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chronic limb ischemia

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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
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/28256175/recanalization-of-peripheral-chronic-total-occlusions-no-fancy-devices-just-a-crossing-catheter
#4
Alessandro Cannavale, Tariq Ali, Chen-Yang Shen, George Kassimis, Miltiadis Krokidis
BACKGROUND: Chronic total occlusions (CTOs) are challenging to treat endovascularly. Classic subintimal approach is offering only moderate success rates mainly due of the lack of dedicated crossing catheters. Purpose of this study is to assess the acute procedural success of the use of a novel hydrophilic crossing catheter in the recanalization of peripheral CTOs. MATERIALS AND METHODS: This is a retrospective, single-centre study of patients with femoropopliteal CTOs...
March 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28242402/hypoalbuminemia-predicts-perioperative-morbidity-and-mortality-after-infrainguinal-lower-extremity-bypass-for-critical-limb-ischemia
#5
Matthew R Peacock, Alik Farber, Mohammad H Eslami, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Nishant K Shah, Jeffrey J Siracuse
OBJECTIVES: Poor nutritional status has been associated with a higher risk of morbidity and mortality in general surgery patients, however outcomes in vascular surgery patients are unclear. Our goal was to determine the effect of poor nutritional status on perioperative morbidity and mortality after lower extremity bypass (LEB). METHODS: The 2005-2012 National Surgical Quality Improvement Program was analyzed to determine associated complications, mortality, length of stay (LOS), and readmissions for patients with hypoalbuminemia (serum albumin <3...
February 24, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28240525/infrapopliteal-calcification-patterns-in-critical-limb-ischemia-diagnostic-pathologic-and-therapeutic-implications-in-the-search-for-the-endovascular-holy-grail
#6
Jihad A Mustapha, Larry J Diaz-Sandoval, Fadi Saab
Critical limb ischemia (CLI) represents the terminal stage of peripheral arterial disease (PAD) and is characterized by multilevel and multivessel disease. Amongst patients with infrainguinal disease, approximately one third have predominantly isolated infrapopliteal disease and the remaining two thirds, a combination of femoropopliteal and infrapopliteal disease. Isolated infrapopliteal disease is mainly seen in the elderly, diabetic, or dialysis-dependent patients. These patients have higher risk of amputation and shorter amputation-free survival...
February 27, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28236918/morbidity-and-mortality-after-emergency-lower-extremity-embolectomy
#7
Sergio Casillas-Berumen, Lili Sadri, Alik Farber, Mohammad H Eslami, Jeffrey A Kalish, Denis Rybin, Gheorghe Doros, Jeffrey J Siracuse
OBJECTIVE: Emergency lower extremity embolectomy is a common vascular surgical procedure that has poorly defined outcomes. Our goal was to define the perioperative morbidity for emergency embolectomy and develop a risk prediction model for perioperative mortality. METHODS: The American College of Surgeons National Surgical Quality Improvement database was queried to identify patients undergoing emergency unilateral and lower extremity embolectomy. Patients with previous critical limb ischemia, bilateral embolectomy, nonemergency indication, and those undergoing concurrent bypass were excluded...
March 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28213570/blunted-transcriptional-response-to-skeletal-muscle-ischemia-in-rats-with-chronic-kidney-disease-potential-role-for-impaired-ischemia-induced-angiogenesis
#8
Rafael U Heiss, Fabian Fahlbusch, Johannes Jacobi, Christoph Daniel, Arif B Ekici, Nada Cordasic, Kerstin Amann, Andrea Hartner, Karl F Hilgers
Chronic kidney disease (CKD) is associated with increased cardiovascular morbidity and mortality. Previous studies indicated an impairment of ischemia-induced angiogenesis in skeletal muscle of rats with CKD. We performed a systematic comparison of early gene expression in response to ischemia in rats with or without CKD to identify potential molecular mechanisms underlying impaired angiogenesis in CKD. CKD was induced in male rats by 5/6 nephrectomy (SNX); control rats were sham operated (sham). Eight weeks later, ischemia of the right limb was induced by ligation and resection of the femoral artery...
February 17, 2017: Physiological Genomics
https://www.readbyqxmd.com/read/28194186/safety-and-effectiveness-of-bone-marrow-cell-concentrate-in-the-treatment-of-chronic-critical-limb-ischemia-utilizing-a-rapid-point-of-care-system
#9
Venkatesh Ponemone, Saniya Gupta, Dalip Sethi, Manish Suthar, Monika Sharma, Richard J Powell, Kenneth Lee Harris, Nungshi Jungla, Priyadarshini Arambam, Upendra Kaul, Ashok Seth, Suhail Bukhari
Critical limb ischemia (CLI) is the end stage of lower extremity peripheral vascular disease (PVD) in which severe obstruction of blood flow results in ischemic rest pain, ulcers and/or gangrene, and a significant risk of limb loss. This open-label, single-arm feasibility study evaluated the safety and therapeutic effectiveness of autologous bone marrow cell (aBMC) concentrate in revascularization of CLI patients utilizing a rapid point-of-care device. Seventeen (17) no-option CLI patients with ischemic rest pain were enrolled in the study...
2017: Stem Cells International
https://www.readbyqxmd.com/read/28190717/perioperative-outcomes-of-infrainguinal-bypass-surgery-in-patients-with-and-without-prior-revascularization
#10
Thomas C F Bodewes, Klaas H J Ultee, Peter A Soden, Sara L Zettervall, Katie E Shean, Douglas W Jones, Frans L Moll, Marc L Schermerhorn
OBJECTIVE: Although an increasing number of patients with peripheral arterial disease undergo multiple revascularization procedures, the effect of prior interventions on outcomes remains unclear. The purpose of this study was to evaluate perioperative outcomes of bypass surgery in patients with and those without prior ipsilateral treatment. METHODS: Patients undergoing nonemergent infrainguinal bypass between 2011 and 2014 were identified in the National Surgical Quality Improvement Program Targeted Vascular module...
February 9, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28151868/impact-of-betablockers-on-general-and-local-outcome-in-patients-hospitalized-for-lower-extremity-peripheral-artery-disease-the-copart-registry
#11
MULTICENTER STUDY
Tristan Mirault, Alexandre Galloula, Jean-Pierre Cambou, Philippe Lacroix, Victor Aboyans, Carine Boulon, Joel Constans, Alessandra Bura-Riviere, Emmanuel Messas
Lower extremity peripheral artery disease (PAD) is one manifestation of atherosclerosis. Patients with PAD have an increased rate of mortality due to concurrent coronary artery disease and hypertension. Betablockers (BB) may, therefore, be prescribed, especially in case of heart failure. However, BB safety in PAD is controversial, because of presumed peripheral hemodynamic consequences of BB that could lead to worsening of symptoms in patients with PAD. In this context, we aimed to determine the impact of BB on all-cause and cardiovascular mortality and amputation rate at 1 year after hospitalization for PAD from the COPART Registry population...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28143739/phase-ib-safety-two-dose-study-of-multigeneangio-in-patients-with-chronic-critical-limb-ischemia
#12
Moshe Y Flugelman, Moshe Halak, Boris Yoffe, Jacob Schneiderman, Chen Rubinstein, Allan-Isaac Bloom, Eran Weinmann, Ilya Goldin, Victor Ginzburg, Olga Mayzler, Aaron Hoffman, Belly Koren, Diana Gershtein, Michal Inbar, Marina Hutoran, Adili Tsaba
Critical limb ischemia (CLI) is the most severe presentation of peripheral arterial disease. We developed cell-based therapy entailing intra-arterial injection of autologous venous endothelial cells (ECs) modified to express angiopoietin 1, combined with autologous venous smooth muscle cells (SMCs) modified to express vascular endothelial growth factor. This combination promoted arteriogenesis in animal models and was safe in patients with limiting claudication. In an open-label, phase Ib study, we assessed the safety and efficacy of this therapy in CLI patients who failed or were unsuitable for surgery or intravascular intervention...
March 1, 2017: Molecular Therapy: the Journal of the American Society of Gene Therapy
https://www.readbyqxmd.com/read/28126175/risk-factors-for-30-day-unplanned-readmission-following-infrainguinal-endovascular-interventions
#13
Thomas C F Bodewes, Peter A Soden, Klaas H J Ultee, Sara L Zettervall, Alexander B Pothof, Sarah E Deery, Frans L Moll, Marc L Schermerhorn
OBJECTIVE: Unplanned hospital readmissions following surgical interventions are associated with adverse events and contribute to increasing health care costs. Despite numerous studies defining risk factors following lower extremity bypass surgery, evidence regarding readmission after endovascular interventions is limited. This study aimed to identify predictors of 30-day unplanned readmission following infrainguinal endovascular interventions. METHODS: We identified all patients undergoing an infrainguinal endovascular intervention in the targeted vascular module of the American College of Surgeons National Surgical Quality Improvement Program between 2012 and 2014...
February 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28109110/-effects-of-polyethylene-oxide-on-blood-perfusion-in-the-hind-limbs-of-rats-with-chronic-hindlimb-ischemia
#14
De-Zhong Zheng, Tao Zhou, Dao-Gang Zha
OBJECTIVE: To evaluate the effects of polyethylene oxide (PEO) on blood perfusion in hind limb skeletal muscles in a rat model of chronic hind limb ischemia. METHDOS: Twelve rat models of chronic hind limb ischemia established by unilateral femoral artery ligation were randomized into PEO and control groups (n=6) and treated with intravenous infusion of PEO and saline through the internal jugular vein every other day for 2 weeks. Contrast-enhanced ultrasonography was performed after the treatments to evaluate the blood flow in the skeletal muscles at different time points and blood flow reserve in the ischemic hind limbs on day 28...
January 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28073665/predictive-ability-of-the-society-for-vascular-surgery-wound-ischemia-and-foot-infection-wifi-classification-system-after-first-time-lower-extremity-revascularizations
#15
Jeremy D Darling, John C McCallum, Peter A Soden, Raul J Guzman, Mark C Wyers, Allen D Hamdan, Hence J Verhagen, Marc L Schermerhorn
OBJECTIVE: The Society for Vascular Surgery (SVS) Wound, Ischemia and foot Infection (WIfI) classification system was proposed to predict 1-year amputation risk and potential benefit from revascularization. Our goal was to evaluate the predictive ability of this scale in a real-world selection of patients undergoing a first-time lower extremity revascularization for chronic limb-threatening ischemia (CLTI). METHODS: From 2005 to 2014, 1336 limbs underwent a first-time lower extremity revascularization for CLTI, of which 992 had sufficient data to classify all three WIfI components (wound, ischemia, and foot infection)...
March 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28050885/results-of-an-international-postmarketing-surveillance-study-of-pl-vegf165-safety-and-efficacy-in-210-patients-with-peripheral-arterial-disease
#16
Roman Deev, Igor Plaksa, Ilia Bozo, Artur Isaev
INTRODUCTION: The effective treatment of chronic lower limb ischemia is one of the most challenging issues confronting vascular surgeons. Current pharmacological therapies play an auxiliary role and cannot prevent disease progression, and new treatment methods are needed. pl-VEGF165, a gene therapy drug, was approved in Russia for the treatment of atherosclerotic peripheral arterial disease (PAD) after clinical studies in 2011. The study drug is an original gene construction in which pl-VEGF165 1...
January 3, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/28045669/long-term-outcomes-of-successful-endovascular-therapy-via-the-retrograde-approach-for-below-the-knee-chronic-total-occlusion-in-patients-with-critical-limb-ischemia-after-a-failed-antegrade-approach
#17
Junya Matsumi, Takuma Takada, Noriaki Moriyama, Tomoki Ochiai, Kazuki Tobita, Koki Shishido, Kazuya Sugitatsu, Shingo Mizuno, Futoshi Yamanaka, Masato Murakami, Yutaka Tanaka, Saeko Takahashi, Takeshi Akasaka, Shigeru Saito
OBJECTIVE: This study evaluated long-term results following successful endovascular therapy (EVT) for chronic total occlusion (CTO) below the knee (BTK) using the retrograde approach after a failed antegrade approach. METHODS: Nineteen patients (19 limbs) with critical limb ischemia (CLI) who underwent successful EVT for BTK-CTO using the retrograde approach after a failed antegrade approach during 2010-2014 were studied. RESULTS: Mean duration of the follow-up period was 25...
January 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28041804/endovascular-treatment-of-the-common-femoral-artery-in-the-vascular-quality-initiative
#18
Jeffrey J Siracuse, Kathryn Van Orden, Jeffrey A Kalish, Mohammad H Eslami, Marc L Schermerhorn, Virendra I Patel, Denis Rybin, Alik Farber
OBJECTIVE: Endovascular interventions of the common femoral (CFA) and deep (DFA) femoral arteries are becoming more common. However, there is very little published data for guidance. Our objective was to analyze practice patterns and outcomes from these interventions. METHODS: The Vascular Quality Initiative (2010-2015) was queried for all endovascular interventions of the CFA and DFA. Cases that were emergent or for acute limb ischemia were excluded. Those with isolated CFA with or without DFA treatment were analyzed...
December 29, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27986757/cyanate-impaired-angiogenesis-association-with-poor-coronary-collateral-growth-in-patients-with-stable-angina-and-chronic-total-occlusion
#19
Jia Teng Sun, Ke Yang, Jing Yan Mao, Wei Feng Shen, Lin Lu, Qi Hong Wu, Yan Ping Wang, Li Ping Wu, Rui Yan Zhang
BACKGROUND: Cyanate has recently gained attention for its role in the pathogenesis of vascular injury. Nonetheless, the effect of cyanate on angiogenesis remains unclear. METHODS AND RESULTS: In this study, we demonstrated that oral administration of cyanate impaired blood perfusion recovery in a mouse hind-limb ischemia model. A reduction in blood perfusion recovery at day 21 was observed in the ischemic tissue of cyanate-treated mice. Likewise, there were fewer capillaries in the ischemic hind-limb tissue of cyanate-exposed mice...
December 16, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27928584/endovascular-management-of-infected-femoral-artery-pseudoaneurysms-in-high-risk-patients-a-case-series
#20
Mario D'Oria, Giada Sgorlon, Cristiano Calvagna, Francesca Zamolo, Stefano Chiarandini, Roberto Adovasio, Filippo Griselli
We report our experience with the urgent treatment of two high-risk patients with infected femoral artery pseudoaneurysms (IFAPs) with the placement of a self-expandable covered stent (SECS). In both cases, there was no perioperative mortality and the aneurysm exclusion was successful without early or late stent thrombosis/stent fracture nor acute or chronic limb ischemia or limb loss. There was no recurrence of local or systemic infection during the follow-up period. Endovascular therapy represents a feasible treatment option for IFAPs in those patients for whom the risk of open surgical repair would be prohibitive, especially under urgent circumstances...
December 7, 2016: Cardiovascular and Interventional Radiology
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