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chronic limb ischemia

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https://www.readbyqxmd.com/read/29038476/pro-angiogenic-effect-of-rantes-loaded-polysaccharide-based-microparticles-for-a-mouse-ischemia-therapy
#1
N Suffee, C Le Visage, H Hlawaty, R Aid-Launais, V Vanneaux, J Larghero, O Haddad, O Oudar, N Charnaux, A Sutton
Peripheral arterial disease results from the chronic obstruction of arteries leading to critical hindlimb ischemia. The aim was to develop a new therapeutic strategy of revascularization by using biodegradable and biocompatible polysaccharides-based microparticles (MP) to treat the mouse hindlimb ischemia. For this purpose, we deliver the pro-angiogenic chemokine Regulated upon Activation, Normal T-cell Expressed and Secreted (RANTES)/CCL5 in the mouse ischemic hindlimb, in solution or incorporated into polysaccharide-based microparticles...
October 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29036797/effects-of-venotonic-drugs-on-the%C3%A2-microcirculation-comparison-between-ruscus-extract-and-micronized-diosmine1
#2
Fatima Zely Garcia de Almeida Cyrino, Daniela Signorelli Balthazar, Fernando Lencastre Sicuro, Eliete Bouskela
BACKGROUND: Chronic venous disease of the lower limbs is a common public health problem worldwide with negative impact on quality of life and results with drugs used to treat it are sparse, probably due to lack of good experimental models. OBJECTIVE: In this investigation we have tested the effects of two commonly used venotonic substances, Ruscus extract and micronized diosmine, on the microcirculation in vivo. METHODS: These substances were given orally, by gavage, during two weeks, twice daily and observations were made using the hamster cheek pouch preparation...
October 7, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/29034032/current-perspective-on-hemodialysis-patients-with-peripheral-artery-disease
#3
REVIEW
Shin Okamoto, Osamu Iida, Toshiaki Mano
The prevalence of peripheral artery disease is substantially higher in patients on chronic hemodialysis than in the general population. The presence of calcified lesions characteristic of hemodialysis patients has an adverse influence on the initial success and long-term outcomes of both surgical bypass and endovascular therapy. Although the selection of revascularization strategy depends on whether an autologous vein is available and if the patient has a life expectancy of at least two years, it is difficult to predict the life expectancy in a real-world clinical situation...
June 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29022506/autologous-cell-therapy-for-vascular-regeneration-the-role-of-proangiogenic-cells
#4
Vanessa Bianconi, Francesca Fallarino, Massimo Raffaele Mannarino, Francesco Bagaglia, Meisam Naeimi Kararoudi, Caterina Oriana Aragona, Rita Romani, Matteo Pirro
Autologous cell therapy represents a novel treatment option for vascular regeneration in different disease conditions. Both experimental and clinical studies indicate a therapeutic potential for different proangiogenic cells (PCs), including endothelial progenitor cells (EPCs) in the treatment of peripheral artery disease. A significant improvement of ischemic symptoms has been reported in different trials evaluating PCs for the treatment of critical limb ischemia. However, contrasting results from different meta-analyses question the efficacy of PC-based approaches on long-term outcomes, including amputation and survival...
October 12, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28978866/two-year-clinical-outcomes-post-implantation-of-epic-tm-self-expanding-nitinol-stents-for-the-aortoiliac-occlusive-disease-in-patients-with-peripheral-arterial-disease
#5
Takuya Tsujimura, Osamu Iida, Masashi Fujita, Masaharu Masuda, Shin Okamoto, Takayuki Ishihara, Kiyonori Nanto, Takashi Kanda, Shota Okuno, Yasuhiro Matsuda, Masahiko Fujihara, Yoshiaki Yokoi, Toshiaki Mano
AIM: We investigated 2-year clinical outcomes after implantaton of Epic(TM) self-expanding nitinol stents for patients with peripheral artery disease (PAD) due to the aortoiliac occlusive disease (AIOD). METHODS: This study was a multicenter and retrospective study. From February 2013 through October 2014, 292 lesions (chronic total occlusion, 21%; TASC Ⅱ C/D, 35%) in 217 consecutive patients (74±8 years; male, 81%; diabetes mellitus, 47%; dialysis, 21%; critical limb ischemia, 29%) who had undergone endovascular therapy (EVT) with Epic(TM) self-expanding nitinol stents for PAD with AIOD were analyzed...
October 5, 2017: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/28971112/maggot-debridement-therapy-with-a-direct-dressing-can-cause-compression-injuries-in-patients-with-chronic-limb-ischemia
#6
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/28951878/the-effect-of-charcot-neuroarthropathy-on-limb-preservation-in-diabetic-patients-with-foot-wound-and-critical-limb-ischemia-after-balloon-angioplasty
#7
Mehmet Burak Çildağ, Ömer Faruk Kutsi Köseoğlu
OBJECTIVE: The aim of this article is to investigate one-year limb preservation rates after below-the-knee angioplasty in patients with diabetic foot wound who only have critical limb ischemia (CLI) and those who have Charchot neuroarthropathy (CN) accompanied by CLI. METHODS: This single-center, retrospective study consists of 63 patients with diabetic foot wound who had undergone lower extremity balloon angioplasty of at least 1 below-the-knee (BTK) vessel. Only those patients with postprocedural technical success of 100% were selected from the database...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28951156/black-patients-present-with-more-severe-vascular-disease-and-a-greater-burden-of-risk-factors-than-white-patients-at-time-of-major-vascular-intervention
#8
Peter A Soden, Sara L Zettervall, Sarah E Deery, Kakra Hughes, Michael C Stoner, Philip P Goodney, Ageliki G Vouyouka, Marc L Schermerhorn
BACKGROUND: Although many studies have demonstrated racial disparities after major vascular surgery, few have identified the reasons for these disparities, and those that did often lacked clinical granularity. Therefore, our aim was to evaluate differences in initial vascular intervention between black and white patients. METHODS: We identified black and white patients' initial carotid, abdominal aortic aneurysm (AAA), and infrainguinal peripheral artery disease (PAD) interventions in the Vascular Quality Initiative (VQI) registry from 2009 to 2014...
September 23, 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
#9
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/28930755/vegf-and-igf-delivered-from-alginate-hydrogels-promote-stable-perfusion-recovery-in-ischemic-hind-limbs-of-aged-mice-and-young-rabbits
#10
Erin M Anderson, Eduardo A Silva, Yibai Hao, Kathleen D Martinick, Sarah A Vermillion, Alexander G Stafford, Elisabeth G Doherty, Lin Wang, Edward J Doherty, Paul M Grossman, David J Mooney
Biomaterial-based delivery of angiogenic growth factors restores perfusion more effectively than bolus delivery methods in rodent models of peripheral vascular disease, but the same success has not yet been demonstrated in clinically relevant studies of aged or large animals. These studies explore, in clinically relevant models, a therapeutic angiogenesis strategy for the treatment of peripheral vascular disease that overcomes the challenges encountered in previous clinical trials. Alginate hydrogels providing sustained release of vascular endothelial growth factor (VEGF) and insulin-like growth factor-1 (IGF) were injected into ischemic hind limbs in middle-aged and old mice, and also in young rabbits, as a test of the scalability of this local growth factor treatment...
2017: Journal of Vascular Research
https://www.readbyqxmd.com/read/28912015/stem-cell-based-peripheral-vascular-regeneration
#11
Yasuyuki Fujita, Atsuhiko Kawamoto
Chronic critical limb ischemia (CLI) represents an end-stage manifestation of peripheral arterial disease (PAD). CLI patients are at very high risk of amputation and cardiovascular complications, leading to severe morbidity and mortality. Because many patients with CLI are ineligible for conventional revascularization procedures, it is urgently needed to explore alternative strategies to improve blood supply in the ischemic tissue. Although researchers initially focused on gene/protein therapy using proangiogenic growth factors/cytokines, recent discovery of somatic stem/progenitor cells including bone marrow (BM)-derived endothelial progenitor cells (EPCs) and mesenchymal stem cells (MSCs) has drastically developed the field of therapeutic angiogenesis for CLI...
September 11, 2017: Advanced Drug Delivery Reviews
https://www.readbyqxmd.com/read/28884985/staged-endovascular-repair-of-critical-limb-ischemia-in-high-risk-patients-the-procedural-and-clinical-outcomes
#12
Guang Liu, Chaoyi Cui, Minyi Yin, Kaichuang Ye, Xaiobing Liu, Jinbao Qin, Huihua Shi, Xintian Huang, Min Lu, Xinwu Lu, Weimin Li, Mier Jiang
PURPOSE: To retrospectively evaluate the procedural and clinical outcomes after staged angioplasty in high-risk, chronic, critical limb ischemia (CLI) patients. METHODS: Between 2013 and 2015, 29 patients (29 limbs) (mean age 77 years) were treated by staged revascularization procedures in (i) the iliac artery-DFA alone or with the femoropopliteal artery followed by (ii) the femoropopliteal artery and a below-the-knee artery. All patients had long-segment iliofemoral artery and below-the-knee artery (TASCII D) occlusions with abnormal serum myoglobin and ischemic lesions...
September 7, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28872035/prevalence-and-severity-of-peripheral-arterial-disease-among-patient-with-heel-pressure-ulcer-a-retrospective-study-of-42-patients
#13
Guillaume Tisserand, Nora Zenati, Christophe Seinturier, Sophie Blaise, Gilles Pernod
Heel pressure ulcer is a major complication in elderly hospitalized patients. The association with peripheral arterial disease (PAD) which is also a frequent disease in this population is poorly known. The aim of this study was to assess the prevalence of PAD and critical limb ischemia (CLI) in patients with heel pressure ulcer. Patients referred to the vascular medicine department for heel pressure ulcer from October 2014 to June 2015 were included in the study. The assessment of peripheral arterial disease was made with the results of ankle brachial index and/or doppler ultra sound of lower limb arteries...
September 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28870682/association-of-arterial-calcification-with-chronic-limb-ischemia-in-patients-with-peripheral-artery-disease
#14
Sara L Zettervall, Andre P Marshall, Paul Fleser, Raul J Guzman
OBJECTIVE: Arterial calcification is associated with an increased risk of limb events, including amputation. The association between calcification in lower extremity arteries and the severity of ischemia, however, has not been assessed. We thus sought to determine whether the extent of peripheral artery calcification (PAC) was correlated with Rutherford chronic ischemia categories and hypothesized that it could independently contribute to worsening limb status. METHODS: We retrospectively reviewed all patients presenting with symptomatic peripheral artery disease who underwent evaluation by contrast and noncontrast computed tomography scan of the lower extremities as part of their assessment...
September 1, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28866449/fractional-flow-reserve-in-below-the-knee-arteries-with-critical-limb-ischemia-and-validation-against-gold-standard-morphologic-functional-measures-and-long-term-clinical-outcomes
#15
Zoltán Ruzsa, Szilárd Róna, Gábor G Tóth, Péter Sótonyi, Olivier F Bertrand, Balázs Nemes, Béla Merkely, Kálmán Hüttl
INTRODUCTION: The aim of this study was to assess the applicability of fractional flow reserve measurement (FFR) in below-the-knee (BTK) arteries and to evaluate its correlation with non-invasive functional parameters before and after angioplasty. METHODS: We enrolled 39 patients with severe BTK arterial lesions. Inclusion criteria were critical limb ischemia (Rutherford 4-6) and angiographically proven arterial stenosis of the distal lower limb (percent diameter stenosis ≥70%)...
July 18, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28844467/patient-selection-and-perioperative-outcomes-of-bypass-and-endovascular-intervention-as-first-revascularization-strategy-for-infrainguinal-arterial-disease
#16
Thomas C F Bodewes, Jeremy D Darling, Sarah E Deery, Thomas F X O'Donnell, Alexander B Pothof, Katie E Shean, Frans L Moll, Marc L Schermerhorn
OBJECTIVE: The optimal initial revascularization strategy remains uncertain for patients with peripheral arterial disease. The purpose of this study was to evaluate current nationwide selection and perioperative outcomes of patients undergoing bypass or endovascular intervention for infrainguinal disease in those with no prior ipsilateral revascularization. METHODS: Patients undergoing nonemergent first-time infrainguinal revascularization were identified in the Targeted Vascular module of the National Surgical Quality Improvement Program (NSQIP) for 2011 to 2014 and stratified by symptom status (chronic limb-threatening ischemia [CLTI] or claudication)...
August 22, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28840054/limb-remote-ischemic-conditioning-promotes-myelination-by-upregulating-pten-akt-mtor-signaling-activities-after-chronic-cerebral-hypoperfusion
#17
Xiaohua Li, Changhong Ren, Sijie Li, Rongrong Han, Jinhuan Gao, Qingjian Huang, Kunlin Jin, Yinghao Luo, Xunming Ji
Limb Remote ischemic conditioning (LRIC) has been proved to be a promising neuroprotective method in white matter lesions after ischemia; however, its mechanism underlying protection after chronic cerebral hypoperfusion remains largely unknown. Here, we investigated whether LRIC promoted myelin growth by activating PI3K/Akt/mTOR signal pathway in a rat chronic hypoperfusion model. Thirty adult male Sprague Dawley underwent permanent double carotid artery (2VO), and limb remote ischemic conditioning was applied for 3 days after the 2VO surgery...
July 2017: Aging and Disease
https://www.readbyqxmd.com/read/28822661/preoperative-anemia-associated-with-adverse-outcomes-after-infrainguinal-bypass-surgery-in-patients-with-chronic-limb-threatening-ischemia
#18
Thomas C F Bodewes, Alexander B Pothof, Jeremy D Darling, Sarah E Deery, Douglas W Jones, Peter A Soden, Frans L Moll, Marc L Schermerhorn
OBJECTIVE: Preoperative anemia in elderly patients undergoing surgery is prevalent and associated with adverse events; however, the interaction with other risk factors in patients with chronic limb-threatening ischemia (CLTI) is not well described. The purpose of this study was to assess the association between lower hematocrit (HCT) levels on admission and postoperative outcomes after infrainguinal bypass surgery. METHODS: Patients with CLTI undergoing nonemergent infrainguinal bypass were identified in the targeted vascular module of National Surgical Quality Improvement Program (NSQIP; 2011-2014)...
August 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28807382/association-between-statin-therapy-and-amputation-free-survival-in-patients-with-critical-limb-ischemia-in-the-critisch-registry
#19
Konstantinos Stavroulakis, Matthias Borowski, Giovanni Torsello, Theodosios Bisdas
OBJECTIVE: Secondary prevention in patients with critical limb ischemia (CLI) is crucial for the reduction of cardiovascular morbidity and mortality. Nonetheless, current recommendations are extrapolated from other high-risk populations because of the lack of CLI-dedicated trials. The aim of this explorative study was to evaluate the association of statin therapy with the outcomes of CLI patients. METHODS: The First-Line Treatments in Patients With Critical Limb Ischemia (CRITISCH) registry is a prospective multicenter registry analyzing the effectiveness of all available treatment strategies in 1200 CLI patients...
August 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28791851/clinical-risk-factors-for-loss-of-stent-primary-patency-in-patients-with-chronic-legs-ischemia
#20
Klaudia Koza, Paweł Grzelązka, Adrianna Trofimiuk, Karol Suppan, Marcin Wasielewski, Joanna Wiśniewska, Jacek Budzyński
BACKGROUND: The outcome of endovascular therapy can be influenced by a number of factors, either demographic, biochemical, angiographic or procedural. Knowledge about these factors may help in the individualization of therapeutic methods, surveillance intensity, and should, ultimately, improve intervention efficacy. OBJECTIVES: The aim of this study was to estimate the effect of clinical and biochemical factors on the late outcome of lower limb artery stenting. MATERIAL AND METHODS: The medical documentation of 91 patients with at least a 1 year follow-up after the stenting of a lower limb artery was retrospectively evaluated...
March 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
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