scholarly journals Factors Affecting Patency of Subintimal Infrainguinal Angioplasty in Patients with Critical Lower Limb Ischemia

2006 ◽  
Vol 32 (6) ◽  
pp. 668-674 ◽  
Author(s):  
A.M. Lazaris ◽  
C. Salas ◽  
A.C. Tsiamis ◽  
P.A. Vlachou ◽  
A. Bolia ◽  
...  
Keyword(s):  
Lower Limb ◽  
Limb Ischemia ◽  
Lower Limb Ischemia ◽  
Factors Affecting

scholarly journals Contemporary Management of Acute Lower Limb Ischemia: Determinants of Treatment Choice

2020 ◽  
Vol 9 (5) ◽  
pp. 1501
Author(s):  
Aleksander Lukasiewicz
Keyword(s):  
Lower Limb ◽  
Limb Ischemia ◽  
Lower Limb Ischemia ◽  
Factors Affecting ◽  
Tibial Arteries ◽  
Contemporary Management ◽  
Active Cancer ◽  
Selection Of ◽  
Concurrent Cancer

The role of endovascular procedures in the treatment of acute lower limb ischemia (ALI) is expanding. For treatment, the choice between surgical or endovascular is still debated. The aim of this study was to identify factors that determine the selection of treatment. This study included 307 ALI patients (209 with thrombosis). Patient details, factors affecting the procedure choice, and outcomes were analyzed. The majority of patients were operated on (52.4%). Surgery was more frequent in embolic patients with embolus (odds ratio (OR) 33.85; 95% confidence interval (CI) 6.22–184.19, p < 0.0001), severe ischemia (OR 1.79; 95% CI 1.2–2.66, p = 0.0041), and active cancer (OR 4.99; 95% CI 1.26–19.72, p = 0.02). Tibial arteries involvement was negatively related to surgery (OR 0.25; 95% CI 0.06–0.95, p = 0.04). The complications and amputation rates were comparable. Reinterventions were more common in the endovascular group (19 (20.2%) vs. 17 (8.9%), p = 0.007). The six-month mortality was higher in the operated patients (12.6% vs. 3.2%, respectively, p = 0.001). The determinants of the treatment path are ischemia severity, concurrent cancer, embolus, and peripheral lesion location. Modification of the Rutherford acute lower limb ischemia classification is required to improve the decision-making in patients with profound ischemia.

Cardiac troponin I in patients with acute upper and lower limb ischemia

VASA ◽  
2008 ◽  
Vol 37 (4) ◽  
pp. 327-332 ◽  
Author(s):  
Koutouzis ◽  
Sfyroeras ◽  
Moulakakis ◽  
Kontaras ◽  
Nikolaou ◽  
...  
Keyword(s):  
Upper Limb ◽  
Lower Limb ◽  
Cardiac Troponin ◽  
Cardiac Involvement ◽  
Troponin I ◽  
Limb Ischemia ◽  
Elevated Troponin ◽  
Troponin Elevation ◽  
Lower Limb Ischemia ◽  
Ischemia Group

Background: The aim of this study was to investigate the presence, etiology and clinical significance of elevated troponin I in patients with acute upper or lower limb ischemia. The high sensitivity and specificity of cardiac troponin for the diagnosis of myocardial cell damage suggested a significant role for troponin in the patients investigated for this condition. The initial enthusiasm for the diagnostic potential of troponin was limited by the discovery that elevated cardiac troponin levels are also observed in conditions other than acute myocardial infarction, even conditions without obvious cardiac involvement. Patients and Methods: 71 consecutive patients participated in this study. 31 (44%) of them were men and mean age was 75.4 ± 10.3 years (range 44–92 years). 60 (85%) patients had acute lower limb ischemia and the remaining (11; 15%) had acute upper limb ischemia. Serial creatine kinase (CK), isoenzyme MB (CK-MB) and troponin I measurements were performed in all patients. Results: 33 (46%) patients had elevated peak troponin I (> 0.2 ng/ml) levels, all from the lower limb ischemia group (33/60 vs. 0/11 from the acute upper limb ischemia group; p = 0.04). Patients with lower limb ischemia had higher peak troponin I values than patients with upper limb ischemia (0.97 ± 2.3 [range 0.01–12.1] ng/ml vs. 0.04 ± 0.04 [0.01–0.14] ng/ml respectively; p = 0.003), higher peak CK values (2504 ± 7409 [range 42–45 940] U/ml vs. 340 ± 775 [range 34–2403] U/ml, p = 0.002, respectively, in the two groups) and peak CK-MB values (59.4 ± 84.5 [range 12–480] U/ml vs. 21.2 ± 9.1 [range 12–39] U/ml, respectively, in the two groups; p = 0.04). Peak cardiac troponin I levels were correlated with peak CK and CK-MB values. Conclusions: Patients with lower limb ischemia often have elevated troponin I without a primary cardiac source; this was not observed in patients presenting with acute upper limb ischemia. It is very important for these critically ill patients to focus on the main problem of acute limb ischemia and to attempt to treat the patient rather than the troponin elevation per se. Cardiac troponin elevation should not prevent physicians from providing immediate treatment for limb ischaemia to these patients, espescially when signs, symptoms and electrocardiographic findings preclude acute cardiac involvement.

Acute limb ischemia in a patient with pre-fibrotic myelofibrosis complicated by heparin-induced thrombocytopenia and thrombosis – case report and systematic review of dabigatran use

VASA ◽  
2020 ◽  
pp. 1-6 ◽  
Author(s):  
Marina Di Pilla ◽  
Stefano Barco ◽  
Clara Sacco ◽  
Giovanni Barosi ◽  
Corrado Lodigiani
Keyword(s):  
Systematic Review ◽  
Case Report ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Acute Limb Ischemia ◽  
Review Of The Literature ◽  
Heparin Induced Thrombocytopenia ◽  
Lower Limb Ischemia ◽  
Vein Thrombosis ◽  
Left Lower Limb

Summary: A 49-year-old man was diagnosed with pre-fibrotic myelofibrosis after acute left lower-limb ischemia requiring amputation and portal vein thrombosis. After surgery he developed heparin-induced thrombocytopenia (HIT) with venous thromboembolism, successfully treated with argatroban followed by dabigatran. Our systematic review of the literature supports the use of dabigatran for suspected HIT.

Giant cell arteriitis in critical bilateral lower limb ischemia

VASA ◽  
2013 ◽  
Vol 42 (5) ◽  
pp. 375-378 ◽  
Author(s):  
Magdalena Chudala ◽  
Katarzyna Drozdz ◽  
Pawel Gac ◽  
Tomasz Kuniej ◽  
Bozena Sapian-Raczkowska ◽  
...  
Keyword(s):  
Giant Cell ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Lower Limb Ischemia ◽  
Bilateral Lower Limb

Lower limb ischemia, the cause arising from difficult healing wounds – a case report

Leczenie Ran ◽  
2015 ◽  
Vol 12 (2) ◽  
pp. 59-67
Author(s):  
Paulina Mościcka ◽  
Maria T. Szewczyk ◽  
Elżbieta Hancke ◽  
Justyna Cwajda-Białasik ◽  
Paweł Wierzchowski ◽  
...  
Keyword(s):  
Case Report ◽  
Lower Limb ◽  
Limb Ischemia ◽  
Lower Limb Ischemia ◽  
Healing Wounds

Potential Benefits From Heating the High-Dose rtPA Boluses Used in Catheter-Directed Thrombolysis for Acute/Subacute Lower Limb Ischemia

2003 ◽  
Vol 10 (4) ◽  
pp. 739-744 ◽  
Author(s):  
Dimitrios K. Tsetis ◽  
Asterios N. Katsamouris ◽  
Athanasios D. Giannoukas ◽  
Adam A. Hatzidakis ◽  
Theodoros Kostas ◽  
...  
Keyword(s):  
Lower Limb ◽  
Limb Ischemia ◽  
High Dose ◽  
Lower Limb Ischemia ◽  
Catheter Directed Thrombolysis ◽  
Potential Benefits

Regional thrombolysis in case of acute lower limb ischemia

2018 ◽  
Vol 16 (7(part 2)) ◽  
pp. 55-58
Author(s):  
A. V. Maksimov ◽  
◽  
E. A. Gaysina ◽  
R. M. Nuretdinov ◽  
◽  
...  
Keyword(s):  
Lower Limb ◽  
Limb Ischemia ◽  
Lower Limb Ischemia
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