scholarly journals The role of percutaneous angioplasty in the management of chronic lower limb ulcers of arterial aetiology

2020 ◽  
Author(s):  
Ηλίας Κεχαγιάς-Αθανασόπουλος
Keyword(s):  
Lower Limb ◽  
Percutaneous Angioplasty ◽  
Chronic Lower Limb Ulcers

Πραγματοποιήθηκε μία μονοκεντρική προοπτική μελέτη παρατήρησης, στην οποία συμπεριελήφθησαν οι ασθενείς που παρουσίασαν ισχαιμικά έλκη κάτω άκρων την περίοδο μεταξύ Ιουνίου 2009 και Ιουνίου 2015. Κριτήρια επιλογής ήταν Σφυροβραχιόνιος Δείκτης (ΣΒΔ) <0,9 ή Δακτυλοβραχιόνιος Δείκτης (ΔΒΔ) <0,7, σε περίπτωση ασυμπίεστων κνημιαίων αγγείων στα σφυρά. Κριτήρια αποκλεισμού ήταν: άρνηση συμμετοχής, άρνηση ενδαγγειακής θεραπείας, απόλυτη αντένδειξη για χρήση ενδοφλεβίου σκιαγραφικού κατά την κρίση του ερευνητή, μη-ελεγχόμενο πρόβλημα πήξεως, άρνηση ή αδυναμία συγκατάθεσης ή επανόδου για επανεξέταση. Η επαναγγείωση πραγματοποιήθηκε ενδαγγειακά όποτε ήταν δυνατόν, κατόπιν της αρχικής εκτίμησης σε όλους τους ασθενείς. Επιπρόσθετα, αποκλείσθηκαν επίσης οι ασθενείς στους οποίους η χειρουργική επαναγγείωση θεωρήθηκε πρώτης γραμμής θεραπεία. Κατά την διάρκεια της περιόδου της μελέτης εξετάσθηκαν 225 ασθενείς με ισχαιμικά έλκη κάτω άκρων. Από αυτούς, 12 ασθενείς αποκλείσθηκαν λόγω διαφόρων αντενδείξεων ενδαγγειακής θεραπείας. Από τους υπόλοιπους 213 ασθενείς, οι 52 είχαν εξαιρετικά απρόσφορη κατανομή, βλαβών για ενδαγγειακή θεραπεία, κατά την εκτίμηση της θεραπευτικής ομάδας, αφήνοντας 161 ασθενείς (76%) οι οποίοι ακολούθησαν ενδαγγειακή θεραπεία. επιπλέον, 17 ασθενείς δεν εμφανίστηκαν στους επανελέγχους και δεν έφθασαν κάποιο τελικό σημείο της μελέτης. Τελικά, 144 ασθενείς μελετήθηκαν, οι 102 εκ των οποίων (71%) παρακολουθήθηκαν για πάνω από 24 μήνες. Τα δεδομένα μας υποστηρίζουν την τεχνική και κλινική επιτυχία της αγγειοπλαστικής στην αντιμετώπιση των ισχαιμικών ελκών των κάτω άκρων, με υψηλά ποσοστά επιτυχίας και διάσωσης μέλους. Η αγγειοπλαστική ήταν τεχνικά επιτυχής και πρόσφορη σε σχεδόν όλους τους ασθενείς με μόνο μία μειονότητα περιπτώσεων απρόσφορη για διαδερμικές τεχνικές λόγω εκτεταμένης και πολύπλοκης κατανομής αθηρωματικών αλλοιώσεων. Μία άλλη σημαντική πτυχή της μελέτης μας ήταν ότι οι περισσότερες βλάβες των ασθενών μας ταξινομήθηκαν ως TASC II τύπου C και D, με 98% και 95% τεχνική επιτυχία αντίστοιχα, ενδεικτικό ότι οι ενδαγγειακές τεχνικές δύναται να πραγματοποιηθούν σε ασθενείς στους οποίους παλαιότερα συνιστάτο χειρουργική θεραπεία.

The role of delayed lower limb embolectomy in patients with late ischemia

Chirurgia ◽  
2020 ◽  
Vol 32 (6) ◽  
Author(s):  
Walid M. Gamal ◽  
Abdrheem F. Mohamed ◽  
Zeniab M. Askary
Keyword(s):  
Lower Limb

scholarly journals The Role of Circulating Biomarkers in Peripheral Arterial Disease

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.

Bilateral asymmetries in professional cyclists during a Grand Tour

2020 ◽  
pp. 1-7
Author(s):  
Alejandro Javaloyes ◽  
Manuel Mateo-March ◽  
Felipe P. Carpes ◽  
Manuel Moya-Ramon ◽  
Raúl Lopez-Grueso ◽  
...  
Keyword(s):  
Injury Prevention ◽  
Intensity Distribution ◽  
Power Output ◽  
Lower Limb ◽  
Overuse Injury ◽  
Power Balance ◽  
Grand Tour ◽  
Race Time ◽  
Potential Link

BACKGROUND: Pedalling asymmetries are a topic of interest to cycling coaches and athletes due to a potential link with performance and injury prevention. OBJECTIVES: The aim of this study is to describe the bilateral asymmetry of professional cyclists during two editions of a Grand Tour. METHODS: Here we set out to determine the power balance (power produced by each lower limb) between stronger and weaker leg (dominant vs. non-dominant) of 12 UCI professional cyclists competing at two Giro d’Italia editions. Power data were recorded during competition stages. Further analysis considered power data clustered into individual intensity zones (from Z1 to Z7). RESULTS: Higher intensity elicited better power balance (lower asymmetry) regardless of the stage profile. Intensity distribution analysed according to the role of the cyclist was lower for climbers in Z2 (p= 0.006) and Z7 (p= 0.002) and higher in Z5 (p= 0.023) compared to team helpers. Power balance ranged from 0 to 9 % across the different athletes. CONCLUSIONS: Increase in power output improves power balance, especially in team helpers, and the lower power balance at lower exercise intensities, which are most of the race time, may elicit significant cumulative loading on a given leg of the cyclists, which requires further attention regarding risks of overuse injury.

scholarly journals Role of adhesion molecules in the induction of restenosis after angioplasty in the lower limb

2006 ◽  
Vol 43 (5) ◽  
pp. 969-977 ◽  
Author(s):  
Peter Heider ◽  
Moritz Georg Wildgruber ◽  
Wolfgang Weiss ◽  
Hermann Jakob Berger ◽  
Eckstein Hans Henning ◽  
...  
Keyword(s):  
Adhesion Molecules ◽  
Lower Limb

Deep dissecting haematoma in patients with dermatoporosis: implications for home nursing

2021 ◽  
Vol 26 (Sup3) ◽  
pp. S6-S13
Author(s):  
Valentina Vanzi ◽  
Elena Toma
Keyword(s):  
Wound Healing ◽  
Emergency Management ◽  
Lower Limb ◽  
Essential Role ◽  
Early Recognition ◽  
Wound Management ◽  
Home Nursing ◽  
High Prevalence ◽  
Clinical Emergency

Dermatoporosis is a chronic cutaneous insufficiency/fragility syndrome with a high prevalence in older adults. Dermatoporotic skin becomes thin and fragile and tends to tear. It may lead to deep dissecting haematomas (DDHs) as a final stage of dermatoporosis, which is a clinical emergency. Management can be challenging, as patients with lower-limb haematomas are frequently older and affected by multiple comorbidities, or are probably on medications that negatively influence wound healing. This article describes the essential role of nurses in prevention, early recognition and wound management of DDHs in patients with dermatoporosis.

scholarly journals ROLE OF COLOUR DOPPLER IN EVALUATION OF ACUTE DEEP VEIN THROMBOSIS OF LOWER LIMB

2019 ◽  
Vol 8 (8) ◽  
pp. 512-516
Author(s):  
Vijay Bahadur Singh ◽  
Punya Pratap Singh ◽  
Rajesh Malik ◽  
Lovely Kaushal ◽  
Vijay Verma ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Lower Limb ◽  
Colour Doppler ◽  
Vein Thrombosis ◽  
Acute Deep Vein Thrombosis ◽  
Deep Vein

Role of ultrasound guided epidural anesthesia for lower limb surgery in children with previously repaired meningomyelocele

2017 ◽  
Vol 28 (3) ◽  
pp. 287-290 ◽  
Author(s):  
Vrushali C. Ponde ◽  
Vinit V. Bedekar ◽  
Dilip Chavan ◽  
Anuya Gursale ◽  
Dipal Shah
Keyword(s):  
Epidural Anesthesia ◽  
Lower Limb ◽  
Ultrasound Guided ◽  
Lower Limb Surgery

The role of intravascular ultrasound in lower limb revascularization in patients with peripheral arterial disease

2017 ◽  
Vol 36 (6) ◽  
Author(s):  
Gregory C. Makris ◽  
Pavlina Chrysafi ◽  
Mark Little ◽  
Rafiuddin Patel ◽  
Mark Bratby ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Intravascular Ultrasound ◽  
Lower Limb ◽  
Arterial Disease ◽  
Peripheral Arterial
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