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Critical limb ischaemia

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https://www.readbyqxmd.com/read/27919610/renal-artery-stenosis-in-patients-with-peripheral-artery-disease-prevalence-risk-factors-and-long-term-prognosis
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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...
November 8, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27808440/an-integrative-review-of-health-related-quality-of-life-in-patients-with-critical-limb-ischaemia
#8
REVIEW
Susan Monaro, Sandra West, Janice Gullick
AIMS & OBJECTIVES: The aim of this review is to examine the domains and the domain-specific characteristics within a Peripheral Arterial Disease health-related quality of life framework for their usefulness in defining critical limb ischaemia health-related quality of life. BACKGROUND: Critical Limb Ischaemia presents a highly individualised set of personal and health circumstances. Treatment options include conservative management, revascularisation or amputation...
November 3, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27733016/the-emerging-role-of-microdialysis-in-diabetic-patients-undergoing-amputation-for-limb-ischaemia
#9
Lampros Liasis, George Malietzis, George Galyfos, Thanos Athanasiou, Harry T Papaconstantinou, Fragiska Sigala, Georgios Zografos, Konstantinos Filis
INTRODUCTION: Lower limb ischaemia in diabetic patients is a result of macro- and microcirculation dysfunction. Diabetic patients undergoing limb amputation carry high mortality and morbidity rates, and decision making concerning the level of amputation is critical. Aim of this study is to evaluate a novel microdialysis technique in order to monitor tissue microcirculation preoperatively and predict the success of limb amputation in such patients. MATERIALS AND METHODS: Overall, 165 patients with type II diabetes mellitus undergoing lower limb amputation were enrolled...
October 12, 2016: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/27723450/fully-automated-clinical-grade-bone-marrow-processing-a-single-centre-experience
#10
Benedetta Mazzanti, Serena Urbani, Simone Dal Pozzo, Paola Bufano, Lara Ballerini, Alessia Gelli, Irene Sodi, Irene Donnini, Massimo Di Gioia, Stefano Guidi, Julien Camisani, Riccardo Saccardi
BACKGROUND: Clinical grade processing of harvested bone marrow is required in various clinical situations, particularly in the management of ABO mismatching in allogeneic haematopoietic stem cell transplantation (HSCT) and in regenerative medicine. MATERIAL AND METHODS: We report a single-centre experience using a fully automated, clinical grade, closed system (Sepax, Biosafe, Switzerland). From 2003 to 2015, 125 procedures were performed in our laboratory, including buffy-coat production for HSCT (n=58), regenerative medicine in an orthopaedic setting (n=54) and density-gradient separation in a trial for treatment of critical limb ischaemia (n=13)...
September 27, 2016: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/27707633/long-term-results-of-inframalleolar-bypass-for-critical-limb-ischaemia
#11
E Saarinen, P Kauhanen, M Söderström, A Albäck, M Venermo
INTRODUCTION: As the population ages and the incidence of diabetes increases, the expected number of patients with critical limb ischaemia (CLI) requiring distal revascularization will remain high or even increase. The aim of this study was to investigate the long-term results of inframalleolar bypass. MATERIAL AND METHODS: A total of 352 inframalleolar bypasses for CLI performed between 2002 and 2013 were included. Risk factors were evaluated and patency (both clinical and imaging based), leg salvage, survival, and amputation free survival (AFS) assessed...
December 2016: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27696675/microrna-let-7g-possesses-a-therapeutic-potential-for-peripheral-artery-disease
#12
Po-Yuan Hsu, Edward Hsi, Tzu-Ming Wang, Ruey-Tay Lin, Yi-Chu Liao, Suh-Hang H Juo
Peripheral artery disease (PAD) is a manifestation of systemic atherosclerosis and conveys a significant health burden globally. Critical limb ischaemia encompasses the most severe consequence of PAD. Our previous studies indicate that microRNA let-7g prevents atherosclerosis and improves endothelial functions. This study aimed to investigate whether and how let-7g therapy may improve blood flow to ischaemic limbs. The present study shows that let-7g has multiple pro-angiogenic effects on mouse ischaemic limb model and could be a potential therapeutic agent for PAD...
October 3, 2016: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/27679725/takotsubo-cardiomyopathy-with-left-ventricular-thrombus-presenting-as-critical-limb-ischaemia
#13
Gaurav Gulsin, Solange Serna, Clare Morris, Abutariq Taher, Ian Loke
Takotsubo cardiomyopathy (TC) is a rare condition, characterized by acute left ventricular (LV) dysfunction in the absence of flow-limiting coronary artery disease, usually provoked by a physical or emotional stressor. The condition is far more common in women. The commonest presenting symptoms in patients with TC are chest pain and shortness of breath, often mimicking an acute coronary syndrome. A number of complications of TC are recognized, and very rarely patients experience cardioembolic phenomena secondary to LV thrombus formation in TC...
August 2016: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/27650636/comparison-of-angioplasty-and-bypass-surgery-for-critical-limb-ischaemia-in-patients-with-infrapopliteal-peripheral-artery-disease
#14
S D Patel, L Biasi, I Paraskevopoulos, J Silickas, T Lea, A Diamantopoulos, K Katsanos, H Zayed
BACKGROUND: Both infrapopliteal (IP) bypass surgery and percutaneous transluminal angioplasty have been shown to be effective in patients with critical limb ischaemia (CLI). The most appropriate method of revascularization has yet to be established, as no randomized trials have been reported. The aim of this study was to compare the outcomes of patients with similar characteristics treated using either revascularization method. METHODS: Consecutive patients undergoing IP bypass and IP angioplasty for CLI (Rutherford 4-6) at a single institution were compared following propensity score matching...
December 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27638628/non-invasive-management-of-peripheral-arterial-disease
#15
K J Williams, A Babber, R Ravikumar, A H Davies
BACKGROUND: Peripheral arterial disease (PAD) is common and symptoms can be debilitating and lethal. Risk management, exercise, radiological and surgical intervention are all valuable therapies, but morbidity and mortality rates from this disease are increasing. Circulatory enhancement can be achieved using simple medical electronic devices, with claims of minimal adverse side effects. The evidence for these is variable, prompting a review of the available literature. METHODS: Embase and Medline were interrogated for full text articles in humans and written in English...
September 17, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27629349/lower-limb-magnetic-resonance-angiography-performance-of-extracellular-contrast-agents-versus-blood-pool-contrast-agent-for-both-dynamic-and-high-spatial-resolution-imaging-in-extended-phase
#16
G Roditi, A Christie, S Chandramohan
AIM: To prospectively compare the performance of extracellular space contrast agents (ECSCAs) versus a blood-pool contrast agent (BPCA) for a comprehensive lower-limb magnetic resonance angiography (MRA) protocol in patients with either claudication or critical ischaemia. MATERIALS AND METHODS: Thirty patients with claudication underwent lower-limb magnetic resonance angiography (MRA) (dynamic crural, three-station bolus chase, and infra-inguinal high resolution) using a triphasic injection method with both a ECSCA and BPCA to allow intra-individual comparison, and 30 patients with critical ischaemia were scanned with either a ECSCA or BPCA...
September 11, 2016: Clinical Radiology
https://www.readbyqxmd.com/read/27626262/-assessment-of-surgical-risk-in-patients-with-lower-limb-chronic-critical-ischaemia
#17
Iu I Kazakov, I B Lukin, N Iu Sokolova, M A Strakhov
Analysed herein are both immediate and remote results of surgical treatment of 93 patients presenting with chronic atherosclerotic occlusion of the femoral-popliteal-tibial segment in the stage of critical ischaemia. The patients were subjected to autovenous femoropopliteal bypass grafting to the isolated arterial segment or balloon angioplasty with stenting of the superficial femoral artery. While choosing the method of arterial reconstruction we assessed concomitant diseases, primarily lesions of the coronary and cerebral circulation...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/27623758/ankle-brachial-index-for-the-diagnosis-of-lower-limb-peripheral-arterial-disease
#18
Fay Crawford, Karen Welch, Alina Andras, Francesca M Chappell
BACKGROUND: Peripheral arterial disease (PAD) of the lower limb is common, with prevalence of both symptomatic and asymptomatic disease estimated at 13% in the over 50 age group. Symptomatic PAD affects about 5% of individuals in Western populations between the ages of 55 and 74 years. The most common initial symptom of PAD is muscle pain on exercise that is relieved by rest and is attributed to reduced lower limb blood flow due to atherosclerotic disease (intermittent claudication). The ankle brachial index (ABI) is widely used by a variety of healthcare professionals, including specialist nurses, physicians, surgeons and podiatrists working in primary and secondary care settings, to assess signs and symptoms of PAD...
September 14, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27592245/pericytes-in-diabetes-associated-vascular-disease
#19
Nele Warmke, Kathryn J Griffin, Richard M Cubbon
Pericytes are mural cells that support and stabilise the microvasculature, and are present in all vascular beds. Pericyte-endothelial cell crosstalk is essential in both remodelling and quiescent vasculature, and this complex interaction is often disrupted in disease states. Pericyte loss is believed to be an early hallmark of diabetes-associated microvascular disease, including retinopathy and nephropathy. Here we review the current literature defining pericyte biology in the context of diabetes-associated vascular disease, with a particular focus on whether pericytes contribute actively to disease progression...
November 2016: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/27552783/the-place-of-nailfold-capillaroscopy-among-instrumental-methods-for-assessment-of-some-peripheral-ischaemic-syndromes-in-rheumatology
#20
Sevdalina N Lambova
Micro- and macrovascular pathology is a frequent finding in a number of common rheumatic diseases. Secondary Raynaud's phenomenon (RP) is among the most common symptoms in systemic sclerosis and several other systemic autoimmune diseases including a broad differential diagnosis. It should be also differential from other peripheral vascular syndromes such as embolism, thrombosis, etc., some of which lead to clinical manifestation of the blue toe syndrome. The current review discusses the instrumental methods for vascular assessments...
April 2016: Folia Medica
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