scholarly journals Clinical outcome of the patients with femoropopliteal artery disease after endovascular therapy: focused on drug-coated-balloon-related distal embolism detected by laser doppler flowmetry

2021 ◽  
Author(s):  
Kuniyoshi Fukai ◽  
Takuo Nakagami ◽  
Tetsuro Hamaoka ◽  
Masakazu Kikai ◽  
Shinichiro Yamaguchi
Keyword(s):  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Laser Doppler Flowmetry ◽  
Endovascular Therapy ◽  
Previous History ◽  
Laser Doppler ◽  
Lesion Length ◽  
Doppler Flowmetry ◽  
Femoropopliteal Artery ◽  
Artery Disease

AbstractSeveral trials have shown that paclitaxel drug-coated balloons (DCBs) significantly reduce restenosis rates. However, some reports have shown distal embolisms occurring after DCBs. No study has analyzed the clinical outcomes of patients with DCB-induced distal embolism. This study aimed to investigate the clinical outcomes of DCB-induced distal embolism in patients with femoropopliteal artery disease. Between February 2018 and April 2019, consecutive patients (n = 32) who presented with de novo femoropopliteal artery disease and underwent endovascular therapy using DCB were retrospectively reviewed in a single-center study. Patients were divided into two groups based on whether distal embolism was detected using laser doppler flowmetry (DEL group) or not (non-DEL group). Baseline characteristics and 1-year clinical outcomes were compared between the groups. DEL was found in 44% of limbs (DEL group: n = 15, non-DEL group: n = 19). Below-the-knee arterial runoff ≤ 1 (p = 0.033), popliteal lesion (p = 0.044), ambulation difficulty (p = 0.021), and previous history of coronary artery disease (p = 0.013) were identified as predictive factors of DEL. Procedural factors, reference vessel diameter, lesion length, and total drug amount were not predictive of DEL. The overall target lesion restenosis (TLR) rate was 17.4% (n = 5). The TLR rate was not significantly different between the DEL and non-DEL groups (13.3% vs. 15.8%, p = 0.55). Severe calcification was the only significant factor for TLR (4.2% vs. 40.0%, p = 0.02). Among patients with femoropopliteal disease, there was no difference in 1-year clinical outcome between patients who underwent DEL and those who did not.

Abstract 13743: Prognostic Values of Ratio of Serum Eicosapentaenoic Acid to Arachidonic Acid on Clinical Outcome after Endovascular Therapy in Patients with Peripheral Artery Disease due to Femoropopliteal Artery Lesions

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Keiichi Hishikari ◽  
Shigeki Kimura ◽  
Yosuke Yamakami ◽  
Keisuke Kojima ◽  
Takatoshi Shigeta ◽  
...  
Keyword(s):  
Arachidonic Acid ◽  
Clinical Outcome ◽  
Endovascular Therapy ◽  
Roc Curve ◽  
Curve Analysis ◽  
Peripheral Artery ◽  
Roc Curve Analysis ◽  
Cutoff Value ◽  
Femoropopliteal Artery ◽  
Artery Disease

Background: Peripheral artery disease (PAD) patients have a substantially increased risk of mortality and cardiovascular morbidity than those without PAD. However, risk prediction tools have not been established among patients with PAD to identify who is likely destined for adverse clinical outcome. Eicosapentaenoic acid to arachidonic acid (EPA/AA) ratio has emerged as predictor of mortality endpoints in vascular diseases, especially, coronary artery disease and cerebrovascular disease. In contrast, the prognostic value of EPA/AA ratios in patients with PAD is unclear. We sought to examine whether assessment of serum ratio of EPA/AA in patients with PAD due to femoropopliteal artery lesions can predict clinical outcome after endovascular therapy (EVT). Methods: We obtained serum EPA/AA ratio in 132 consecutive patients with PAD due to femoropopliteal artery lesions before EVT. We analyzed the incidence of major adverse event (MAE) including major adverse limb event (MALE) and any-cause death. The clinical characteristics and laboratory variables were compared and analyzed between MAE group and non-MAE group. Cox regression analyses were used for survival tests. Receiver operating characteristics (ROC) curve analysis was used to determine an optimal cutoff value for EPA/AA ratio to predict MAE after EVT. Results: At a median follow-up of 17 months, MALE occurred in 39 patients (29.5%) and 10 patients (7.6%) died. Significantly lower level of preprocedural serum EPA/AA ratio was observed in the MAE group than non-MAE group. Multivariable Cox analysis showed critical limb ischemia (hazard ratio, 2.93; 95% confidence interval [CI], 1.59-5.40; P = 0.001) and preprocedural serum EPA/AA ratio (hazard ratio, 0.08; 95% CI, 0.02-0.43; P = 0.003) were independent predictors of MAE after EVT. The cutoff value of EPA/AA ratio via ROC curve analysis was 0.29 (66.3% sensitivity, 73.5% specificity). Conclusions: Our findings suggest that lower serum EPA/AA ratio is associated with a greater risk of MALE and any-cause death after EVT in patients with PAD due to femoropopliteal artery lesions.

Three-Year Clinical Outcomes Following Implantation of LifeStent Self-Expanding Nitinol Stents in Patients With Femoropopliteal Artery Lesions

Angiology ◽  
2021 ◽  
pp. 000331972110426
Author(s):  
Michinao Tan ◽  
Mitsuyoshi Takahara ◽  
Yoshimitsu Soga ◽  
Shinsuke Mori ◽  
Taketsugu Tsuchiya ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Outcomes ◽  
Randomized Study ◽  
Vessel Diameter ◽  
Lesion Length ◽  
Total Occlusion ◽  
Femoropopliteal Artery ◽  
Nitinol Stents ◽  
Independent Risk Factors ◽  
Artery Disease

The aim of this study was to evaluate midterm clinical outcomes after implantation of LifeStent self-expanding nitinol stents for the treatment of femoropopliteal lesions. This retrospective, multicenter, non-randomized study examined 260 femoropopliteal lesions in 250 consecutive patients with peripheral artery disease implanted with LifeStents from April 2016 to April 2017. The prevalence of chronic total occlusion (CTO), lesion length ≥25 cm, and distal reference vessel diameter (RVD) <5 mm was 58%, 35%, and 50%, respectively. The 3-year restenosis rate in the overall population was estimated to be 72.9% and a major adverse limb event was observed in 36.9%. Multivariate analysis revealed that chronic limb-threatening ischemia (CLTI) (odds ratio [OR]: 8.04; 95% confidence interval [CI]: 1.86–34.7), CTO (OR: 4.87; 95% CI: 1.43–16.6), lesion length ≥25 cm (OR: 5.95; 95% CI: 1.11–32.0), and distal RVD <5 mm (OR: 4.43; 95% CI: 1.34–14.6) were independent risk factors for 3-year restenosis. The present study demonstrated the midterm clinical outcomes and risk factors for restenosis after implantation of the LifeStent in femoropopliteal artery lesions. CLTI, CTO, lesion length ≥25 cm, and distal RVD <5 mm predicted decreased patency after a 3-year follow-up.

The response of skin perfusion and of rheological and immunological variables to intravenous prostanoid administration in Raynaud’s phenomenon secondary to collagenosis

VASA ◽  
2005 ◽  
Vol 34 (4) ◽  
pp. 243-249 ◽  
Author(s):  
Drinda ◽  
Neumann ◽  
Pöhlmann ◽  
Vogelsang ◽  
Stein ◽  
...  
Keyword(s):  
Laser Doppler Flowmetry ◽  
Raynaud’S Phenomenon ◽  
Raynaud's Phenomenon ◽  
Plasma Viscosity ◽  
Laser Doppler ◽  
Erythrocyte Aggregation ◽  
Control Group ◽  
Long Term Effects ◽  
Doppler Flowmetry

Background: Prostanoids are used in the treatment of Raynaud’s phenomenon and acral perfusion disorders secondary to collagenosis. In subjective terms, intravenous administration of these agents produces success in more than 50% of patients. The therapeutic outcome of clinical administration of alprostadil or iloprost may vary from individual to individual. Patients and methods: The following variables were analysed in a cross-over study in 27 patients with collagenosis and Raynaud’s phenomenon: plasma viscosity and erythrocyte aggregation (rheological variables), partial pressure of oxygen and laser Doppler flowmetry in the finger region, and lymphocyte phenotyping and interleukin (IL) determinations (immunological variables). Results: Laser Doppler flowmetry revealed significant differences between patients with secondary Raynaud’s phenomenon and a control group of 25 healthy subjects. Laser Doppler readings did not change significantly as a result of the treatments. Therapy with iloprost produced a reduction in IL-1beta, L-selectin (CD 62 L) and IL-6. Conclusion: The change in immunological variables due to iloprost may explain the long-term effects of prostaglandins in the treatment of Raynaud’s phenomenon. From our results it is not possible to infer any preference for iloprost or alprostadil.

Microcirculation disorders in patients with vibration disease and comorbidity

2020 ◽  
pp. 672-672
Author(s):  
A. N. Kuks ◽  
N. V. Slivnitsyna
Keyword(s):  
Type 2 Diabetes ◽  
Laser Doppler Flowmetry ◽  
Laser Doppler ◽  
Combined Effects ◽  
Doppler Flowmetry ◽  
Vibration Disease ◽  
History Of

The results of laser Doppler flowmetry in patients with vibration disease associated with the combined effects of local and general vibration with a history of type 2 diabetes are presented.

Peculiarities of microcirculation in periodont tissues in children of key age groups sufficient type 1 diabetes. Part II

2019 ◽  
Vol 24 (2) ◽  
pp. 108-119 ◽  
Author(s):  
B. N. Davydov ◽  
D. A. Domenyuk ◽  
S. V. Dmitrienko
Keyword(s):  
Diabetes Mellitus ◽  
Blood Flow ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Laser Doppler Flowmetry ◽  
Laser Doppler ◽  
Diabetic Microangiopathy ◽  
Healthy Children ◽  
Doppler Flowmetry

Relevance. Morpho-functional changes in peripheral circulation established in type 1 diabetes mellitus correlate with changes in central hemodynamics, allowing the use of microcirculation indicators as diagnostic and prognostic criteria for assessing the degree of functional vascular disorders. Identifcation of microcirculation features of the blood by the method of laser Doppler flowmetry in children with different experience of type 1 diabetes in key age categories.Materials and methods. The study included 67 children with type 1 diabetes mellitus aged 12-15 years with an experience of the disease from six months to ten years. The comparison group consisted of 38 healthy children. The state of the microvasculature was assessed by laser Doppler flowmetry using a laser analyzer for capillary blood flow LAKK-OP.Results. In children with an experience of type 1 diabetes of less than two years, microcirculation disorders in periodontal tissues correspond to the hyperemic form, accompanied by increased perfusion, a decrease in the amplitude of low-frequency oscillations, increased heart rate, high blood flling, and blood flow bypass. For children with an endocrinopathy experience of more than three years, microcirculation disorders correspond to a stagnant form, combined with a decrease in perfusion due to stagnation of blood in the venular link, endothelial domination with suppression of neurogenic and cardiac fluctuations, low efciency and redistribution of blood flow in favor of the nutritive link.Conclusions. With the increase in experience, the degree of compensation of type 1 diabetes, the progression of diabetic microangiopathy, it is advisable to designate two stages of development of microcirculatory disorders. Early – compensatory with active adaptation, including neurogenic and endothelial regulation mechanisms. Late – decompensation with passive adaptation, supporting the effectiveness of microcirculation due to myogenic control of regulation, shunting and increasing the rate of blood outflow.

Laser doppler flowmetry in assessing the effectiveness of treatment of chronic demodex blefaritis

2017 ◽  
Vol 10 (2) ◽  
pp. 62-66 ◽  
Author(s):  
T.N. Safonova ◽  
◽  
N.P. Kintyukhina ◽  
V.V. Sidorov ◽  
O.V. Gladkova ◽  
...  
Keyword(s):  
Laser Doppler Flowmetry ◽  
Laser Doppler ◽  
Doppler Flowmetry
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