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Critical limb ischaemia

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https://www.readbyqxmd.com/read/29318581/prostanoids-for-critical-limb-ischaemia
#1
REVIEW
Valeria Vietto, Juan Va Franco, Victoria Saenz, Denise Cytryn, Jose Chas, Agustín Ciapponi
BACKGROUND: Peripheral arterial occlusive disease (PAOD) is a common cause of morbidity and mortality due to cardiovascular disease in the general population. Although numerous treatments have been adopted for patients at different disease stages, no option other than amputation is available for patients presenting with critical limb ischaemia (CLI) unsuitable for rescue or reconstructive intervention. In this regard, prostanoids have been proposed as a therapeutic alternative, with the aim of increasing blood supply to the limb with occluded arteries through their vasodilatory, antithrombotic, and anti-inflammatory effects...
January 10, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29314703/a-retrospective-cost-analysis-of-angioplasty-compared-to-bypass-surgery-for-lower-limb-arterial-disease-in-an-australian-tertiary-health-service
#2
Natalie Ly Ngu, James Lisik, Dinesh Varma, Gerard S Goh
INTRODUCTION: Percutaneous transluminal angioplasty (PTA) and surgical bypass (BYP) are treatment options for symptomatic peripheral arterial disease (PAD). PTA and BYP have different clinical outcomes and cost implications. This paper aims to compare hospital-related costs of PTA and BYP for PAD of the lower limbs in an Australian health service. METHODS: A retrospective cost analysis using clinical and financial data from an urban, tertiary hospital was performed...
January 5, 2018: Journal of Medical Imaging and Radiation Oncology
https://www.readbyqxmd.com/read/29306852/trichosporon-asahii-septic-thrombophlebitis-following-lower-extremity-amputation-in-an-immunocompetent-host
#3
Pradeep Kumar Mada, Folusakin Ayoade, Ailing Li, John Todd
A 59-year-old man with a history of peripheral vascular disease status post femoral popliteal bypass presented with critical limb ischaemia of the left leg. An arterial Doppler ultrasound showed an occluded graft requiring an above knee amputation. Five days after surgery, the patient developed fever, leucocytosis, significant stump swelling and pain, and serosanguinous discharge from his wound. Wound swab cultures from the stump grew Trichosporon asahii A venous Doppler ultrasound revealed extensive thrombosis of the left lower extremity...
January 6, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29305093/pilot-assessment-of-the-angiosome-concept-by-intra-operative-fluorescence-angiography-after-tibial-bypass-surgery
#4
Ulrich Rother, Werner Lang, Raymund E Horch, Ingo Ludolph, Alexander Meyer, Olaf Gefeller, Susanne Regus
OBJECTIVES: The "angiosome" concept as a model for decision making in revascularisation of patients with critical limb ischaemia (CLI) has been subject to lively discussion in recent years. The aim of this prospective pilot study was to use intra-operative fluorescence angiography to provide further data on the angiosome concept on the level of microcirculation after tibial bypass surgery. DESIGN, MATERIALS, AND METHODS: This was a prospective analysis of 40 patients presenting with CLI Rutherford stage IV to VI before and after tibial bypass surgery...
January 2, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29273390/outcomes-of-patients-with-critical-limb-ischaemia-in-the-euclid-trial
#5
Lars Norgren, Manesh R Patel, William R Hiatt, Daniel M Wojdyla, F Gerry R Fowkes, Iris Baumgartner, Kenneth W Mahaffey, Jeffrey S Berger, W Schuyler Jones, Brian G Katona, Peter Held, Juuso I Blomster, Frank W Rockhold, Martin Björck
OBJECTIVES: Critical limb ischaemia (CLI) implies an increased risk of cardiovascular morbidity and mortality, and the optimal antithrombotic treatment is not established. DESIGN, MATERIALS, METHODS: The EUCLID trial investigated the effect of monotherapy with ticagrelor versus clopidogrel in 13,885 patients with peripheral artery disease (PAD); the primary endpoint was cardiovascular death, myocardial infarction, or ischaemic stroke. Patients planned for revascularisation or amputation within 3 months, were excluded...
December 19, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29273182/-peripheral-arterial-disease-treatment
#6
Iléana Desormais, Victor Aboyans, Francis Pesteil, Philipe Lacroix
Medical management of peripheral arterial disease (PAD) patients is aimed at limb symptom relief and reducing systemic major adverse events risk. For the first purpose: exercise therapy is recommended in case of claudication; multidisciplinary evaluation for surgical options is mandatory in case of critical limb ischaemia. Reducing cardiac and stroke risk can be achieved through: statin prescription in most of the cases; antiplatelet agents in symptomatic PAD patients; cardio-vascular risk factors control.
December 19, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/29240065/-secondary-reconstructions-after-endovascular-treatment-of-a-woman-with-critical-lower-limb-ischaemia
#7
A V Gavrilenko, A A Kravchenko, D V Shatalova
Primary endovascular interventions carried out according to the indications determined by the TASC II guidelines have proved successful in treatment of patients presenting with critical lower limb ischaemia. However, performing secondary and complicated reconstructions requires an individual approach with the assessment of all possible risks involved. Presented herein is a clinical case report regarding repeat reconstruction in a woman with critical lower limb ischaemia after a previously performed endovascular intervention...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/29225030/a-rare-cause-of-critical-limb-ischaemia-an-aneurysmal-persistent-sciatic-artery
#8
Gabriele Pagliariccio, Luciano Carbonari
No abstract text is available yet for this article.
December 7, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29116654/cardiovascular-and-all-cause-mortality-in-patients-with-intermittent-claudication-and-critical-limb-ischaemia
#9
S T W van Haelst, C Koopman, H M den Ruijter, F L Moll, F L Visseren, I Vaartjes, G J de Borst
BACKGROUND: The aim of this study was to evaluate absolute mortality risks and to determine whether changes in mortality risk occurred in patients with intermittent claudication (IC) or critical limb ischaemia (CLI) in the Netherlands between 1998 and 2010. METHODS: Data for patients treated between 1998 and 2010 were obtained from Dutch nationwide registers: the Hospital Discharge Register, Population Register and Cause of Death Register. The registers were used to obtain information regarding IC and CLI hospitalizations, co-morbidities, demographic factors, and date and cause of death...
November 8, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/29109739/a-case-of-polyarteritis-nodosa-presenting-as-rapidly-progressing-intermittent-claudication-of-right-leg
#10
Chathuranga Lakmal Fonseka, Sampath Rukshani Galappaththi, Dayakshi Abeyaratne, Nirmali Tissera, Lalith Wijayaratne
Background: Polyarteritis nodosa (PAN) is a medium vessel vasculitis which causes significant morbidity and mortality. Usually, it presents with constitutional symptoms with angiographic evidence of aneurysms or segmental stenosis of arteries of mesenteric or renal vasculature. It is exceedingly uncommon for PAN to present with symptomatic progressive intermittent claudication. Case Presentation: We describe a 60-year-old male who presented with rapidly progressive intermittent claudication of his right leg...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/29105269/the-impact-of-coronary-artery-disease-and-left-ventricular-ejection-fraction-on-the-prognosis-of-patients-with-peripheral-artery-disease
#11
Takuya Tsujimura, Osamu Iida, Takayuki Ishihara, Masashi Fujita, Masaharu Masuda, Shin Okamoto, Kiyonori Nanto, Takashi Kanda, Akihiro Sunaga, Mitsuyoshi Takahara, Masaaki Uematsu
The impact of the severity of coronary artery disease (CAD) and left ventricular ejection fraction (LVEF) on the prognosis of patients with peripheral artery disease (PAD) has not been systematically studied. We retrospectively analysed 622 patients with PAD (intermittent claudication (IC): n = 446; critical limb ischaemia (CLI): n = 176). The association of SYNTAX score and LVEF with mortality was analysed using the Cox proportional hazard model. In patients with IC, a high SYNTAX score was significantly associated with mortality, whereas reduced LVEF was significantly associated with mortality in patients with CLI...
November 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29065790/surgical-and-endovascular-venous-arterialization-for-treatment-of-critical-limb-ischaemia
#12
Michael Lichtenberg, Michiel A Schreve, Roberto Ferraresi, Daniel A F van den Heuvel, Çagdas Ünlü, Vincent Cabane, Steven Kum
Patients with critical limb ischaemia have a poor life expectancy. Aggressive revascularization is accepted in order to preserve their independence in the final phase of their lives. Bypass surgery and more recently endovascular interventions with angioplasty and stenting have become the treatment of choice to prevent amputation and to resolve pain. However, as many as 20 % of patients with critical limb ischaemia are unsuitable candidates for a vascular intervention because of extensive occlusions of outflow in the crural and pedal vessels...
October 25, 2017: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29057728/-a-multidisciplinary-approach-in-diabetic-foot-disease-is-mandatory
#13
J G van Baal, W B Aan de Stegge, N C Schaper
The history of two patients (66- and 53-year-old males) with diabetes and peripheral neuropathy illustrates the variety of clinical presentations and pitfalls in treatment of diabetic foot ulcers. Peripheral arterial disease and mechanical stress as a consequence of peripheral neuropathy are important risk factors for developing an ulcer and eventually loss of a limb. Revascularisation of the limb should be considered in the presence of critical limb ischaemia or in the presence of mild to severe ischaemia in combination with a deep infection...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29026631/salmonella-typhimurium-gastroenteritis-leading-to-chronic-prosthetic-vascular-graft-infection
#14
Milo Cullinan, Michael Clarke, Tim Dallman, Steven Peart, Deborah Wilson, Daniel Weiand
Introduction. It is estimated up to 6 % of prosthetic vascular grafts become infected. Staphylococcus aureus is predominant in early infection and coagulase-negative staphylococci are predominant in late infections. Enterobacteriaceae cause 14-40 % of prosthetic vascular graft infections. This is, to our knowledge the first reported case of Salmonella gastroenteritis causing chronic prosthetic vascular graft infection (PVGI). Case presentation. A 57 years old lady presented with signs and symptoms of prosthetic vascular graft infection...
August 2017: JMM Case Reports
https://www.readbyqxmd.com/read/28971112/maggot-debridement-therapy-with-a-direct-dressing-can-cause-compression-injuries-in-patients-with-chronic-limb-ischemia
#15
Akio Nishijima, Naoto Yamamoto, Ryuichi Yoshida, Satoshi Yanagibayashi, Megumi Takikawa, Rie Hayasaka, Eri Maruyama, Junko Nishijima, Mitsuru Sekido
While there are no reports regarding dressing-associated iatrogenic skin ulcer as an adverse event of maggot debridement therapy (MDT), MDT is clinically used on patients with critical limb ischaemia with dermal fragility. Herein we report causes and counter measures for a case of iatrogenic skin ulcer induced by MDT dressing.
2017: Case Reports in Plastic Surgery & Hand Surgery
https://www.readbyqxmd.com/read/28902825/-treatment-of-patients-with-critical-lower-limb-ischaemia-endovascular-methods-or-reconstructive-operations
#16
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
#17
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
#18
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
#19
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
#20
David Holmes
No abstract text is available yet for this article.
August 23, 2017: Nature
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