Role of transoesophageal echocardiography in determining the source of peripheral arterial embolism

We reviewed the incidence and outcome of all cases of upper and lower limb embolism surgically treated in our vascular unit, from January 2001 to June 2006, to assess the role of transthoracic and transesophageal echocardiography in defining the source of the embolus. Transthoracic echocardiography was carried out postoperatively, and patients in whom the embolic source was not found underwent transesophageal echocardiography. There were 85 patients (mean age, 69 years) who underwent embolectomy: 58 for lower and 27 for upper limb ischemia. The source or potential source of thrombus was demonstrated in 17 (20%) patients after transthoracic echocardiography. Fifty-three patients had transesophageal echocardiography, the source of embolism was found in 85%, and the subsequent management was changed in 47% of them. Arterial limb emboli are still prevalent in developing countries. Transthoracic echocardiography is a good screening tool for detecting a potential cardiac source of peripheral embolism, with transesophageal echocardiography being reserved for specific indications.

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What Is Currently the Role of TcPO2 in the Choice of the Amputation Level of Lower Limbs? A Comprehensive Review

Journal of Clinical Medicine ◽

10.3390/jcm10071413 ◽

2021 ◽

Vol 10 (7) ◽

pp. 1413

Author(s):

Judith Catella ◽

Anne Long ◽

Lucia Mazzolai

Keyword(s):

Arterial Disease ◽

Major Amputation ◽

Lower Limbs ◽

Limb Amputation ◽

Quality Of Data ◽

Amputation Level ◽

Increased Risk ◽

Transcutaneous Oximetry ◽

Peripheral Arterial

Some patients still require major amputation for lower extremity peripheral arterial disease treatment. The purpose of pre-operative amputation level selection is to determine the most distal amputation site with the highest healing probability without re-amputation. Transcutaneous oximetry (TcPO2) can detect viable tissue with the highest probability of healing. Several factors affect the accuracy of TcPO2; nevertheless, surgeons rely on TcPO2 values to determine the optimal amputation level. Background about the development of TcPO2, methods of measurement, consequences of lower limb amputation level, and the place of TcPO2 in the choice of the amputation level are reviewed herein. Most of the retrospective studies indicated that calf TcPO2 values greater than 40 mmHg were associated with a high percentage of successful wound healing after below-knee-amputation, whereas values lower than 20 mmHg indicated an increased risk of unsuccessful healing. However, a consensus on the precise cut-off value of TcPO2 necessary to assure healing is missing. Ways of improvement for TcPO2 performance applied to the optimization of the amputation-level are reported herein. Further prospective data are needed to better approach a TcPO2 value that will promise an acceptable risk of re-amputation. Standardized TcPO2 measurement is crucial to ensure quality of data.

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The Role of Circulating Biomarkers in Peripheral Arterial Disease

International Journal of Molecular Sciences ◽

10.3390/ijms22073601 ◽

2021 ◽

Vol 22 (7) ◽

pp. 3601

Author(s):

Goren Saenz-Pipaon ◽

Esther Martinez-Aguilar ◽

Josune Orbe ◽

Arantxa González Miqueo ◽

Leopoldo Fernandez-Alonso ◽

...

Keyword(s):

Peripheral Arterial Disease ◽

Lower Limb ◽

Prediction Models ◽

Arterial Disease ◽

Cardiac Damage ◽

Thrombotic Occlusion ◽

Medical Treatments ◽

Peripheral Arterial ◽

Inflammatory Molecules

Peripheral arterial disease (PAD) of the lower extremities is a chronic illness predominantly of atherosclerotic aetiology, associated to traditional cardiovascular (CV) risk factors. It is one of the most prevalent CV conditions worldwide in subjects >65 years, estimated to increase greatly with the aging of the population, becoming a severe socioeconomic problem in the future. The narrowing and thrombotic occlusion of the lower limb arteries impairs the walking function as the disease progresses, increasing the risk of CV events (myocardial infarction and stroke), amputation and death. Despite its poor prognosis, PAD patients are scarcely identified until the disease is advanced, highlighting the need for reliable biomarkers for PAD patient stratification, that might also contribute to define more personalized medical treatments. In this review, we will discuss the usefulness of inflammatory molecules, matrix metalloproteinases (MMPs), and cardiac damage markers, as well as novel components of the liquid biopsy, extracellular vesicles (EVs), and non-coding RNAs for lower limb PAD identification, stratification, and outcome assessment. We will also explore the potential of machine learning methods to build prediction models to refine PAD assessment. In this line, the usefulness of multimarker approaches to evaluate this complex multifactorial disease will be also discussed.

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Peripheral arterial embolism arising from pulmonary adenocarcinoma

The Annals of Thoracic Surgery ◽

10.1016/s0003-4975(03)01143-3 ◽

2004 ◽

Vol 77 (4) ◽

pp. 1426-1428 ◽

Cited By ~ 15

Author(s):

Jesus Loscertales ◽

Miguel Congregado ◽

Carlos Arenas ◽

Andres Arroyo ◽

Juan Carlos Giron ◽

...

Keyword(s):

Pulmonary Adenocarcinoma ◽

Arterial Embolism ◽

Peripheral Arterial

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The epidemiology of onychomycosis: possible role of smoking and peripheral arterial disease

Journal of the European Academy of Dermatology and Venereology ◽

10.1046/j.1468-3083.2000.00124.x ◽

2000 ◽

Vol 14 (6) ◽

pp. 466-469 ◽

Cited By ~ 84

Author(s):

Aditya K. Gupta ◽

Madhulika A. Gupta ◽

Richard C. Summerbell ◽

Elizabeth A. Cooper ◽

Nellie Konnikov ◽

...

Keyword(s):

Peripheral Arterial Disease ◽

Arterial Disease ◽

Peripheral Arterial

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Role of Disease Status and Type D Personality in Outcomes in Patients With Peripheral Arterial Disease

The American Journal of Cardiology ◽

10.1016/j.amjcard.2005.05.059 ◽

2005 ◽

Vol 96 (7) ◽

pp. 996-1001 ◽

Cited By ~ 45

Author(s):

Annelies E. Aquarius ◽

Johan Denollet ◽

Jaap F. Hamming ◽

Jolanda De Vries

Keyword(s):

Peripheral Arterial Disease ◽

Disease Status ◽

Arterial Disease ◽

Type D Personality ◽

Type D ◽

Peripheral Arterial

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Cell Therapy in Patients with Critical Limb Ischemia

Stem Cells International ◽

10.1155/2015/931420 ◽

2015 ◽

Vol 2015 ◽

pp. 1-13 ◽

Cited By ~ 27

Author(s):

Rita Compagna ◽

Bruno Amato ◽

Salvatore Massa ◽

Maurizio Amato ◽

Raffaele Grande ◽

...

Keyword(s):

Cell Therapy ◽

Critical Limb Ischemia ◽

Limb Ischemia ◽

Tissue Loss ◽

Systematic Analysis ◽

Peripheral Arterial Obstructive Disease ◽

Peripheral Arterial ◽

Cellular Components

Critical limb ischemia (CLI) represents the most advanced stage of peripheral arterial obstructive disease (PAOD) with a severe obstruction of the arteries which markedly reduces blood flow to the extremities and has progressed to the point of severe rest pain and/or even tissue loss. Recent therapeutic strategies have focused on restoring this balance in favor of tissue survival using exogenous molecular and cellular agents to promote regeneration of the vasculature. These are based on stimulation of angiogenesis by extracellular and cellular components. This review article carries out a systematic analysis of the most recent scientific literature on the application of stem cells in patients with CLI. The results obtained from the detailed analysis of the recent literature data have confirmed the beneficial role of cell therapy in reducing the rate of major amputations in patients with CLI and improving their quality of life.

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