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.

Role of Surgical Options for Critical Lower Limb Ischemia

2012 ◽  
pp. 767-775
Author(s):  
Frank J. Veith ◽  
Neal S. Cayne ◽  
Nicholas J. Gargiulo ◽  
Evan C. Lipsitz ◽  
Enrico Ascher
Keyword(s):  
Lower Limb ◽  
Limb Ischemia ◽  
Lower Limb Ischemia ◽  
Surgical Options

scholarly journals The role of hypoxia-inducible factorin the syndrome of chronic lower limb ischemia and influence of diabetes mellitus on process of angiogenesis

2017 ◽  
Vol 16 (3) ◽  
pp. 4-9 ◽  
Author(s):  
M. N. Kudykin ◽  
V. V. Beschastnov ◽  
R. A. Deryabin ◽  
G. E. Sheiko ◽  
L. M. Celousova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Lower Limb ◽  
Hypoxia Inducible Factor ◽  
Limb Ischemia ◽  
Peripheral Artery ◽  
Lower Limb Ischemia ◽  
Cell Responses ◽  
Patients With Diabetes ◽  
Artery Disease

In this review, we pay attention to the role of the hypoxia-inducible factor (HIF) in the development of response of the organism to hypoxia. Special attention is given to the regulation of the cell responses to hypoxia in chronic peripheral artery disease in patients with diabetes mellitus (DM). Cells can survive by activation of a transcription of genes, involved in angiogenesis, glucose metabolism and cell proliferation. Artificial rising of concentration and activity of HIF stimulates an angiogenesis and improves ulcers healing of the lower extremities. The data of the literature are provided on the possible methods of increasing HIF concentration in tissues, which could be a new way to stimulate wound healing in the patients with DM.

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