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Critical limb ischaemia

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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
#1
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
#2
https://www.readbyqxmd.com/read/28131536/dual-antiplatelet-therapy-improves-outcome-in-diabetic-patients-undergoing-endovascular-femoropopliteal-stenting-for-critical-limb-ischaemia
#3
O Thott, F Granath, J Malmstedt, C-M Wahlgren
OBJECTIVE: The purpose of this study was to analyse the effect of dual antiplatelet therapy (DAPT) compared to aspirin on outcome after endovascular interventions in patients with CLI. METHODS: This was a population based retrospective nationwide cohort analysis. Several linked national databases in Sweden: Swedish National Vascular Registry, Prescribed Drug Registry and National Discharge Registry. A total of 1941 patients (median age 79; range 43-103 years; women 58%) were identified with CLI who had undergone primary femoropopliteal endovascular intervention between 2006 and 2012...
January 25, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28128018/german-guideline-on-the-diagnosis-and-treatment-of-peripheral-artery-disease-a-comprehensive-update-2016
#4
Holger Lawall, Peter Huppert, Christine Espinola-Klein, Claudia Silke Zemmrich, Gerhard Ruemenapf
The prevalence of peripheral artery disease (PAD) is increasing worldwide and is strongly age-related, affecting about 20 % of Germans over 70 years of age. Recent advances in endovascular and surgical techniques as well as clinical study results on comparative treatment methods strengthened the need for a comprehensive review of the published evidence for diagnosis, management, and prevention of PAD. The interdisciplinary guideline exclusively covers distal aorta and atherosclerotic lower extremity artery disease...
January 27, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/28089406/intervention-should-not-be-the-thermopylae-to-avoid-amputation-commentary-on-not-all-patients-with-critical-limb-ischaemia-require-revascularisation
#5
EDITORIAL
M A Cairols
No abstract text is available yet for this article.
January 12, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28069703/loss-of-osteoglycin-promotes-angiogenesis-in-limb-ischaemia-mouse-models-via-modulation-of-vascular-endothelial-growth-factor-and-vascular-endothelial-growth-factor-receptor-2-signalling-pathway
#6
Qi-Hong Wu, Yu Ma, Cheng-Chao Ruan, Yan Yang, Xin-He Liu, Qian Ge, Ling-Ran Kong, Ji-Wei Zhang, Chen Yan, Ping-Jin Gao
OBJECTIVE: Osteoglycin (OGN) has been noted for its implication in cardiovascular disease in recent studies. However, the relationship between OGN and angiogenesis remains unknown. Therefore, we aimed to investigate the effect of OGN on ischaemia-induced angiogenesis and to address the underlying mechanisms. METHODS AND RESULTS: The expression of OGN was decreased in a limb ischaemia mouse model. OGN knockout (KO) mice were used to further understand the role of OGN after ischaemia...
January 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28065441/clinimetric-evaluation-of-the-vascular-quality-of-life-questionnaire-in-patients-with-lower-limb-ischaemia
#7
A P Conijn, T B K Santema, S Bipat, M J W Koelemay, R J de Haan
OBJECTIVES: Although commonly used to measure health related quality of life in patients with lower limb ischaemia, the measurement properties of the VascuQol and its assumed underlying health dimensions have not been studied in depth. The objective of this study was therefore to evaluate aspects of reliability and validity of the Dutch version of the VascuQol in patients with intermittent claudication (IC) and critical limb ischaemia (CLI). METHODS: Two datasets containing 195 patients with IC and 150 patients with CLI were used...
January 4, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28027892/venous-arterialisation-for-salvage-of-critically-ischaemic-limbs-a-systematic-review-and-meta-analysis
#8
REVIEW
M A Schreve, C G Vos, A C Vahl, J P P M de Vries, S Kum, G J de Borst, Ç Ünlü
BACKGROUND: Critical limb ischaemia (CLI) is the end stage of peripheral artery disease (PAD) and is associated with high amputation and mortality rates and poor quality of life. For CLI patients with no revascularisation options, venous arterialisation could be a last resort for limb salvage. OBJECTIVE: To review the literature on the clinical effectiveness of venous arterialisation for lower limb salvage in CLI patients with no revascularisation options. METHOD: Different databases were searched for papers published between January 1966 and January 2016...
December 24, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27959471/lumbar-sympathectomy-techniques-for-critical-lower-limb-ischaemia-due-to-non-reconstructable-peripheral-arterial-disease
#9
REVIEW
Veena Kl Karanth, Tulasi Kota Karanth, Laxminarayan Karanth
BACKGROUND: Critical lower limb ischaemia (CLI) is a manifestation of peripheral arterial disease (PAD) that is seen in patients with typical chronic ischaemic rest pain or patients with ischaemic skin lesions - ulcers or gangrene - for longer than 2 weeks. Critical lower limb ischaemia is the most severe form of PAD, and interventions to improve arterial perfusion become necessary. Although surgical bypass has been the gold standard for revascularisation, the extent or the site of disease may be such that the artery cannot be reconstructed or bypassed...
13, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27958688/results-of-surgical-interventions-for-critical-limb-ischaemia-due-to-vasculitis-or-collagen-tissue-related-disease
#10
Kota Yamamoto, Katsuyuki Hoshina, Atsushi Akai, Toshihiko Isaji, Daisuke Akagi, Takuya Miyahara, Toshiaki Watanabe
BACKGROUND: In this study, we aimed to clarify both systemic and local prognosis after surgical interventions for critical limb ischaemia (CLI) due to vasculitis or connective tissue related disease, and to search for any risk factors that can worsen the prognosis. METHODS: One hundred and ninety three patients that underwent surgical interventions for CLI between 2005 and 2014 were followed up for a median of 2.7 years. The patients were grouped into a group with vasculitis or connective tissue related disease (V) or with atherosclerosis (control: C)...
December 13, 2016: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/27939742/long-term-primary-patency-rate-after-nitinol-self-expandable-stents-implantation-in-long-totally-occluded-femoropopliteal-tasc-ii-c-d-lesions-retrospective-study
#11
Mahmoud Farouk Elmahdy, Piergiovanni Buonamici, Maurizio Trapani, Renato Valenti, Angela Migliorini, Guido Parodi, David Antoniucci
BACKGROUND: Endovascular therapy for long femoropopliteal lesions using percutaneous transluminal balloon angioplasty or first-generation of peripheral stents has been associated with unacceptable one-year restenosis rates. However, with recent advances in equipment and techniques, a better primary patency rate is expected. So, this study was conducted to detect the long-term primary patency rate of nitinol self-expandable stents implanted in long, totally occluded femoropopliteal lesions (TASC II type C & D), and determine the predictors of reocclusion or restenosis in the stented segments...
November 18, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/27935893/-results-of-using-various-methods-of-autovenous-femoropopliteal-bypass-grafting-below-the-knee-joint-fissure
#12
B S Sukovatykh, L N Belikov, M B Sukovatykh, D V Sidorov, M A Inarkhov, E B Inokhodova
The objective of the study was to improve therapeutic outcomes in patients presenting with lower limb critical ischaemia by means of optimizing the technique of femoropopliteal bypass grafting. The authors analysed the results of comprehensive examination and treatment of a total of 90 patients presenting with critical lower limb ischaemia on the background of atherosclerotic lesions of arteries of the femoropopliteal and crural segments. Depending on the technology of performing femoropopliteal bypass grafting, the patients were subdivided into three groups each consisting of 30 subjects...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/27935892/-two-year-results-of-infrainguinal-reconstructions-using-autovenous-shunts-and-xenografts
#13
I S Tishchenko, V N Zolkin, N V Maksimov, I N Korotkov, I Yu Demidov, M A Barzaeva
The authors analysed two-year results of inftrainguinal distal arterial reconstructions using xenograft ("kemAngioprosthesis") as compared with an autovein. Ours was a retrospective study including a total of 110 patients who endured 57 femoropopliteal (distal) and 54 femorotibial bypasses by means of both an autovein and a xenograft used as a shunt. The indications for reconstructive operation in the majority of cases was critical ischaemia induced by an atherosclerotic lesion of the femoropoplitealtibial segment corresponding to type D according to the TASC II classification...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/27919610/renal-artery-stenosis-in-patients-with-peripheral-artery-disease-prevalence-risk-factors-and-long-term-prognosis
#14
V Aboyans, I Desormais, J Magne, G Morange, D Mohty, P Lacroix
OBJECTIVE/BACKGROUND: The objective was to determine the prevalence and clinical determinants of renal artery stenosis (RAS) in patients undergoing digital subtraction angiography (DSA) for the assessment of peripheral artery disease (PAD), and to evaluate its prognostic significance. METHODS: All DSAs performed from January 2000 to January 2006 were retrospectively reviewed for assessment of PAD in patients naive for any prior revascularisation of lower-limb arteries...
December 2, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27919605/not-all-patients-with-critical-limb-ischaemia-require-revascularisation
#15
T B Santema, R M Stoekenbroek, J van Loon, M J W Koelemay, D T Ubbink
OBJECTIVES: International guidelines recommend revascularisation as the preferred treatment for patients with critical limb ischaemia (CLI). Most contemporary research focuses on the outcome of invasive procedures for CLI, but little is known about the outcome of conservative management. Amputation free survival (AFS) and overall survival (OS) was investigated in patients with CLI who did or did not receive revascularisation, and characteristics associated with clinical outcomes were explored...
December 2, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27894392/-advances-in-the-research-on-effect-of-detecting-skin-perfusion-pressure-in-clinic
#16
X L Pan, C M Han
Skin perfusion pressure (SPP) is the perfusion pressure at the skin level, and it can serve as an index of microcirculation in skin and subcutaneous tissue. SPP can be measured simply, with less injury and high reproducibility in a short time, without interfering vascular calcification. It has been widely used in various fields, including evaluation of critical limb ischaemia and effect of vascular surgery, selection of proper level of amputation, and prediction of wound healing. So far, there is no relevant reports about the application of SPP in China...
November 20, 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/27890526/femoropopliteal-in-stent-restenosis-repair-midterm-outcomes-after-paclitaxel-eluting-balloon-use-plaisir-trial
#17
N Bague, P Julia, A Sauguet, J M Pernès, P Chatelard, J F Garbé, S Penillon, J M Cardon, P Commeau, O Planché, B Guyomarch, Y Gouëffic
OBJECTIVE: The aim was to assess 18 month outcomes of the paclitaxel eluting balloon (PEB) in patients with femoropopliteal (FP) in-stent restenosis (ISR). METHODS: In a national prospective and multicentre cohort study, symptomatic patients with femoropopliteal in-stent restenosis were included from January 2012 to June 2013. Patients were treated by paclitaxel eluting balloon angioplasty (In Pact Admiral, Medtronic, Santa Rosa, CA, USA). Clinical and duplex scan follow-up evaluations were performed at 1, 3, 6, 9, 12, and 18 months...
November 24, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27889202/analysis-of-the-elective-treatment-process-for-critical-limb-ischaemia-with-tissue-loss-diabetic-patients-require-rapid-revascularisation
#18
K Noronen, E Saarinen, A Albäck, M Venermo
OBJECTIVES: The number of elderly people is increasing; inevitably, the result will be more patients with critical limb ischaemia (CLI) in the future. Tissue loss in CLI is related to a high risk of major amputation. The aim of this study was to analyze the treatment process from referral to revascularisation, to discover possible delays and reasons behind them, and to distinguish patients benefitting the most from early revascularisation. METHODS: A retrospective analysis was performed of 394 consecutive patients with a combined 447 affected limbs, referred to the outpatient clinic during 2010-2011 for tissue loss of suspected ischaemic origin...
November 24, 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27869551/critical-limb-ischaemia-and-the-response-to-bone-marrow-derived-cell-therapy-according-to-tcpo2-measurement
#19
Mario Maufus, Marie Antoinette Sevestre-Pietri, Carmine Sessa, Bernard Pignon, Harald Egelhofer, Stephane Dupas, Philippe Nguyen, Celine Genty, Gilles Pernod
BACKGROUND: Cell therapy is an emerging potential biotherapy for critical limb ischaemia (CLI) patients who are not eligible for revascularization. However, the findings on this technique's efficacy are inconsistent. Trials investigating this topic focused on the more severe CLI patients who were often beyond any therapy. Therefore, identifying those who may truly benefit from cell transplantation is now warranted. To this end, we studied the prognostic value of tcPO2 for major amputation after 1 year in patients treated with bone marrow-derived cells...
November 21, 2016: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/27826785/recanalisation-of-chronically-occluded-remote-superficial-femoral-artery-endarterectomy-through-angioplasty-for-limb-salvage
#20
Mohammad Ali Husainy, Hani Slim, Hisham Rashid, Dean Y Huang
We report a novel application of balloon angioplasty to recanalise a chronically occluded remote endarterectomy superficial femoral artery. This patient previously had two occluded surgical bypass grafts in an attempt to revascularise the limb and presented with critical limb ischaemia and necrotic foot ulcerations. Following the angioplasty, the patient showed significant improvement in rest pain and healing of the ulcerations. This technique may be useful for limb salvage in patients where surgical options have been exhausted...
February 2017: Cardiovascular and Interventional Radiology
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