scholarly journals Comparison of Digital Subtraction Angiography Combined Arterial Thrombectomy Versus Simple Arterial Thrombectomy in the Treatment of Acute Lower Limb Ischemia

2021 ◽  
Author(s):  
Hongwei Ge ◽  
Bin Song ◽  
Xin Wang ◽  
Yunfeng Zhu ◽  
Yiming Huang ◽  
...  
Keyword(s):  
Blood Flow ◽  
Success Rate ◽  
Digital Subtraction Angiography ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Digital Subtraction ◽  
Lower Limb Ischemia ◽  
Primary Surgery ◽  
Group A ◽  
Group B

Abstract Background: This study aimed to compare the clinical efficacy of digital subtraction angiography (DSA) combined arterial thrombectomy versus simple arterial thrombectomy in the treatment of acute lower limb ischemia (ALI). Methods: This retrospective cohort study collected the clinical data from 125 patients (129 affected lower limbs) with ALI who underwent emergency surgery from March 2010 to November 2019. Patients were consecutively divided into Group A and Group B. Patients in Group A underwent simple arterial thrombectomy via the Fogarty catheterization. Patients in Group B underwent arterial thrombectomy, and the DSA was performed during the surgery. The differences in the success rate of primary surgery, the second intervention rate, and the amputation/mortality rate within 30-d after surgery were compared. Results: In Group A, 4 of 70 limbs (5.7%) were amputated, 54 of 70 limbs (77.1%) had improved blood flow, 14 of 70 limbs (20.0%) received a second intervention, and 3 of 68 patients (4.4%) died within 30 d. In Group B, 1 of 59 limbs (1.7%) was amputated, 56 of 59 limbs (94.9%) had improved blood flow, 3 of 59 limbs (5.1%) received a second intervention, and 2 of 57 patients (3.5%) died within 30-d. The success rate of primary surgery, the second intervention rate, and the amputation rate of Group B were significantly lower than Group A (P<0.05). Conclusion: Arterial thrombectomy combined with DSA may effectively improve the clinical efficacy of patients with ALI.

scholarly journals Comparison of digital subtraction angiography combined arterial thrombectomy versus simple arterial thrombectomy in the treatment of acute lower limb ischemia

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hongwei Ge ◽  
Bin Song ◽  
Xin Wang ◽  
Yunfeng Zhu ◽  
Yiming Huang ◽  
...  
Keyword(s):  
Blood Flow ◽  
Success Rate ◽  
Digital Subtraction Angiography ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Digital Subtraction ◽  
Lower Limb Ischemia ◽  
Primary Surgery ◽  
Group A ◽  
Group B

Abstract Background This study aimed to compare the clinical efficacy of digital subtraction angiography (DSA) combined arterial thrombectomy versus simple arterial thrombectomy in the treatment of acute lower limb ischemia (ALI). Methods This retrospective cohort study collected the clinical data from 124 patients (128 affected lower limbs) with ALI who underwent emergency surgery from March 2010 to November 2019. Patients were consecutively divided into Group A and Group B. Patients in Group A underwent simple arterial thrombectomy via the Fogarty catheterization. Patients in Group B underwent arterial thrombectomy, and the DSA was performed during the surgery. The differences in the success rate of primary surgery, the second intervention rate, and the amputation/mortality rate within 30-days after surgery were compared. Results In Group A, 4 of 70 limbs (5.7%) were amputated, 54 of 70 limbs (77.1%) had improved blood flow, 14 of 70 limbs (20.0%) received a second intervention, and 3 of 68 patients (4.4%) died within 30 days. In Group B, 1 of 58 limbs (1.7%) was amputated, 56 of 58 limbs (96.6%) had improved blood flow, 3 of 58 limbs (5.2%) received a second intervention, and 2 of 56 patients (3.5%) died within 30-days. The success rate of primary surgery, the second intervention rate, and the amputation rate of Group B were significantly lower than Group A (P < 0.05). Conclusion Arterial thrombectomy combined with DSA may effectively improve the clinical efficacy of patients with ALI.

Comparison Between Computed Tomography Angiography and Digital Subtraction Angiography in Critical Lower Limb Ischemia

2019 ◽  
Vol 15 (5) ◽  
pp. 496-503 ◽  
Author(s):  
Hesham Ebrahim Ahmed Al-rudaini ◽  
Ping Han ◽  
Huimin Liang
Keyword(s):  
Digital Subtraction Angiography ◽  
Ct Angiography ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Definitive Treatment ◽  
Digital Subtraction ◽  
Arterial Tree ◽  
Lower Limb Ischemia ◽  
Significant Difference ◽  
Peripheral Arterial

Background:CT Angiography (CTA) of aortoiliac and lower extremity arteries is a relatively recent innovation of CT imaging that has changed after the introduction of multi-detector row scanners.Objective:The study aimed to evaluate the diagnostic accuracy of Multidetector Computed Tomographic Angiography (MDCTA) in the assessment of arterial tree in patients with Peripheral Arterial Occlusive Disease (PAOD), as compared to Digital Subtraction Angiography (DSA).Methods:A single-center nonrandomized prospective study was conducted on 50 patients complaining of peripheral arterial disease (chronic stage) from February 2017 to October 2017. All the patients were exposed to DSA and CTA prior to definitive treatment. The images were then analyzed using maximum intensity projection, volume-rendered, and curved multiplane reformation techniques.Results:All the patients involved in this study were susceptible according to their clinical presentation. The statistical analysis exposed a highly significant difference between CTA and DSA in the assessment of stenosis at the level of Femoropopliteal segment (P<0.01), while for infrapopliteal segment, there was no statistically significant difference between CTA and DSA having 8% versus 14% insignificant stenosis and 62% versus 47% significant stenosis in CTA and DSA, respectively. The overall accuracy of CT angiography in the femoropopliteal segments was 95.20% while in the infrapopliteal segment it was 94.5%.Conclusion:Multidetector CT angiography was found to be a reliable alternative mean for pathoanatomical description of the arterial lesions in critical lower limb ischemia and its subsequent management in comparison to digital subtraction angiography.

scholarly journals Quality of life assessment in patients with acute limb ishemia

2020 ◽  
Vol 23 (2) ◽  
pp. 15-18
Author(s):  
Gennady V. Sinyavin ◽  
Aleksandr N. Kosenkov ◽  
Ivan A. Vinоkurоv ◽  
Gevorg V. Mnatsakanjan ◽  
Sanija N. Odinokova ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Blood Flow ◽  
Lower Limb ◽  
Short Form ◽  
Surgical Care ◽  
Limb Ischemia ◽  
Life Assessment ◽  
Quality Of Life Assessment ◽  
Lower Limb Ischemia

Background. In conditions of permanent progress in the quality of surgical care in various areas of surgery, it is very important to allow patients themselves to evaluate provided treatment. Aims: this paper analyzes the quality of life in individuals with acute lower limb ischemia who have undergone lower limb revascularization surgery. Materials and methods. An assessment of the quality of life of 122 patients with acute lower limb ischemia (ALI) of II degree who were treated at the Moscow Сity Сlinical Hospital оf S.S. Yudin from 2016 to 2018 (average age 72.1 14.7 years) was performed. The quality of life was assessed using the medical Outcomes Study-Short Form (MOS SF-36) quality of life assessment methodology. Results. When assessing the quality of life of patients, it was found that the psychological and physical components of patients health are significantly affected by the angiotropic effect of the affecting factor associated with the presence of diabetes mellitus. 1 month after surgical restoration of blood flow against the background of the initial embolism, 83.6% of the respondents who did not suffer from diabetes noted a persistent improvement in their General condition and quality of life. Conclusion. This method of assessing the quality of life after surgical restoration of blood flow in patients with acute lower limb ischemia can be used in angiosurgical practice and clearly reflects of patient satisfaction with the treatment.

Organ dysfunction after blood flow restoration in patients with acute lower limb ischemia

2019 ◽  
Vol 12 (5) ◽  
pp. 477
Author(s):  
Yu. V. Belov ◽  
G. V. Sinyavin ◽  
I. A. Vinokurov ◽  
G. V. Mnatsakanyan
Keyword(s):  
Blood Flow ◽  
Organ Dysfunction ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Lower Limb Ischemia ◽  
Flow Restoration

scholarly journals Outcome of Early Surgical Intervention in Acute Lower Limb Ischemia due to Thromboembolism

2014 ◽  
Vol 7 (1) ◽  
pp. 38-43
Author(s):  
QA Azad ◽  
NAK Ahsan ◽  
AM Asif Rahim ◽  
SAN Alam ◽  
M Rahman
Keyword(s):  
Lower Limb ◽  
Surgical Intervention ◽  
Limb Ischemia ◽  
Artery Occlusion ◽  
Arterial Embolism ◽  
Vascular Flow ◽  
Femoral Artery Occlusion ◽  
Group A ◽  
Group B ◽  
Early Surgical Intervention

Background: Acute lower extremity ischemia is a common vascular disease and considered limb- and life- threatening. The present study evaluated and compared the outcome of early and late surgical intervention in acute lower limb ischemia due to thromboembolism. Methodology: This non randomized comparative parallel study was conducted at the Department of Cardiovascular Surgery, NICVD, Dhaka, Bangladesh from January 2007 to December 2008 for duration of two year. Total 80 patients were enrolled in this study. The patients were divided into equal two groups, Group A, for early surgical intervention (with in 24 hours) and Group B, late surgical intervention (more than 24 hours). Results: Mean (±SD) age of both Group A and Group B was 51.93 (±11.73) and 47.00 (± 11.01) years. Male and female ratio of the total study population was 1.76:1 Pain and absence of pulse distal to occlusion was common for all. Cold extremity, sensory deficit, motor deficit, diminish vascular flow was the commonest findings of both group. In Group A, 57.5% had superficial femoral artery occlusion, 22.5% had iliac artery and 20.0% popliteal artery occlusion. In Group B, 42.5% had superficial femoral artery occlusion, 32.5% had popliteal artery occlusion and 25.0% had iliac artery occlusion. Fasciotomy was performed in 15.0% patients of Group A and in 22.0% patients of Group B. After Fogarty embolectomy in group A and group B had warm extremity (80.0% vs. 65.0%), pulsation distal to occlusion (90.0% vs. 75.0%), intact sensory function (82.5% vs. 67.5%), intact motor function (80.0% vs. 65.0%), and normal vascular flow by Doppler US (80.0% vs. 65.0%). During postoperative period history of bleeding, infection, reperfusion injury, muscle necrosis and limb amputation were 12.5% vs. 10.0%, 5.0% and 7.5%, 17.5% vs. 35.0%, 15.0% vs. 12.5% and 37.5% vs. 32.5% respectively. Conclusion: Duration of embolism may be the significant factor determining the outcomes of the management of acute arterial embolism in the lower extremities. The 24- hour duration of arterial embolism is a crucial factor influencing the surgical the management and early diagnosis and shifting of patients to specified centre as early as possible to save limb as well as life. DOI: http://dx.doi.org/10.3329/cardio.v7i1.20799 Cardiovasc. j. 2014; 7(1): 38-43

Is initial success of thrombolytic therapy with rt-PA in patients with lower limb ischemia durable? A long-term follow-up series

VASA ◽  
2007 ◽  
Vol 36 (2) ◽  
pp. 114-120 ◽  
Author(s):  
Geier ◽  
Mumme ◽  
Köster ◽  
Marpe ◽  
Hummel ◽  
...  
Keyword(s):  
Thrombolytic Therapy ◽  
Success Rate ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Long Term Results ◽  
Bleeding Complications ◽  
Acute Ischemia ◽  
Lower Limb Ischemia

Background: Catheter-directed intraarterial thrombolytic therapy with rt-PA has been established as an alternative to surgery in selected patients with lower limb ischemia. The purpose of this study is to evaluate its long-term results and to try to identify patient variables influencing outcome. Patients and methods: The results of thrombolytic treatment for acute or subacute lower limb ischemia in 82 patients (51 male, 31 female) were retrospectively analysed. Clinical data (time of symptoms onset, clinical stage, type of affected vessel, anatomical localisation) as well as comorbidities were recorded. The success rate of thrombolysis as well as the incidence of adverse events was evaluated. Patients with initial success were followed up after a median of 52,5 months. Results: Thrombolytic therapy was successful in 67 cases (82%). An additional endovascular or surgical procedure was necessary in 39 of these patients (48%). The overall bleeding rate was 18% and the mortality and major amputation rate was 1%. 42 patients with early clinical success were available for follow-up. 34 of them (81%) were free of ischemic symptoms and the overall limb salvage rate was 96%. We could not identify factors significantly influencing early or long-term results, although there was a trend towards better results in patients with acute ischemia and in patients with occluded native arteries. Conclusions: Intraarterial local thrombolytic therapy has a relatively high initial success rate in selected patients with lower limb ischemia, but is associated with a significant number of bleeding complications. Furthermore, additional procedures are required in almost half the patients. Initial success is durable at the long-term in the majority of cases. Better selection of patients and refinements of the thrombolytic therapy might help to further improve results and lower the bleeding complications.

Role of Cilostazol in Rats with Diabetic Lower Limb Ischemia and Its Influences on Changes in Matrix Metallopeptidase-9 and Matrix Metalloproteinase-8

2020 ◽  
Vol 10 (3) ◽  
pp. 402-407
Author(s):  
Yao Tang ◽  
Jian Huang ◽  
Liming Shen ◽  
Zhanao Liu ◽  
Dayong Zhou
Keyword(s):  
Blood Flow ◽  
Smooth Muscle ◽  
Smooth Muscle Cells ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Vascular Wall ◽  
Normal Group ◽  
The Other ◽  
Model Group ◽  
Lower Limb Ischemia

Objective: To assess cilostazol’s effect on rats with diabetic lower limb ischemia. Methods: 36 Sprague-Dawley rats were randomly separated into normal group (n = 12), model group (n = 12) and cilostazol group (n = 12). The model of diabetic lower limb ischemia was prepared and normal saline was intraperitoneally injected postoperatively into model group. Besides, cilostazol was administrated through intraperitoneal injection after establishment of model in cilostazol group. After intervention for 6 weeks, doppler blood flow imager was employed to detect blood flow, and the expressions of MMP-8 and MMP-9 were assessed via immunohistochemistry, western blotting or quantitative polymerase chain reaction (qPCR). TUNEL assay was performed to evaluate cell apop-tosis. Results: Doppler blood flow imager showed that compared with normal group, perfusion unit (PU) index was significantly reduced in the other two groups (P < 0.05) with higher value in cilosta-zol group (P < 0.05). The immunohistochemistry results revealed that in comparison with those in normal group, MMP-8 and MMP-9 positive staining was significantly elevated in the other two groups (P < 0.05) with higher level in cilostazol group than model group. In addition, MMP-8 and MMP-9 expressions were significantly elevated in other two groups (P < 0.05), with higher level in cilostazol group (P < 0.05). Moreover, the vascular wall smooth muscle cells in the other two groups had a significantly elevated apoptosis rate (P < 0.05) with higher apoptosis in cilostazol group (P < 0.05). Conclusion: Cilostazol up-regulates MMP-8 and MMP-9 to increase the apoptosis of vascular wall smooth muscle cells, thereby improving the blood flow in rats with diabetic lower limb ischemia.

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