scholarly journals A Reperfusion BOLD-MRI Tissue Perfusion Protocol Reliably Differentiate Patients with Peripheral Arterial Occlusive Disease from Healthy Controls

2021 ◽  
Vol 10 (16) ◽  
pp. 3643
Author(s):  
Kristina Törngren ◽  
Stefanie Eriksson ◽  
Jonathan Arvidsson ◽  
Mårten Falkenberg ◽  
Åse A. Johnsson ◽  
...  
Keyword(s):  
Lower Limb ◽  
Peripheral Arterial Occlusive Disease ◽  
Reactive Hyperemia ◽  
Tissue Perfusion ◽  
Arterial Occlusive Disease ◽  
Blood Oxygenation ◽  
Occlusive Disease ◽  
Healthy Controls ◽  
Bold Mri ◽  
Peripheral Arterial

There is no established technique that directly quantifies lower limb tissue perfusion. Blood oxygenation level-dependent magnetic resonance imaging (BOLD-MRI) is an MRI technique that can determine skeletal muscle perfusion. BOLD-MRI relies on magnetic differences of oxygenated and deoxygenated hemoglobin, and regional changes in oxy/deoxyhemoglobin ratio can be recorded by T2* weighted MRI sequences. We aimed to test whether BOLD-MRI can differentiate lower limb tissue perfusion in peripheral arterial occlusive disease (PAOD) patients and healthy controls. Twenty-two PAOD patients and ten healthy elderly volunteers underwent lower limb BOLD-MRI. Reactive hyperemia was provoked by transient cuff compression and images of the gastrocnemius and soleus muscles were continuously acquired at rest, during ischemia and reperfusion. Key BOLD parameters were baseline T2* absolute value and time to T2* peak value after cuff deflation (TTP). Correlations between imaging parameters and ankle-brachial index (ABI) was investigated. The mean TTP was considerably prolonged in PAOD patients compared to healthy controls (m. gastrocnemius: 111 ± 46 versus 48 ± 22 s, p = 0.000253; m. soleus: 100 ± 42 versus 41 ± 30 s, p = 0.000216). Both gastrocnemius and soleus TTP values correlated strongly with ABI (−0.82 and −0.78, p < 0.01). BOLD-MRI during reactive hyperemia differentiated most PAOD patients from healthy controls. TTP was the most decisive parameter and strongly correlated with the ABI.

scholarly journals Extra anatomical bypass grafting for limb salvage: a case report

2017 ◽  
Vol 4 (9) ◽  
pp. 3146
Author(s):  
R. Muralidhar ◽  
Suraj Muralidhar
Keyword(s):  
Case Report ◽  
Lower Limb ◽  
Peripheral Arterial Occlusive Disease ◽  
Lower Extremities ◽  
Arterial Occlusive Disease ◽  
Occlusive Disease ◽  
Bypass Grafting ◽  
Vascular Bed ◽  
Risk Patients ◽  
Peripheral Arterial

Extra-anatomical bypass grafting is a recognised method of lower limb re-vascularisation in high-risk patients who cannot tolerate aortic cross clamping, or in those with a hostile abdomen1.  Extra-anatomic bypasses are surgical arterial bypass procedures that circumvent the “normal” anatomical pathways. While such procedures can be performed in any vascular bed, the term most frequently is used to describe those bypasses that reroute blood to the lower extremities, avoiding intracavitary procedures3. Initially introduced as alternative revascularization methods in the treatment of peripheral arterial occlusive disease and as techniques for bringing blood back to the lower extremities. Here, we present you a case of Peripheral Arterial Occlusive Disease where an Axillo-Femoral bypass was done.

scholarly journals Factors influencing quality of life following lower limb amputation for peripheral arterial occlusive disease: A systematic review of the literature

2017 ◽  
Vol 41 (6) ◽  
pp. 537-547 ◽  
Author(s):  
Fiona Davie-Smith ◽  
Elaine Coulter ◽  
Brian Kennon ◽  
Sally Wyke ◽  
Lorna Paul
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Lower Limb ◽  
Peripheral Arterial Occlusive Disease ◽  
Arterial Occlusive Disease ◽  
Occlusive Disease ◽  
Lower Limb Amputation ◽  
Limb Amputation ◽  
Peripheral Arterial

Background: The majority of lower limb amputations are undertaken in people with peripheral arterial occlusive disease, and approximately 50% have diabetes. Quality of life is an important outcome in lower limb amputations; little is known about what influences it, and therefore how to improve it. Objectives: The aim of this systematic review was to identify the factors that influence quality of life after lower limb amputation for peripheral arterial occlusive disease. Methods: MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Science and Cochrane databases were searched to identify articles that quantitatively measured quality of life in those with a lower limb amputation for peripheral arterial occlusive disease. Articles were quality assessed by two assessors, evidence tables summarised each article and a narrative synthesis was performed. Study design: Systematic review. Results: Twelve articles were included. Study designs and outcome measures used varied. Quality assessment scores ranged from 36% to 92%. The ability to walk successfully with a prosthesis had the greatest positive impact on quality of life. A trans-femoral amputation was negatively associated with quality of life due to increased difficulty in walking with a prosthesis. Other factors such as older age, being male, longer time since amputation, level of social support and presence of diabetes also negatively affected quality of life. Conclusion: Being able to walk with a prosthesis is of primary importance to improve quality of life for people with lower limb amputation due to peripheral arterial occlusive disease. To further understand and improve the quality of life of this population, there is a need for more prospective longitudinal studies, with a standardised outcome measure. Clinical relevance This is of clinical relevance to those who are involved in the rehabilitation of persons with lower limb amputations. Improved quality of life is associated with successful prosthetic use and focus should be directed toward achieving this.

Severe severe psychological repulsion reaction in patient with PAD resulted in natural lower extremity mummification

VASA ◽  
2009 ◽  
Vol 38 (3) ◽  
pp. 272-274
Author(s):  
Stanisic ◽  
Brzezinski ◽  
Winckiewicz
Keyword(s):  
Case Report ◽  
Lower Extremity ◽  
Critical Limb Ischemia ◽  
Lower Limb ◽  
Peripheral Arterial Occlusive Disease ◽  
Limb Ischemia ◽  
Developed Countries ◽  
Arterial Occlusive Disease ◽  
Occlusive Disease ◽  
Peripheral Arterial

This case report describes the very uncommon event of mummification of the lower limb occurring naturally in a patient with peripheral arterial occlusive disease aggravated by severe reactive aversion and serves as a warning that this can happen in cases of untreated advanced critical limb ischemia even in well developed countries.

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