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chronic limb ischemia

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https://www.readbyqxmd.com/read/28506476/adherence-to-lipid-management-guidelines-is-associated-with-lower-mortality-and-major-adverse-limb-events-in-patients-undergoing-revascularization-for-chronic-limb-threatening-ischemia
#1
Thomas F X O'Donnell, Sarah E Deery, Jeremy D Darling, Katie E Shean, Murray A Mittleman, Gabrielle N Yee, Matthew R Dernbach, Marc L Schermerhorn
OBJECTIVE: The 2013 American College of Cardiology/American Heart Association lipid management guidelines recommend high-intensity statins for all patients ≤75 years old with chronic limb-threatening ischemia (CLTI) and moderate-intensity statins for CLTI patients >75 years old without contraindications or on dialysis, but these recommendations are based primarily on coronary and stroke data. We aimed to validate these guidelines in patients with CLTI and to assess current adherence to these recommendations...
May 12, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28502550/lower-extremity-computed-tomography-angiography-can-help-predict-technical-success-of-endovascular-revascularization-in-the-superficial-femoral-and-popliteal-artery
#2
Nathan K Itoga, Tanner Kim, Anna M Sailer, Dominik Fleischmann, Matthew W Mell
OBJECTIVE: Preprocedural computed tomography angiography (CTA) assists in evaluating vascular morphology and disease distribution and in treatment planning for patients with lower extremity peripheral artery disease (PAD). The aim of the study was to determine the predictive value of radiographic findings on CTA and technical success of endovascular revascularization of occlusions in the superficial femoral artery-popliteal (SFA-pop) region. METHODS: Medical records and available imaging studies were reviewed for patients undergoing endovascular intervention for PAD between January 2013 and December 2015 at a single academic institution...
May 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28496017/comparison-of-the-incidence-of-complications-and-secondary-surgical-interventions-necessary-in-patients-with-chronic-lower-limb-ischemia-treated-by-both-open-and-endovascular-surgeries
#3
Dariusz Janczak, Maciej Malinowski, Wojciech Bąkowski, Katarzyna Krakowska, Karol Marschollek, Paweł Marschollek, Mariusz Chabowski
BACKGROUND: Peripheral arterial disease (PAD) affects 3%-10% of the population before the age of 70 years and 15%-20% after that age.The aim of the study was to compare the incidence of complications and secondary interventions in patients who underwent each type of treatment. METHODS: We analyzed 734 medical records of the Department of Surgery at the 4th Military Teaching Hospital in Wroclaw, In total, 394 were operated on with open surgery; an endarterectomy (59...
May 11, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28488306/physician-initiated-first-in-human-clinical-study-using-a-novel-angiogenic-peptide-ag30-5c-for-patients-with-severe-limb-ulcers
#4
Hironori Nakagami, Toshifumi Yamaoka, Misa Hayashi, Atsushi Tanemura, Yasushi Takeya, Hitomi Kurinami, Ken Sugimoto, Ayumi Nakamura, Kazunori Tomono, Katsuto Tamai, Ichiro Katayama, Hiromi Rakugi, Yasufumi Kaneda
AIM: In patients with diabetes or ischemia, angiogenesis and infection control are required for chronic leg ulcers, which substantially impair patients' quality of life. We developed a novel functional peptide, named AG30/5C, with angiogenic and anti-microbial properties. Treatment with AG30/5C significantly accelerated the wound healing of full-thickness defects in mice. To evaluate the safety of AG30/5C in the treatment of leg ulcers, a physician-initiated clinical study was carried out...
May 10, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28488101/impact-of-chronic-renal-failure-on-safety-and-effectiveness-of-paclitaxel-eluting-stents-for-femoropopliteal-artery-disease-subgroup-analysis-from-zilver-ptx-post-market-surveillance-study-in-japan
#5
Yukihisa Ogawa, Hiroyoshi Yokoi, Takao Ohki, Kimihiko Kichikawa, Masato Nakamura, Kimihiro Komori, Shinsuke Nanto, Erin E O'Leary, Aaron E Lottes, Alan T Saunders, Michael D Dake
PURPOSE: Favorable long-term outcomes of the Zilver PTX drug-eluting stent (DES) in femoropopliteal lesions have been demonstrated. Chronic renal failure (CRF) has been shown to be a risk factor for restenosis and decreased limb salvage. The results of the DES in patients with CRF have not previously been reported. This study compares the results with the DES in patients with CRF and those without CRF. METHODS: This retrospective analysis from the Zilver PTX Japan Post-Market Surveillance Study included 321 patients with CRF and 584 patients without CRF...
May 9, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28483615/severe-mesenteric-ischemia-in-a-pregnant-woman-with-antiphospholipid-syndrome
#6
Andrea Padricelli, Anna Maria Giribono, Doriana Ferrara, Flavia Spalla, Umberto Bracale, Luca Del Guercio, Giuseppe Servillo, Carlo Ruotolo, Umberto Marcello Bracale
The antiphospholipid syndrome (APS), either primary or secondary form, is considered an autoimmune disease with presence of at least one clinical and one laboratory abnormalities as defined by The Sydney criteria. Clinical criteria include vascular thrombosis of venous, artery, small vessel in any organ and recurrent pregnancy pathologies. Mesenteric ischemia is a rare and threatening manifestation of APS. We herein report a case of 34-years old pregnant woman referred to our Emergency Room with thoracic and abdominal acute pain...
May 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28479452/cumulative-number-of-treatment-interventions-predicts-health-related-quality-of-life-in-patients-with-critical-limb-ischemia
#7
Matthew A Corriere, Matthew P Goldman, Ryan Barnard, Santiago Saldana, Jeanette M Stafford, Douglas Easterling, Edward H Ip, Gregory L Burke
INTRODUCTION: Health-related quality of life (QOL) is usually assessed after a defined interval following a single intervention, but critical limb ischemia (CLI) is a chronic condition where multiple interventions are often required over a patient's lifetime. We hypothesized that the impact of CLI treatment interventions on QOL is diminished in the setting of multiple previous interventions. To test this hypothesis, we performed a cross-sectional study evaluating associations between cumulative number of previous PAD treatment interventions and QOL adjusting for both comorbidity and disease severity...
May 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28471016/a-novel-lesion-crossing-technique-balloon-deployment-using-forcible-manner-badform-technique
#8
Keisuke Nakabayashi, Hiroshi Ando, Nobuhito Kaneko, Manabu Shiozaki, Daisuke Sunaga, Akihiro Matsui, Kazuhiko Tanaka, Minoru Shimizu
OBJECTIVES: We evaluated the efficacy and safety of a novel endovascular technique for crossing arterial lesions: The BAlloon Deployment using FORcible Manner (BADFORM) technique. BACKGROUND: Endovascular treatment (EVT) for peripheral artery disease has been widely adopted, and developments in device technology and techniques have resulted in acceptable success rates. However, it may be difficult to deliver devices even after wire externalization, especially in the presence of an extremely long chronic total occlusion or severely calcified lesion...
May 4, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28465288/thirty-day-readmissions-after-endovascular-or-surgical-therapy-for-critical-limb-ischemia-analysis-of-the-2013-2014-nationwide-readmissions-databases
#9
Dhaval Kolte, Kevin F Kennedy, Mehdi H Shishehbor, J Dawn Abbott, Sahil Khera, Peter A Soukas, Shafiq T Mamdani, Omar N Hyder, Douglas E Drachman, Herbert D Aronow
Background -Thirty-day readmission rates have gained increasing importance as a key quality metric. A significant number of patients are hospitalized for the management of critical limb ischemia (CLI), but limited data are available on the incidence, predictors, and causes of 30-day readmission after hospitalization for CLI. Methods -Hospitalizations for a primary diagnosis of CLI during which patients underwent endovascular or surgical therapy (revascularization and/or amputation) and were discharged alive were identified in the 2013-2014 Nationwide Readmissions Databases...
May 2, 2017: Circulation
https://www.readbyqxmd.com/read/28450103/regional-variation-in-outcomes-for-lower-extremity-vascular-disease-in-the-vascular-quality-initiative
#10
Peter A Soden, Sara L Zettervall, Katie E Shean, Ageliki G Vouyouka, Philip P Goodney, Joseph L Mills, John W Hallett, Marc L Schermerhorn
BACKGROUND: Increased focus has been placed on perioperative and long-term outcomes in the treatment of peripheral artery disease (PAD), both for purposes of quality improvement and for assessment of performance at a surgeon and institutional level. This study evaluates regional variation in outcomes after treatment for PAD within the Vascular Quality Initiative (VQI). By describing the variation in practice patterns and outcomes across regions, we hope that each regionally based quality group can select which areas are most important for them to focus on as they will have access to their regional data to compare...
April 24, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28422865/crystalglobulinemia-manifesting-as-chronic-arthralgia-and-acute-limb-ischemia-a-clinical-case-report
#11
Nobuya Abe, Tomoko Tomita, Miyuki Bohgaki, Hideki Kasahara, Takao Koike
RATIONALE: Crystalglobulinemia is a rare disease caused by monoclonal immunoglobulins, characterized by irreversible crystallization on refrigeration. It causes systemic symptoms including purpura, arthralgia, and vessel occlusive conditions to be exacerbated by exposure to cold. We report a patient with crystalglobulinemia associated with monoclonal gammopathy of undetermined significance (MGUS) manifesting as chronic arthralgia and recurrent acute arterial occlusion. PRESENTING CONCERNS: A 61-year-old man, who had been diagnosed with MGUS and who had arthralgia of unknown origin, presented with recurrent acute limb ischemia after surgical thromboembolectomy...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28421855/midterm-outcomes-after-infrapopliteal-interventions-in-patients-with-critical-limb-ischemia-based-on-the-tasc-ii-classification-of-below-the-knee-arteries
#12
Gagan D Singh, Ellen K Brinza, Justin Hildebrand, Stephen W Waldo, T Raymond Foley, John R Laird, Ehrin J Armstrong
PURPOSE: To analyze the relationship between the new TransAtlantic Inter-Society Consensus (TASC II) infrapopliteal classification and limb outcomes among patients with critical limb ischemia (CLI). METHODS: A single-center retrospective study was performed on 166 consecutive CLI patients (mean age 71 years; 113 men) undergoing endovascular treatment of 244 infrapopliteal lesions from 2006 to 2013. Patient, procedural, angiographic, and limb outcomes were compared for the new TASC A/B vs C/D classification for infrapopliteal lesions...
April 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28382271/acute-limb-ischemia-and-coronary-artery-disease-in-a-case-of-kimura-s-disease
#13
Woon Heo, Hee Jae Jun, Do Kyun Kang, Ho-Ki Min, Youn-Ho Hwang, Ji Yong Kim, Kyung Han Nam
Kimura disease (KD) is an immune-mediated chronic inflammatory disease of unknown etiology. KD has many complications associated with hypereosinophilia, including various forms of allergic reactions and eosinophilic lung disease. Additionally, hypereosinophilia is associated with hypercoagulability, which may lead to thromboembolic events. A 36-year-old man with KD presented with acute limb ischemia and coronary artery occlusion. He underwent thrombectomy, partial endarterectomy of both popliteal arteries, and coronary artery stent insertion...
April 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28366306/the-largpad-trial-phase-iia-evaluation-of-l-arginine-infusion-in-patients-with-peripheral-arterial-disease
#14
Vikram S Kashyap, Ryan O Lakin, Patricia Campos, Matthew Allemang, Ann Kim, Timur P Sarac, Alfred Hausladen, Jonathan S Stamler
OBJECTIVE: Endothelial function is improved by l-arginine (l-arg) supplementation in preclinical and clinical studies of mildly diseased vasculature; however, endothelial function and responsiveness to l-arg in severely diseased arteries is not known. Our objective was to evaluate the acute effects of catheter-directed l-arg delivery in patients with chronic lower extremity ischemia secondary to peripheral arterial disease. METHODS: The study enrolled 22 patients (45% male) with peripheral arterial disease (mean age, 62 years) requiring lower extremity angiography...
March 30, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28365482/distributed-vasculogenesis-from-modular-agarose-hydroxyapatite-fibrinogen-microbeads
#15
Ana Y Rioja, Ethan L H Daley, Julia C Habif, Andrew J Putnam, Jan P Stegemann
Critical limb ischemia impairs circulation to the extremities, causing pain, disrupted wound healing, and potential tissue necrosis. Therapeutic angiogenesis seeks to repair the damaged microvasculature directly to restore blood flow. In this study, we developed modular, micro-scale constructs designed to possess robust handling qualities, allow in vitro pre-culture, and promote microvasculature formation. The microbead matrix consisted of an agarose (AG) base to prevent aggregation, combined with cell-adhesive components of fibrinogen (FGN) and/or hydroxyapatite (HA)...
March 29, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28350939/the-advancing-role-of-neuromodulation-for-the-management-of-chronic-treatment-refractory-pain
#16
Mohammed F Shamji, Cecile De Vos, Ashwini Sharan
Neuropathic pain is a common cause of disability and health care utilization. While judicious pharmacotherapy and management of comorbid psychological distress can provide for improved quality of life, some patients with treatment-refractory disease require more invasive therapies. Spinal cord stimulation can provide for improvement in pain and decrease in medication utilization, with level 1 evidence supporting its use across various pain etiologies including persistent postoperative neuropathic pain, complex regional pain syndrome, chronic inoperable limb ischemia, treatment refractory angina, and painful diabetic neuropathy...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28349710/endovascular-devices-and-revascularization-techniques-for-limb-threatening-ischemia-in-individuals-with-diabetes
#17
Jayer Chung
Diabetes mellitus (DM) is a rapidly worsening global epidemic over the last thirty-five years. The increased prevalence of DM has changed the phenotypic expression of atherosclerotic limb threatening ischemia (LTI), resulting in an increase in lesions in the tibial vessels. These patients are also afflicted with peripheral neuropathy, foot deformities, and medial calcification of the vasculature. In response to the evolving phenotype of atherosclerosis, newer minimally invasive tools and techniques have been developed to improve the blood supply in LTI...
March 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28292886/optical-probing-of-gastrocnemius-in-patients-with-peripheral-artery-disease-characterizes-myopathic-biochemical-alterations-and-correlates-with-stage-of-disease
#18
Ryan A Becker, Kim Cluff, Nithyanandhi Duraisamy, Hootan Mehraein, Hussam Farhoud, Tracie Collins, George P Casale, Iraklis I Pipinos, Jeyamkondan Subbiah
Peripheral artery disease (PAD) is a condition caused by atherosclerotic blockages in the arteries supplying the lower limbs and is characterized by ischemia of the leg, progressive myopathy, and increased risk of limb loss. The affected leg muscles undergo significant changes of their biochemistry and metabolism including variations in the levels of many key proteins, lipids, and nucleotides. The mechanisms behind these changes are poorly understood. The objective of this study was to correlate the severity of the PAD disease stage and associated hemodynamic limitation (determined by the ankle brachial index, ABI) in the legs of the patients with alterations in the biochemistry of chronically ischemic leg muscle as determined by ATR-Fourier transform infrared micro-spectroscopy...
March 2017: Physiological Reports
https://www.readbyqxmd.com/read/28286751/new-delivery-systems-of-stem-cells-for-vascular-regeneration-in-ischemia
#19
REVIEW
Adegbenro Omotuyi John Fakoya
The finances of patients and countries are increasingly overwhelmed with the plague of cardiovascular diseases as a result of having to chronically manage the associated complications of ischemia such as heart failures, neurological deficits, chronic limb ulcers, gangrenes, and amputations. Hence, scientific research has sought for alternate therapies since pharmacological and surgical treatments have fallen below expectations in providing the desired quality of life. The advent of stem cells research has raised expectations with respect to vascular regeneration and tissue remodeling, hence assuring the patients of the possibility of an improved quality of life...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28274753/results-for-primary-bypass-versus-primary-angioplasty-stent-for-lower-extremity-chronic-limb-threatening-ischemia
#20
Jeremy D Darling, John C McCallum, Peter A Soden, Lindsey Korepta, Raul J Guzman, Mark C Wyers, Allen D Hamdan, Marc L Schermerhorn
BACKGROUND: Long-term results comparing percutaneous transluminal angioplasty with or without stenting (PTA/S) and open surgical bypass for chronic limb-threatening ischemia (CLTI) in patients who have had no prior intervention are lacking. METHODS: All patients undergoing a first-time lower extremity revascularization for CLTI by vascular surgeons at our institution from 2005 to 2014 were retrospectively reviewed. Outcomes included perioperative complications, wound healing, restenosis, primary patency, reintervention, major amputation, RAS events (ie, reintervention, major amputation, or stenosis), and mortality...
March 5, 2017: Journal of Vascular Surgery
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