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chronic limb ischemia

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https://www.readbyqxmd.com/read/29661291/hemodialysis-patients-have-worse-outcomes-after-infrageniculate-revascularization-procedures
#1
Caitlin W Hicks, Joseph K Canner, Kevin Kirkland, Mahmoud B Malas, James H Black, Christopher J Abularrage
BACKGROUND: Hemodialysis (HD) has been shown to be an independent predictor of poor outcomes after femoropopliteal revascularization procedures in patients with chronic limb-threatening ischemia. However, HD patients tend to have isolated infrageniculate disease, an anatomic risk factor for inferior patency. We aimed to compare outcomes for HD versus non-HD patients after infrageniculate open lower extremity bypass (LEB) and endovascular peripheral vascular interventions (PVIs). METHODS: Data from the Society for Vascular Surgery Vascular Quality Initiative database (2008-2014) were analyzed...
June 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29650705/outcomes-of-peripheral-vascular-interventions-in-select-patients-with-lower-extremity-acute-limb-ischemia
#2
Elica Inagaki, Alik Farber, Jeffrey A Kalish, Mohammad H Eslami, Jeffrey J Siracuse, Robert T Eberhardt, Denis V Rybin, Gheorghe Doros, Naomi M Hamburg
BACKGROUND: Contemporary data on patients presenting with acute limb ischemia (ALI), who are selected for treatment with endovascular peripheral vascular interventions (PVI), are limited. Our study examined outcomes following endovascular PVI in patients with ALI by comparing with patients treated for chronic critical limb ischemia using a regional quality improvement registry. METHODS AND RESULTS: Of the 11 035 patients in the Vascular Study Group of New England PVI database (2010-2014), we identified 365 patients treated for lower extremity ALI who were 5:1 frequency matched (by procedure year and arterial segments treated) to 1808 patients treated for critical limb ischemia...
April 12, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29643080/periodic-limb-movements-during-sleep-in-stroke-tia-prevalence-course-and-cardiovascular-burden
#3
Mauro Manconi, Francesco Fanfulla, Raffaele Ferri, Silvia Miano, Josè Haba-Rubio, Raphael Heinzer, Thomas Horvath, Paola Proserpio, Peter Young, Giorgio Moschovitis, Andrea Seiler, Carlo Cereda, Lino Nobili, Roland Wiest, Sebastian R Ott, Claudio L Bassetti
OBJECTIVE: To define the prevalence, time course, and associated factors of periodic limb movements during sleep (PLMS) in patients with ischemic stroke or TIA. METHODS: Patients enrolled in the prospective Sleep-Disordered Breathing in Transient Ischemia Attack (TIA)/Ischemic Stroke and Continuous Positive Airway Pressure (CPAP) Treatment Efficacy (SAS-CARE) study underwent a double polysomnographic investigation in the acute and chronic phases after stroke/TIA, together with a MRI brain scan and a 24-hour blood pressure evaluation...
April 11, 2018: Neurology
https://www.readbyqxmd.com/read/29615358/outcomes-of-infrageniculate-retrograde-versus-transfemoral-access-for-endovascular-intervention-for-chronic-lower-extremity-ischemia
#4
Ashraf G Taha, Adham N Abou Ali, George Al-Khoury, Michael J Singh, Michel S Makaroun, Efthymios D Avgerinos, Rabih A Chaer
OBJECTIVE: Retrograde infrageniculate access is an alternative treatment strategy for patients who have failed to respond to antegrade endovascular intervention. This study compares the outcomes of infrageniculate retrograde arterial access with the conventional transfemoral access for the endovascular management of chronic lower extremity ischemia. METHODS: This was a retrospective single-center review of retrograde endovascular intervention (REI) from 2012 to 2016...
March 31, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29602580/effects-of-chronic-kidney-disease-on-clinical-outcomes-in-patients-with-peripheral-artery-disease-undergoing-endovascular-treatment-analysis-from-the-k-vis-ella-registry
#5
Hyung Oh Kim, Jae-Min Kim, Jong Shin Woo, Donghoon Choi, Young-Guk Ko, Chul-Min Ahn, Seung-Whan Lee, Jae-Hwan Lee, Seung-Hyuk Choi, Cheol Woong Yu, Pil-Ki Min, Chang-Hwan Yoon, In-Ho Chae, Sang-Rok Lee, Yoon Seok Koh, Weon Kim
OBJECTIVES: Chronic kidney disease (CKD) is a risk factor for peripheral artery disease (PAD), but the impact of CKD in PAD patients who received endovascular treatment (EVT) is not well studied. Aim of this study is to clarify the impact of CKD in patients with PAD in real EVT era. METHODS: Using the Korean Vascular Intervention Society (K-VIS) endovascular therapy in lower limb artery disease registry (ELLA) registry, we analyzed 3434 patients who underwent EVT...
March 23, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29588132/epidemiology-of-lower-extremity-peripheral-artery-disease-in-veterans
#6
James Willey, Amgad Mentias, Mary Vaughan-Sarrazin, Kimberly McCoy, Gary Rosenthal, Saket Girotra
OBJECTIVE: The objective of this study was to describe the epidemiology, clinical features, outcomes, and predictors of mortality in veterans with peripheral artery disease (PAD). METHODS: We used national data from the Veterans Health Administration from fiscal years 2009 to 2011 to identify patients with a new diagnosis of PAD. Within this cohort, we describe characteristics of the patients, use of recommended medications, and clinical outcomes during a 3-year follow-up (fiscal year 2014)...
March 24, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29576493/aspiration-thrombectomy-versus-conventional-catheter-directed-thrombolysis-as-first-line-treatment-for-noniatrogenic-acute-lower-limb-ischemia
#7
C H Ricky Kwok, Scott Fleming, Kenneth K C Chan, Jonathan Tibballs, Shaun Samuelson, John Ferguson, Sanjay Nadkarni, Joseph A Hockley, Shirley J Jansen
PURPOSE: To examine the efficacy, safety, and procedural costs of percutaneous aspiration thrombectomy (PAT) as a first-line treatment for noniatrogenic acute lower limb ischemia (ALI) compared with conventional catheter-directed thrombolysis (CDT). MATERIALS AND METHODS: All patients who underwent endovascular intervention for ALI from January 2015 to August 2017 were included. Fifteen patients were treated with the use of primary PAT and 27 patients were treated with the use of primary CDT...
March 22, 2018: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29576404/treatment-outcomes-in-diabetic-patients-with-chronic-limb-threatening-ischemia
#8
Patric Liang, Peter A Soden, Sara L Zettervall, Katie E Shean, Sarah E Deery, Raul J Guzman, Allen D Hamdan, Marc L Schermerhorn
OBJECTIVE: There are conflicting reports about outcomes after infrainguinal bypass for chronic limb-threatening ischemia (CLTI) in patients with diabetes. We compared perioperative outcomes between patients with and patients without diabetes in the current era. METHODS: The National Surgical Quality Improvement Program vascular module, 2011 to 2014, was used to identify patients undergoing infrainguinal revascularization for CLTI. Patients with and without diabetes were compared in terms of presentation, comorbidities, operative approach, and 30-day outcomes...
March 22, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29571623/real-world-evidence-of-superiority-of-endovascular-repair-in-treating-ruptured-abdominal-aortic-aneurysm
#9
Akshay Kumar Gupta, Hanaa Dakour Aridi, Satinderjit Locham, Besma Nejim, Frank J Veith, Mahmoud B Malas
OBJECTIVE: The majority of previous studies, including randomized controlled trials, have failed to provide sufficient evidence of superiority of endovascular aneurysm repair (EVAR) over open aortic repair (OAR) of ruptured abdominal aortic aneurysm (rAAA) while comparing mortality and complications. This is in part due to small study size, patient selection bias, scarce adjustment for essential variables, single insurance type, or selection of only older patients. This study aimed to provide real-world, contemporary, comprehensive, and robust evidence on mortality of EVAR vs OAR of rAAA...
March 20, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29550703/coxiella-burnetii-endocarditis-on-bioprosthetic-aortic-valve-with-peripheral-arterial-embolism
#10
Anne-Laure Faucon, Jean-Luc Mainardi, Oana Zamfir, Hervé Gorka, Patrick Bruneval, André Pruna
Acute limb ischemia related to Coxiella burnetii endocarditis is rare. We report an original case of a 68-year-old man hospitalized for recurrent acute left limb ischemia in a context of atrial flutter, which revealed C. burnetii endocarditis. This case illustrates that even if embolic events are uncommon, septic embolisms must be systematically searched for in case of C. burnetii endocarditis. Conversely, extensive etiologic explorations must be performed in case of systemic embolism. New molecular techniques represent a major step forward in infective endocarditis diagnosis...
February 16, 2018: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
https://www.readbyqxmd.com/read/29534983/cutaneous-manifestations-of-chronic-vascular-disease
#11
REVIEW
Steven M Dean
In the contemporary era of medical diagnosis via sophisticated radiographic imaging and/or comprehensive serological testing, a focused physical examination remains paramount in recognizing the cutaneous manifestations of chronic vascular disease. Recognition of the unique cutaneous signs of lymphatic and venous hypertension assists in the diagnosis as well as the staging and classification of both lymphedema and chronic venous insufficiency. Awareness of explicit dermatologic vasomotor manifestations aids not only in the identification of acrocyanosis, Raynaud phenomenon, pernio, and erythromelalgia but also mitigates confusion related to their clinical overlap...
March 10, 2018: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29504494/a-3-month-safety-assessment-of-human-bone-marrow-derived-mesenchymal-stromal-cells-administered-once-by-the-intramuscular-route-to-immunodeficient-mice
#12
Michael Creane, Mary Mc Elroy, Aoife Duffy, Chaansha Shaik Dawood, Timothy O'Brien
Critical limb ischemia (CLI) represents the severest manifestation of peripheral arterial disease and is a major unmet medical need. This disease occurs when the arterial blood supply within the limb fails to meet the metabolic demands of the resting muscle or tissue, resulting in chronic ischemic rest pain and/or tissue necrosis. Human mesenchymal stromal cells, termed hMSCs, represent an exciting therapeutic modality for the treatment of this disease due to their immunomodulatory and tissue reparative functions...
January 1, 2018: Toxicologic Pathology
https://www.readbyqxmd.com/read/29502998/ambulation-and-functional-outcome-after-major-lower-extremity-amputation
#13
Atish Chopra, Amir F Azarbal, Enjae Jung, Cherrie Z Abraham, Timothy K Liem, Gregory J Landry, Gregory L Moneta, Erica L Mitchell
OBJECTIVE: Major lower extremity amputations (MLEAs) remain a significant source of disability. It is unknown whether postamputation functional outcomes and outcome predictability have changed with a population of increasingly aging and obese patients. Accordingly, we sought to evaluate contemporary trends. METHODS: A retrospective chart review was performed to identify patients undergoing MLEA using Current Procedural Terminology codes in a university hospital...
March 1, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29501899/covered-stent-treatment-of-a-chronically-thrombosed-popliteal-artery-aneurysm-in-the-setting-of-critical-limb-ischemia-following-multiple-failed-bypass-operations
#14
Nassiri N, Huntress LA
Endovascular salvage of failed surgical bypasses has been scantly reported for treatment of infrainguinal occlusive disease. While catheter-directed thrombolysis and/or mechanical thromboembolectomy have been the mainstay of endovascular salvage of previous bypass grafts, native vessel recanalization remains seldom attempted. Herein, we present a unique approach to native vessel recanalization of a chronically thrombosed popliteal artery aneurysm for non-healing distal ulceration.
March 1, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29501594/eversion-femoral-endarterectomy-for-iliofemoral-occlusive-disease-a-description-of-technique-and-series-of-cases
#15
Matthew D Kronick, Natasha Saiyed, Marc Norris, Neal Hadro, Marvin E Morris
BACKGROUND: Eversion endarterectomy (EE) is a well described technique for the treatment of extra-cranial cerebrovascular disease. Longitudinal arteriotomy and closure with patch angioplasty is the standard for infra-inguinal arterial occlusive disease in the iliofemoral segment. A potential drawback of this technique is the introduction of exogenous material into the field. We herein describe a technique of transverse femoral arteriotomy with primary closure for treatment of chronic limb ischemia involving the iliofemoral system...
February 28, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29485958/identifying-the-risk-factor-and-prevention-of-limb-ischemia-in-extracorporeal-membrane-oxygenation-with-femoral-artery-cannulation
#16
Chih-Chien Yen, Chih-Hong Kao, Chien-Sung Tsai, Shin-Han Tsai
OBJECTIVE: Application of extracorporeal membrane oxygenation (ECMO) for life support has been widely used in various fields of resuscitation. When the common femoral artery (CFA) is used during cannulation for ECMO support in adults, it is often complicated by limb ischemia. Placement of distal perfusion catheter (DPC) can reduce the incidence of limb ischemia and increases the likelihood of limb preservation, but selection criteria is uncertain. METHODS: This is a retrospective study...
January 16, 2018: Heart Surgery Forum
https://www.readbyqxmd.com/read/29484959/chronic-total-occlusion-crossing-approach-based-on-plaque-cap-morphology-the-ctop-classification
#17
Fadi Saab, Michael R Jaff, Larry J Diaz-Sandoval, Gwennan D Engen, Theresa N McGoff, George Adams, Ashraf Al-Dadah, Philip P Goodney, Farhan Khawaja, Jihad A Mustapha
PURPOSE: To present the chronic total occlusion (CTO) crossing approach based on plaque cap morphology (CTOP) classification system and assess its ability to predict successful lesion crossing. METHODS: A retrospective analysis was conducted of imaging and procedure data from 114 consecutive symptomatic patients (mean age 69±11 years; 84 men) with claudication (Rutherford category 3) or critical limb ischemia (Rutherford category 4-6) who underwent endovascular interventions for 142 CTOs...
February 1, 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29482487/two-wire-technique-with-a-gooseneck-snare-to-bail-out-the-tip-separation-of-a-crosser-catheter
#18
Yoshito Kadoya, Kan Zen, Yohei Oda, Satoaki Matoba
Tip separation of a Crosser catheter is a serious complication; however, there is limited information on bailout methods. Here, we describe a case of successful retrieval of the separated tip of a Crosser catheter using a 2-wire technique with a gooseneck snare. A 76-year-old woman with a history of hemodialysis and diabetes mellitus who developed ulcers on her right toes was diagnosed as having critical limb ischemia and underwent transfemoral antegrade endovascular treatment of the anterior tibial artery (ATA)...
January 1, 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29459014/regional-variation-in-racial-disparities-among-patients-with-peripheral-artery-disease
#19
Thomas F X O'Donnell, Chloe Powell, Sarah E Deery, Jeremy D Darling, Kakra Hughes, Kristina A Giles, Grace J Wang, Marc L Schermerhorn
OBJECTIVE: Prior studies identified significant racial disparities as well as regional variation in outcomes of patients with peripheral artery disease (PAD). We aimed to determine whether regional variation contributes to these racial disparities. METHODS: We identified all white or black patients who underwent infrainguinal revascularization or amputation in 15 deidentified regions of the Vascular Quality Initiative between 2003 and 2017. We excluded three regions with <100 procedures...
February 16, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29456512/local-injections-of-superoxide-dismutase-attenuate-the-exercise-pressor-reflex-in-rats-with-femoral-artery-occlusion
#20
Jihong Xing, Jian Lu, Jiahao Liu, Jianhua Li
The exercise pressor reflex is amplified in patients with peripheral artery disease (PAD) and in an experimental PAD model of rats induced by femoral artery occlusion. Heightened blood pressure worsens the restricted blood flow directed to the limbs in this disease. The purpose of this study was to determine the role played by muscle oxidative stress in regulating the augmented pressor response to static exercise in PAD. We hypothesized that limb ischemia impairs muscle superoxide dismutase (SOD) thereby leading to abnormal autonomic responsiveness observed in PAD animals, and a chronic compensation of SOD for anti-oxidation improves the exaggerated exercise pressor reflex...
2018: Frontiers in Physiology
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