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Critical limb ischaemia

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https://www.readbyqxmd.com/read/28528282/management-options-in-the-treatment-of-femoral-pseudoaneurysms-secondary-to-intravenous-drug-abuse-a-case-series
#1
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...
May 5, 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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
https://www.readbyqxmd.com/read/28131536/editor-s-choice-dual-antiplatelet-therapy-improves-outcome-in-diabetic-patients-undergoing-endovascular-femoropopliteal-stenting-for-critical-limb-ischaemia
#13
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...
March 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
#14
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...
March 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
#15
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
#16
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
#17
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
#18
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
#19
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...
December 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
#20
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
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