced a skin reaction to chlorhexidine 6 months previously during an angioplasty procedure. After intubation, once in the operating theatre, the patient had a urinary catheter inserted using Instillagel. Around 30 min later the patient had a full-blown anaphylactic reaction that required aggressive medical management and the abandoning of surgery. Postoperative allergy testing confirmed that the suspected primary trigger for the anaphylaxis was indeed chlorhexidine, which was present in Instillagel...
August 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28797662/amputation-rates-mortality-and-pre-operative-comorbidities-in-patients-revascularised-for-intermittent-claudication-or-critical-limb-ischaemia-a-population-based-study
#7
E Baubeta Fridh, M Andersson, M Thuresson, B Sigvant, B Kragsterman, S Johansson, P Hasvold, M Falkenberg, J Nordanstig
OBJECTIVES: The aims of this population based study were to describe mid- to long-term amputation risk, cumulative incidence of death or amputation, and differences in pre-operative comorbidities in patients revascularised for lower limb peripheral artery disease (PAD). METHODS: This was an observational cohort study. Data from the Swedish National Quality Registry for Vascular Surgery (Swedvasc) were combined with mandatory national health care registries and patient medical records...
August 7, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28795888/effective-wound-bed-preparation-using-maggot-debridement-therapy-for-patients-with-critical-limb-ischaemia
#8
A Nishijima, M Gosho, R Yoshida, S Yanagibayashi, M Takikawa, J Nishijima, M Sekido, N Yamamoto
OBJECTIVE: Patients with critical limb ischaemia (CLI) lack sufficient blood flow in to the limb, which leads to difficulties in the normal wound healing process. Therefore, maggot debridement therapy (MDT) has not generally been recommended for CLI patients. We evaluated the effectiveness of wound bed preparation by MDT in CLI patients who had undergone mid-foot amputation. METHODS: Patients who underwent mid-foot amputation after angioplasty between April 2014 and October 2016 were retrospectively investigated by classifying them into an MDT group or a conventional treatment group...
August 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28790028/staged-retroperitoneal-mesenteric-revascularisation-and-aortobifemoral-bypass-after-endovascular-rescue-for-acute-mesenteric-ischaemia
#9
Shepard Peir Johnson, Melani Lighter, Harry Linne Anderson, Abdulhameed Aziz
Visceral artery revascularisation through a retroperitoneal approach provides an infrequent yet viable, alternative means of managing mesenteric ischaemia in patients with previous abdominal operations. We present a unique case implementing this surgical approach in a 55-year-old man in which we performed a retroperitoneal aortobifemoral bypass with concomitant retrograde jump graft from the aortic prosthesis to the superior mesenteric artery (SMA) for bilateral lower extremity rest pain and chronic mesenteric ischaemia...
August 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28754429/assessment-of-minimum-important-difference-and-substantial-clinical-benefit-with-the-vascular-quality-of-life-questionnaire-6-when-evaluating-revascularisation-procedures-in-peripheral-arterial-disease
#10
J Nordanstig, M Pettersson, M Morgan, M Falkenberg, C Kumlien
OBJECTIVES: Patient reported outcomes are increasingly used to assess outcomes after peripheral arterial disease (PAD) interventions. VascuQoL-6 (VQ-6) is a PAD specific health-related quality of life (HRQoL) instrument for routine clinical practice and clinical research. This study assessed the minimum important difference for the VQ-6 and determined thresholds for the minimum important difference and substantial clinical benefit following PAD revascularisation. MATERIALS AND METHODS: This was a population-based observational cohort study...
July 25, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28753096/conservative-treatment-of-patients-with-thromboangiitis-obliterans-or-cannabis-associated-arteritis-presenting-with-critical-lower-limb-ischaemia
#11
George Galyfos, Stavros Kerasidis, Georgios Kastrisios, Sotirios Giannakakis, Ioannis Sachmpazidis, Christiana Anastasiadou, Georgios Geropapas, Anastasios Papapetrou, Gerasimos Papacharalampous, Chrisostomos Maltezos
BACKGROUND: Proper management of patients with thromboangiitis obliterans (TAO) or cannabis-associated arteritis (CAA), presenting with critical lower limb ischaemia (CLI) remains controversial, and data are limited. PATIENTS AND METHODS: Patients with TAO or CAA presenting with CLI between 2011 and 2016 were retrospectively evaluated. Patients requiring primary intervention were excluded. Conservative treatment included: (a) weight-adjusted bemiparin plus six hours/day intravenous iloprost for 28 days, (b) aspirin (100 mg/day) plus cilostazol (100 mg twice/day) after discharge, and (c) strict recommendations/monitoring for smoking cessation...
July 28, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28711979/acute-kidney-injury-and-critical-limb-ischaemia-associated-with-the-use-of-the-so-called-legal-high-3-fluorophenmetrazine
#12
Michael Fawzy, Wei San Wong-Morrow, Anthony Beaumont, Chris K T Farmer
Until the law in the United Kingdom (UK) changed in May 2016 so called "legal highs" or "new psychoactive substances" were freely available in high street shops across the UK. Following prohibition these drugs are still easily purchased illegally via the internet. We report a case of a patient who self-administered 3-fluorophenmetrazine intravenously with catastrophic consequences. Adverse effects were almost immediate with symptoms of malaise and tachycardia. Two days post administration he was transferred to the intensive therapy unit with acute kidney injury and irreversible four limb ischaemia...
July 15, 2017: CEN Case Reports
https://www.readbyqxmd.com/read/28670345/the-comparative-efficacy-of-angiosome-directed-and-indirect-revascularisation-strategies-to-aid-healing-of-chronic-foot-wounds-in-patients-with-co-morbid-diabetes-mellitus-and-critical-limb-ischaemia-a-literature-review
#13
Benedictine Y C Khor, Pamela Price
BACKGROUND: Ischaemic ulcerations have been reported to persist and/or deteriorate despite technically successful revascularisations; a higher incidence of which affects patients with diabetes and critical limb ischaemia. In the context of wound healing, it is unclear if applications of the angiosome concept in 'direct revascularisation' (DR) would be able to aid the healing of chronic foot ulcerations better than the current 'best vessel' or 'indirect revascularisation' (IR) strategy in patients with co-morbid diabetes and critical limb ischaemia...
2017: Journal of Foot and Ankle Research
https://www.readbyqxmd.com/read/28665187/is-contrast-enhanced-ultrasonography-a-useful-tool-for-the-evaluation-of-muscular-microcirculation-in-patients-with-critical-limb-ischaemia
#14
Christophe Seinturier, Sophie Blaise, Olivier Pichot, Sebastien Guigard, Céline Genty, Jean Luc Magne, Jean Luc Bosson, Gilles Pernod, Patrick Henry Carpentier
No abstract text is available yet for this article.
June 30, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28594805/-survival-of-patients-with-primary-and-secondary-amputations-for-critical-lower-limb-ischaemia
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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