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https://www.readbyqxmd.com/read/29226477/cell-therapy-for-critical-limb-ischemia-an-integrated-review-of-pre-clinical-and-clinical-studies
#1
REVIEW
Mohammad Qadura, Daniella C Terenzi, Subodh Verma, Mohammed Al-Omran, David A Hess
Critical limb ischemia (CLI), the most severe form of peripheral artery disease, is characterized by pain at rest and non-healing ulcers in the lower extremities. For patients with CLI, where the extent of atherosclerotic artery occlusion is too severe for surgical bypass or percutaneous interventions, limb amputation remains the only treatment option. Thus, cell-based therapy to restore perfusion and promote wound healing in patients with CLI is under intense investigation. Despite promising preclinical studies in animal models, transplantation of bone marrow (BM) derived cell populations in patients with CLI has shown limited benefit preventing limb amputation...
December 11, 2017: Stem Cells
https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#2
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29169544/systematic-review-and-meta-analysis-of-duplex-ultrasound-surveillance-for-infrainguinal-vein-bypass-grafts
#3
REVIEW
Abd Moain Abu Dabrh, Khaled Mohammed, Wigdan Farah, Qusay Haydour, R Eugene Zierler, Zhen Wang, Larry J Prokop, M Hassan Murad
OBJECTIVE: Duplex ultrasound (DUS) surveillance of infrainguinal vein bypass grafts is widely practiced, but the evidence of its effectiveness compared with other methods of surveillance remains unclear. METHODS: Following an a priori protocol developed by the guidelines committee from the Society for Vascular Surgery, this systematic review and meta-analysis included randomized and nonrandomized comparative studies that enrolled patients who underwent infrainguinal arterial reconstruction and received DUS surveillance for follow-up compared with any other method of surveillance...
December 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29162367/arterial-reconstructions-for-chronic-lower-extremity-ischemia-in-preadolescent-and-adolescent-children
#4
Jonathan L Eliason, Dawn M Coleman, Adam Gumushian, James C Stanley
OBJECTIVE: Chronic lower extremity ischemia in pediatric patients is uncommon. The intent of this study was to better define the arterial reconstructive options and their long-term durability in preadolescent and adolescent children having clinically relevant arterial occlusions affecting the lower extremity. METHODS: The medical records of 33 consecutive pediatric patients who underwent lower extremity revascularization for chronic ischemia at the University of Michigan from 1974 to 2016 were reviewed...
November 18, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29155119/high-serum-bilirubin-is-associated-with-lower-prevalence-of-peripheral-arterial-disease-among-cardiac-patients
#5
Michishige Ozeki, Hideaki Morita, Masatoshi Miyamura, Tomohiro Fujisaka, Shu-Ichi Fujita, Takahide Ito, Kensaku Shibata, Suguru Tanaka, Koichi Sohmiya, Masaaki Hoshiga, Nobukazu Ishizaka
Several studies have shown that subjects with higher serum bilirubin may have a lower risk of cardiovascular disorders. We herein investigated whether serum bilirubin concentration is associated with lower extremity ischemia among cardiology patients. In total, 935 patients without a history of angioplasty or bypass surgery of the lower limb arteries and who had bilateral ankle-brachial index measurements were included in the study. Peripheral arterial disease (PAD) was defined to be present when ABI of either or both sides was <0...
November 18, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29132880/rivaroxaban-with-or-without-aspirin-in-patients-with-stable-peripheral-or-carotid-artery-disease-an-international-randomised-double-blind-placebo-controlled-trial
#6
Sonia S Anand, Jackie Bosch, John W Eikelboom, Stuart J Connolly, Rafael Diaz, Peter Widimsky, Victor Aboyans, Marco Alings, Ajay K Kakkar, Katalin Keltai, Aldo P Maggioni, Basil S Lewis, Stefan Störk, Jun Zhu, Patricio Lopez-Jaramillo, Martin O'Donnell, Patrick J Commerford, Dragos Vinereanu, Nana Pogosova, Lars Ryden, Keith A A Fox, Deepak L Bhatt, Frank Misselwitz, John D Varigos, Thomas Vanassche, Alvaro A Avezum, Edmond Chen, Kelley Branch, Darryl P Leong, Shrikant I Bangdiwala, Robert G Hart, Salim Yusuf
BACKGROUND: Patients with peripheral artery disease have an increased risk of cardiovascular morbidity and mortality. Antiplatelet agents are widely used to reduce these complications. METHODS: This was a multicentre, double-blind, randomised placebo-controlled trial for which patients were recruited at 602 hospitals, clinics, or community practices from 33 countries across six continents. Eligible patients had a history of peripheral artery disease of the lower extremities (previous peripheral bypass surgery or angioplasty, limb or foot amputation, intermittent claudication with objective evidence of peripheral artery disease), of the carotid arteries (previous carotid artery revascularisation or asymptomatic carotid artery stenosis of at least 50%), or coronary artery disease with an ankle-brachial index of less than 0·90...
November 10, 2017: Lancet
https://www.readbyqxmd.com/read/29104204/-surgical-treatment-of-systemic-and-left-circumflex-coronary-pulmonary-artery-fistulas-with-aneurysm-report-of-a-case
#7
Hiroki Nakabori, Katsuyuki Miyazu, Masahiro Ikeda
Congenital coronary-pulmonary artery fistulas complicated by continuity to a systemic artery and aneurysm are extremely rare. A 78-year-old woman was admitted to our hospital with a complaint of chest discomfort. Coronary angiography showed a coronary aneurysm and coronary-pulmonary artery fistula arising from the left circumflex artery and entering into the right lower pulmonary artery. Computed tomography angiography revealed a left subclavian artery-pulmonary artery fistula communicating with the coronary-pulmonary artery fistula...
November 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/29079006/risk-factors-for-unplanned-readmission-and-stump-complications-after-major-lower-extremity-amputation
#8
John Phair, Charles DeCarlo, Larry Scher, Issam Koleilat, Saadat Shariff, Evan C Lipsitz, Karan Garg
OBJECTIVE: The unplanned 30-day readmission rate is a marker of quality of patient care across many disciplines. Data regarding risk factors for unplanned readmission after major lower extremity amputation (LEA) are limited. We evaluated predictors of readmission at our institution after major LEA. METHODS: We conducted a retrospective review of all patients undergoing above-knee amputation (AKA) or below-knee amputation (BKA) between November 2009 and November 2014...
October 24, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29074114/regional-variation-in-the-cost-of-infra-inguinal-lower-extremity-bypass-surgery-in-the-united-states
#9
Besma J Nejim, Sophie Wang, Isibor Arhuidese, Tammam Obeid, Husain Nader Alshaikh, Hanaa Dakour Aridi, Satinderjit Locham, Mahmoud B Malas
BACKGROUND: Lower extremity bypass (LEB) remains the gold standard revascularization procedure in patients with peripheral arterial disease. The cost of LEB substantially varies based on patient's characteristics and comorbidities. The aim of this study was to assess regional variation in infra-inguinal LEB cost and to identify the specific health care expenditures per service that are associated with the highest cost in each region. METHODS: We identified adult patients who underwent infra-inguinal LEB in the Premier database between June 2009 and March 2015...
October 23, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29066242/estimating-risk-of-adverse-cardiac-event-after-vascular-surgery-using-currently-available-online-calculators
#10
Danielle A Moses, Lily E Johnston, Margaret C Tracci, William P Robinson, Kenneth J Cherry, John A Kern, Gilbert R Upchurch
BACKGROUND: The decision to proceed with vascular surgical interventions requires evaluation of cardiac risk. Recently, several online risk calculators were created to predict outcomes and to lead to a more informed conversation between surgeons and patients. The objective of this study was to compare and further validate these online calculators with actual adverse cardiac outcomes at a single institution. METHODS: All patients from January 2011 through December 2015 undergoing carotid endarterectomy (CEA), infrainguinal lower extremity bypass, open abdominal aortic aneurysm (AAA) repair, and endovascular aneurysm repair (EVAR) on the vascular surgical service were included using the Society for Vascular Surgery Vascular Quality Initiative database at our health system...
October 21, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29049809/association-of-quality-improvement-registry-participation-with-appropriate-follow-up-after-vascular-procedures
#11
Benjamin S Brooke, Adam W Beck, Larry W Kraiss, Andrew W Hoel, Andrea M Austin, Amir A Ghaffarian, Jack L Cronenwett, Philip P Goodney
Importance: Ensuring that patients undergo surveillance imaging after surgery is a key quality metric after many vascular procedures. It is unclear whether hospital participation in a national quality improvement registry such as the Vascular Quality Initiative (VQI) achieves this goal. Objective: To determine if hospital participation in the VQI registry is associated with increased rates of surveillance imaging after vascular procedures. Design, Setting, and Participants: A quasi-experimental study used Medicare claims to study 2174 US hospitals in which 1 530 102 patients had undergone an endovascular abdominal aortic aneurysm repair (EVAR), 1 403 067 patients had undergone a lower extremity bypass (LEB) or peripheral vascular intervention (PVI), and 294 942 patients had undergone carotid endarterectomy (CEA) and carotid artery stenting (CAS) procedures between January 1, 2007, and December 31, 2012...
October 11, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29041831/postoperative-complications-after-lower-extremity-arterial-bypass-increase-the-risk-of-new-deep-venous-thrombosis
#12
Faisal Aziz, Erik Lehman, John Blebea, Fedor Lurie
Background Deep venous thrombosis after any surgical operations is considered a preventable complication. Lower extremity bypass surgery is a commonly performed operation to improve blood flow to lower extremities in patients with severe peripheral arterial disease. Despite advances in endovascular surgery, lower extremity arterial bypass remains the gold standard treatment for severe, symptomatic peripheral arterial disease. The purpose of this study is to identify the clinical risk factors associated with development of deep venous thrombosis after lower extremity bypass surgery...
January 1, 2017: Phlebology
https://www.readbyqxmd.com/read/29026622/lower-extremity-mycotic-aneurysm-in-a-patient-with-listeria-monocytogenes-associated-prosthetic-valve-endocarditis
#13
Elham Rahmati, P Jan Geiseler, Rosemary C She
Introduction.Listeria monocytogenes is a rare etiology of infectious endocarditis with only 30 cases of prosthetic valve and about twice as many native valve infections described in the literature. We describe an unusual presentation of an endovascular embolic phenomenon with associated lower extremity mycotic aneurysm due to Listeria monocytogenes prosthetic aortic valve and aortic endograft infection. Case presentation. This is a case of an elderly gentleman with prior history of bioprosthetic aortic valve placement and aortic arch repair who was admitted with several weeks of constitutional symptoms and left lower leg pain...
May 2017: JMM Case Reports
https://www.readbyqxmd.com/read/28965800/short-and-long-term-readmission-rates-after-infrainguinal-bypass-in-a-safety-net-hospital-are-higher-than-expected
#14
Brianna M Krafcik, Sevan Komshian, Kimberly Lu, Lauren Roberts, Alik Farber, Jeffrey A Kalish, Denis Rybin, Jeffrey J Siracuse
OBJECTIVE: Readmission rates are expected to have an increasing effect on both the hospital bottom line and physician reimbursements. Safety net hospitals may be most vulnerable. We examined readmissions at 30 days, 90 days, and 1 year in a large safety net hospital to determine the magnitude and effect of short- and long-term readmission rates after lower extremity infrainguinal bypass in this setting. METHODS: All nonemergent extremity infrainguinal bypass performed at a large safety net hospital between 2008 and 2016 were identified...
December 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28964617/tibiodistal-vein-bypass-in-critical-limb-ischemia-and-its-role-after-unsuccessful-tibial-angioplasty
#15
Florian K Enzmann, Sebastian K Eder, Thomas Aschacher, Manuela Aspalter, Patrick Nierlich, Klaus Linni, Thomas J Hölzenbein
OBJECTIVE: Technical progress in angioplasty expanded its application to very distal arterial lesions of the lower extremity. In cases of unsuccessful angioplasty tibiodistal bypass surgery may be required for limb salvage. We investigated the long-term outcome of this technique in patients with critical limb ischemia. The purpose of this study was to evaluate whether tibiodistal bypasses done after unsuccessful tibial angioplasty had inferior patency, limb salvage, or survival rates compared with primary tibiodistal bypasses...
September 27, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28947228/outcomes-after-first-time-lower-extremity-revascularization-for-chronic-limb-threatening-ischemia-between-patients-with-and-without-diabetes
#16
Jeremy D Darling, Thomas C F Bodewes, Sarah E Deery, Raul J Guzman, Mark C Wyers, Allen D Hamdan, Hence J Verhagen, Marc L Schermerhorn
OBJECTIVE: The effect of diabetes type and insulin dependence on short- and long-term outcomes after lower extremity revascularization for chronic limb-threatening ischemia (CLTI) warrants additional study and more targeted focus. We sought to address this paucity of information by evaluating outcomes in insulin-dependent and noninsulin-dependent patients after any first-time revascularization. METHODS: We reviewed all limbs undergoing first-time infrainguinal bypass grafting (BPG) or percutaneous transluminal angioplasty with or without stenting (PTA/S) for CLTI at our institution from 2005 to 2014...
September 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28927349/hospital-readmissions-after-elective-lower-extremity-vascular-procedures
#17
Todd R Vogel, Jamie B Smith, Robin L Kruse
Background This study evaluated risk factors associated with 30-day readmission after open and endovascular lower extremity revascularization. Methods Patients admitted with peripheral artery disease and lower extremity procedures were selected from national electronic medical record data, Cerner Health Facts® (2008-2014). Thirty-day readmission was determined. Logistic regression models identified characteristics independently associated with readmission. Results There were 2781 open and 2611 endovascular procedures...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28927214/direct-anastomosis-using-occipital-artery-for-additional-revascularization-in-moyamoya-disease-after-combined-superficial-temporal-artery-middle-cerebral-artery-and-indirect-bypass
#18
Ken Kazumata, Hiroyasu Kamiyama, Hisayasu Saito, Katsuhiko Maruichi, Masaki Ito, Haruto Uchino, Naoki Nakayama, Satoshi Kuroda, Kiyohiro Houkin
BACKGROUND: The posterior cerebral artery (PCA) is involved in approximately 30% of moyamoya disease (MMD) cases. However, there have been insufficient reports describing revascularization techniques in the posterior portion of the brain, particularly of direct anastomosis. OBJECTIVE: To perform a technical assessment in patients with MMD who underwent either occipital artery (OA)-PCA bypass or OA-middle cerebral artery (MCA) bypass. METHODS: A total of 428 revascularization procedures in 368 patients were retrospectively assessed by reviewing clinical charts and radiological data...
April 1, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28920529/surgical-interventions-for-organ-and-limb-ischemia-associated-with-primary-and-secondary-antiphospholipid-antibody-syndrome-with-arterial-involvement
#19
Carlos A Hinojosa, Javier E Anaya-Ayala, Karla Bermudez-Serrato, Ramón García-Alva, Hugo Laparra-Escareno, Adriana Torres-Machorro, Rene Lizola
OBJECTIVE: The association of antiphospholipid antibody syndrome (APS) and hypercoagulability is well known. Arterial compromise leading to ischemia of organs and/or limbs in patients with APS is uncommon, frequently unrecognized, and rarely described. We evaluated our institutional experience. METHODS: Retrospective review was conducted. From August 2007 to September 2016, 807 patients with diagnosis of APS were managed in our Institution. Patients with primary and secondary APS who required interventions were examined...
November 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28894061/-successful-repair-of-chronic-expanding-hematoma-after-coronary-artery-bypass-grafting-by-lower-partial-sternotomy-approach-report-of-a-case
#20
Takateru Yamamoto, Kouhei Takahashi, Katsuaki Tsukioka, Tetsuya Kono
Chronic expanding hematoma (CEH) after coronary artery bypass grafting (CABG) is extremely rare. We reported a case of successful surgical repair of CEH through lower partial sternotomy approach. The patient was a 73-year-old man who underwent CABG. Fifteen years after the operation, he was admitted to referral hospital because of dyspnea on exertion. Echocardiography and computed tomography revealed a giant intrapericardial mass, which was pressing on the inferior wall of the ventricle. To avoid injury of the aorta and the patent bypass graft in the reentry of the chest, we selected lower partial sternotomy approach...
September 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
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