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Journal articles on the topic 'Chronic limb-threatening ischaemia'

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Author: Grafiati
Published: 10 December 2022
Last updated: 28 January 2023

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1

Conte, M. S., and A. Farber. "Revascularization for chronic limb-threatening ischaemia." British Journal of Surgery 102, no. 9 (June 17, 2015): 1007–9. http://dx.doi.org/10.1002/bjs.9848.

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2

Ricco, Jean-Baptiste, Joseph L. Mills, and Philippe Kolh. "Chronic Limb Threatening Ischaemia: Hits and Misses." European Journal of Vascular and Endovascular Surgery 60, no. 5 (November 2020): 643–44. http://dx.doi.org/10.1016/j.ejvs.2020.08.029.

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3

Hali, Fouzia, Imane Khrichfa, Kenza Baline, Farida Marnissi, Nisrine Bennani, Oussama Eladaoui, Mohammed Rafai, Mohamed Elfatimi, and Soumia Chiheb. "Chronic limb-threatening ischaemia revealing a periarteritis nodosa." Sang thrombose vaisseaux 32, no. 2 (April 2020): 74–77. http://dx.doi.org/10.1684/stv.2020.1110.

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4

Twine, Christopher P. "Chronic Limb Threatening Ischaemia in Octogenarians: Intervention or Palliation?" European Journal of Vascular and Endovascular Surgery 60, no. 2 (August 2020): 242. http://dx.doi.org/10.1016/j.ejvs.2020.03.047.

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5

Omar Mohamed Ozaal, AM, and Thanoj Fernando. "Deep vein thrombosis in an elderly patient with chronic limb-threatening ischaemia presented with limb swelling: The role of diagnostic tools and surgical dilemma." SAGE Open Medical Case Reports 10 (January 2022): 2050313X2210891. http://dx.doi.org/10.1177/2050313x221089121.

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Leg and foot swelling is inherently found in 70% of patients with critical limb-threatening ischaemia due to ischaemia, which does not necessitate any specific intervention. Unilateral leg swelling is a vital sign for the clinical suspicion and diagnosis of deep vein thrombosis and phlegmasia. There is a significant surgical dilemma to delay the diagnosis of deep vein thrombosis or phlegmasia in patients with critical limb-threatening ischaemia when a methodical approach is not followed. We report a case of proximal deep vein thrombosis in an elderly patient with ipsilateral critical limb-threatening ischaemia and discuss the role of diagnostic tools. The role of antiplatelets along with vitamin K antagonists, duration of anticoagulation, iliocaval venous obstruction, compression therapy and inferior vena cava filter is discussed.
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6

Monaro, Susan, Sandra West, and Janice Gullick. "The body with chronic limb‐threatening ischaemia: A phenomenologically derived understanding." Journal of Clinical Nursing 29, no. 7-8 (February 3, 2020): 1276–89. http://dx.doi.org/10.1111/jocn.15151.

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7

Lindholt, J. S., I. Cassimjee, T. T. Monareng, and A. T. O. Abdool-Carrim. "New vascular guidelines for treating acute and chronic limb-threatening ischaemia." British Journal of Surgery 107, no. 3 (January 23, 2020): 165–66. http://dx.doi.org/10.1002/bjs.11470.

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8

DAWSON, I., and J. VANBOCKEL. "Late reoperative surgery after infrainguinal bypass surgery for chronic limb-threatening ischaemia." Cardiovascular Surgery 3 (September 1995): 113. http://dx.doi.org/10.1016/0967-2109(95)94290-d.

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9

Verwer, Maarten C., Joep G. J. Wijnand, Martin Teraa, Marianne C. Verhaar, and Gert J. de Borst. "Long Term Survival and Limb Salvage in Patients With Non-Revascularisable Chronic Limb Threatening Ischaemia." European Journal of Vascular and Endovascular Surgery 62, no. 2 (August 2021): 225–32. http://dx.doi.org/10.1016/j.ejvs.2021.04.003.

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10

Miyata, T., S. Mii, H. Kumamaru, A. Takahashi, H. Miyata, K. Shigematsu, N. Azuma, et al. "Risk prediction model for early outcomes of revascularization for chronic limb-threatening ischaemia." British Journal of Surgery 108, no. 8 (March 6, 2021): 941–50. http://dx.doi.org/10.1093/bjs/znab036.

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Abstract Background Quantifying the risks and benefits of revascularization for chronic limb-threatening ischaemia (CLTI) is important. The aim of this study was to create a risk prediction model for treatment outcomes 30 days after revascularization in patients with CLTI. Methods Consecutive patients with CLTI who had undergone revascularization between 2013 and 2016 were collected from the JAPAN Critical Limb Ischemia Database (JCLIMB). The cohort was divided into a development and a validation cohort. In the development cohort, multivariable risk models were constructed to predict major amputation and/or death and major adverse limb events using least absolute shrinkage and selection operator logistic regression. This developed model was applied to the validation cohort and its performance was evaluated using c-statistic and calibration plots. Results Some 2906 patients were included in the analysis. The major amputation and/or mortality rate within 30 days of arterial reconstruction was 5.0 per cent (144 of 2906), and strong predictors were abnormal white blood cell count, emergency procedure, congestive heart failure, body temperature of 38°C or above, and hemodialysis. Conversely, moderate, low or no risk in the Geriatric Nutritional Risk Index (GNRI) and ambulatory status were associated with improved results. The c-statistic value was 0.82 with high prediction accuracy. The rate of major adverse limb events was 6.4 per cent (185 of 2906), and strong predictors were abnormal white blood cell count and body temperature of 38°C or above. Moderate, low or no risk in the GNRI, and age greater than 84 years were associated with improved results. The c-statistic value was 0.79, with high prediction accuracy. Conclusion This risk prediction model can help in deciding on the treatment strategy in patients with CLTI and serve as an index for evaluating the quality of each medical facility.
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11

Chaudhuri, Arindam, and Ramita Dey. "Chronic Limb-Threatening Ischaemia with Aortic Saddle Embolus Treated by Percutaneous Mechanical Thrombectomy." European Journal of Vascular and Endovascular Surgery 59, no. 4 (April 2020): 634. http://dx.doi.org/10.1016/j.ejvs.2019.12.021.

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12

Shan, L. L., L. S. Yang, M. Tew, M. J. Westcott, T. D. Spelman, P. F. Choong, and A. H. Davies. "Quality of Life in Chronic Limb Threatening Ischaemia: Systematic Review and Meta-Analysis." Journal of Vascular Surgery 77, no. 2 (February 2023): 661–62. http://dx.doi.org/10.1016/j.jvs.2022.11.059.

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13

Katelnitsky, I. I., V. V. Darvin, and A. A. Zorkin. "Comprehensive treatment of patients with chronic limb-threatening ischaemia: are we using all the possibilities of anticoagulant therapy?" Russian Medical Inquiry 4, no. 7 (2020): 445–51. http://dx.doi.org/10.32364/2587-6821-2020-4-7-445-451.

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Background: medical correction of the hemostatic system is one of the most important directions for complex treatment of obliterating diseases of lower limbs arteries (ODLLA), including cases of chronic limb-threatening ischaemia (CLTI).Aim: to evaluate the efficacy and safety of the sulodexide use in patients with ODLLA when conducting a comprehensive treatment of CLTI.Patients and Methods: 520 patients underwent two-center prospective study, 318 of whom (211 — with signs of ODLLA, 107 — without signs of CLTI) underwent revascularization interventions, whereas, 202 patients with CLTI received multicomponent complex conservative treatment. In addition to standard treatment, 30 patients who underwent surgery interventions and the group of 50 patients receiving conservative treatment received sulodexide orally in 2 capsules bis in day (1000 LE/day). The severity of the pain syndrome, the distance of pain-free walking, some laboratory indicators of hemostatic system, as well as the presence of adverse events and complications were evaluated before and after treatment. Results: in operated patients with both CLTI and without it, regardless of the sulodexide use, there was a significant decrease in the severity of pain syndrome and an increase in the distance of pain-free walking. Sulodexide use was accompanied by reduced fibrinogen, D-dimer, soluble fibrin monomer complexes (SFMC) and plasminogen activator inhibitor (PAI-1) in the subgroup of patients with CLTI, and indicators of fibrinogen and PAI-1 in the subgroup of patients without CLTI (p<0.05). In non-operated patients with CLTI, sulodexide use was accompanied by a decrease in pain syndrome and indicators of fibrinogen, D-dimer, SFMC, and PAI-1 (p<0.05). However, it was less significant after performed revascularization. There were no adverse events or complications associated with the sulodexide use.Conclusions: improvement of clinical and laboratory parameters was mainly determined by the efficacy of performed limb revascularization. In the complex treatment of patients with ODLLA, the sulodexide use was safe and effective, which was manifested by a decrease in the pain severity, an increase in the distance of pain-free walking and normalization of some coagulogram indicators.KEYWORDS: chronic limb-threatening ischaemia, critical limb ischemia, obliterating diseases of lower limb arteries, complex treatment, sulodexide.FOR CITATION: Katelnitsky I.I., Darvin V.V., Zorkin A.A. Comprehensive treatment of patients with chronic limb-threatening ischaemia: are we using all the possibilities of anticoagulant therapy? Russian Medical Inquiry. 2020;4(7):445–451. DOI: 10.32364/2587-6821-2020-4-7-445-451.
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14

Cherviakov, Iu V., and H. N. Ha. "Results of comprehensive conservative treatment of patients with no-option chronic limb-threatening ischaemia." Angiology and vascular surgery 27, no. 1 (2021): 24. http://dx.doi.org/10.33529/angio2021112.

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15

Tang, Tjun Yip, Ankur Patel, Shereen Xue Yun Soon, Sze Ling Chan, Charyl Jia Qi Yap, Sivanathan Chandramohan, and Tze Tec Chong. "Improving medical adherence and antithrombotic management for patients with chronic limb threatening ischaemia in Singapore." Annals of the Academy of Medicine, Singapore 50, no. 10 (October 29, 2021): 795–97. http://dx.doi.org/10.47102/annals-acadmedsg.2021269.

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16

Gunnarsson, Thordur S., Håkan Pärsson, Anders Gottsäter, and Hans Lindgren. "Transcutaneous O2 and Toe Pressure Changes During Endovascular Revascularisation in Chronic Limb Threatening Ischaemia patients." European Journal of Vascular and Endovascular Surgery 62, no. 6 (December 2021): e76-e77. http://dx.doi.org/10.1016/j.ejvs.2021.10.006.

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17

Lee, Yong-Joon, Chul-Min Ahn, Young-Guk Ko, Kwang H. Park, Jin W. Lee, Seung-Jun Lee, Sung-Jin Hong, et al. "Skin Perfusion Pressure Predicts Early Wound Healing After Endovascular Therapy in Chronic Limb Threatening Ischaemia." European Journal of Vascular and Endovascular Surgery 62, no. 6 (December 2021): 909–17. http://dx.doi.org/10.1016/j.ejvs.2021.08.030.

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18

Ouchterlony, Karin, Kristin Larsson, Gabor Simo, and Birgitta Sigvant. "Secondary Iliaco-appendiceal Fistula After Endovascular Treatment for Chronic Limb-threatening Ischaemia. A Case Report." European Journal of Vascular and Endovascular Surgery 58, no. 6 (December 2019): e539-e540. http://dx.doi.org/10.1016/j.ejvs.2019.06.1235.

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19

van den Berg, Jos C. "Pedal Artery Revascularisation: ‘Bogey’, ‘Birdie’, or ‘Eagle’ in the Treatment of Chronic Limb Threatening Ischaemia?" European Journal of Vascular and Endovascular Surgery 58, no. 6 (December 2019): 864. http://dx.doi.org/10.1016/j.ejvs.2019.07.030.

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20

Shiraki, Tatsuya, Mitsuyoshi Takahara, Osamu Iida, Yoshimitsu Soga, Akio Kodama, Yusuke Miyashita, Yoshiaki Shintani, Masamitsu Endo, and Nobuyoshi Azuma. "Baseline and Updated Information on Nutritional Status in Patients With Chronic Limb Threatening Ischaemia Undergoing Revascularisation." European Journal of Vascular and Endovascular Surgery 61, no. 3 (March 2021): 467–72. http://dx.doi.org/10.1016/j.ejvs.2020.11.036.

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21

Baubeta Fridh, E., M. Andersson, M. Thuresson, B. Sigvant, B. Kragsterman, S. Johansson, P. Hasvold, J. Nordanstig, and M. Falkenberg. "Impact of Comorbidity, Medication, and Gender on Amputation Rate Following Revascularisation for Chronic Limb Threatening Ischaemia." Journal of Vascular Surgery 68, no. 6 (December 2018): 1959–60. http://dx.doi.org/10.1016/j.jvs.2018.10.005.

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22

Fridh, Erik B., Manne Andersson, Marcus Thuresson, Birgitta Sigvant, Björn Kragsterman, Saga Johansson, Pål Hasvold, Joakim Nordanstig, and Mårten Falkenberg. "Impact of Comorbidity, Medication and Gender on Amputation Rate Following Revascularization for Chronic Limb-Threatening Ischaemia." European Journal of Vascular and Endovascular Surgery 58, no. 6 (December 2019): e252. http://dx.doi.org/10.1016/j.ejvs.2019.06.842.

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23

Cassim, M. R. N., S. Godahewa, S. Paviththiran, and S. M. Wijeyaratne. "Percutaneous transluminal lower limb angioplasty [PTA] for chronic limb threatening ischaemia [CLTI] in a low resource setting - 4 year experience." Sri Lanka Journal of Surgery 38, no. 3 (December 31, 2020): 13. http://dx.doi.org/10.4038/sljs.v38i3.8789.

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24

Nickinson, Andrew T. O., Jivka Dimitrova, John S. M. Houghton, Lauren Rate, Svetlana Dubkova, Hannah Lines, Laura J. Gray, et al. "Does the Introduction of a Vascular Limb Salvage Service Improve One Year Amputation Outcomes for Patients with Chronic Limb-Threatening Ischaemia?" European Journal of Vascular and Endovascular Surgery 61, no. 4 (April 2021): 612–19. http://dx.doi.org/10.1016/j.ejvs.2020.12.007.

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25

Kobayashi, T., M. Hamamoto, T. Okazaki, M. Hasegawa, and S. Takahashi. "Does the Global Limb Anatomic Staging System Inframalleolar Modifier Influence Long Term Outcomes of Chronic Limb Threatening Ischaemia after Distal Bypass?" Journal of Vascular Surgery 74, no. 5 (November 2021): 1767. http://dx.doi.org/10.1016/j.jvs.2021.09.004.

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26

Birmpili, P., A. Johal, Q. Li, S. Waton, I. Chetter, J. R. Boyle, and D. Cromwell. "Factors associated with delays in revascularization in patients with chronic limb-threatening ischaemia: population-based cohort study." British Journal of Surgery 108, no. 8 (April 11, 2021): 951–59. http://dx.doi.org/10.1093/bjs/znab039.

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Abstract Background Prompt revascularization in patients with chronic limb-threatening ischaemia (CLTI) is important, and recent guidance has suggested that patients should undergo revascularization within 5 days of an emergency admission to hospital. The aim of this cohort study was to identify factors associated with the ability of UK vascular services to meet this standard of care. Methods Data on all patients admitted non-electively with CLTI who underwent open or endovascular revascularization between 2016 and 2019 were extracted from the National Vascular Registry. The primary outcome was interval between admission and procedure, analysed as a binary variable (5 days or less, over 5 days). Multivariable Poisson regression was used to examine the relationship between time to revascularization and patient and admission characteristics. Results The study analysed information on 11 398 patients (5973 open, 5425 endovascular), 50.6 per of whom underwent revascularization within 5 days. The median interval between admission and intervention was 5 (i.q.r. 2–9) days. Patient factors associated with increased risk of delayed revascularization were older age, greater burden of co-morbidity, non-smoking status, presentation with infection and tissue loss, and a Fontaine score of IV. Patients admitted later in the week were less likely undergo revascularization within 5 days than those admitted on Sundays and Mondays (P &lt; 0.001). Delays were slightly worse among patients having open compared with endovascular procedures (P = 0.005) and in hospitals with lower procedure volumes (P &lt; 0.001). Conclusion Several factors were associated with delays in time to revascularization for patients with CLTI in the UK, most notably the weekday of admission, which reflects how services are organized. The results support arguments for vascular units providing revascularization to have the resources for a 7-day service.
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27

Choy, Oh Sung, Sarah Manewell, Saissan Rajendran, and Sarah J. Aitken. "Variation in treatment and outcomes for patients with chronic limb‐threatening ischaemia in New South Wales, Australia." ANZ Journal of Surgery 91, no. 6 (April 27, 2021): 1211–19. http://dx.doi.org/10.1111/ans.16886.

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28

van Reijen, N. S., T. Hensing, T. K. B. Santema, D. T. Ubbink, and M. J. W. Koelemay. "Outcomes of Conservative Treatment in Patients with Chronic Limb Threatening Ischaemia: A Systematic Review and Meta-Analysis." Journal of Vascular Surgery 74, no. 3 (September 2021): 1045–46. http://dx.doi.org/10.1016/j.jvs.2021.07.097.

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29

van Reijen, Nick S., Tom Hensing, T. (Katrien) B. Santema, Dirk T. Ubbink, and Mark J. W. Koelemay. "Outcomes of Conservative Treatment in Patients with Chronic Limb Threatening Ischaemia: A Systematic Review and Meta-Analysis." European Journal of Vascular and Endovascular Surgery 62, no. 2 (August 2021): 214–24. http://dx.doi.org/10.1016/j.ejvs.2021.01.005.

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30

Harth, C., C. Randon, and F. Vermassen. "Impact of Angiosome Targeted Femorodistal Bypass Surgery on Healing Rate and Outcome in Chronic Limb Threatening Ischaemia." Journal of Vascular Surgery 72, no. 2 (August 2020): 750. http://dx.doi.org/10.1016/j.jvs.2020.05.043.

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31

Harth, Charlotte, Caren Randon, and Frank Vermassen. "Impact of Angiosome Targeted Femorodistal Bypass Surgery on Healing Rate and Outcome in Chronic Limb Threatening Ischaemia." European Journal of Vascular and Endovascular Surgery 60, no. 1 (July 2020): 68–75. http://dx.doi.org/10.1016/j.ejvs.2020.03.011.

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32

Bong, Tiffany SH, Charyl JQ Yap, Shereen XY Soon, and Tjun Y. Tang. "Combination therapy using scoring and sirolimus drug-coated balloons during lower limb endovascular revascularization for chronic limb threatening ischaemia: A case series." SAGE Open Medical Case Reports 10 (January 2022): 2050313X2210858. http://dx.doi.org/10.1177/2050313x221085859.

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The aim of this case series was to document our early experience using combination therapy with UltraScore™ Focused Force percutaneous transluminal angioplasty balloon (BD Interventional, New Jersey, US) and Selution Sustained Limus Release (SLR)™ (M.A. MedAlliance SA, Nyon, Switzerland) sirolimus-coated balloon catheter for anti-restenotic drug elution, in the setting of multifocal high-grade stenosis for chronic limb threatening ischaemia. Our anecdotal experience was that preparing the lesion with scoring balloon and then using sirolimus drug-eluting balloon may have synergistic effect when used in tandem, especially in the setting of calcified arterial lesions, where the scoring wires may achieve deeper clefts within the atheromatous plaque to allow better drug absorption into the arterial wall. We report two cases with high-grade multifocal stenosis affecting the superficial femoral and anterior tibial arteries, respectively. Combination therapy using the scoring balloon to first prepare the lesion followed by sirolimus elution achieved technical and procedural success in both cases and a 100% 30-day primary patency. There were no complications related to flow-limiting dissections, vessel perforation or acute recoil. However, whether this combination therapy leads to better primary vessel patency with longer freedom from target lesion revascularization in the medium term remains to be determined.
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33

Chinai, Natasha, Graeme K. Ambler, Bethany G. Wardle, Dafydd Locker, Dave Bosanquet, Nimit Goyal, Christopher Chick, Robert J. Hinchliffe, and Christopher P. Twine. "Single versus dual antiplatelet therapy following peripheral arterial endovascular intervention for chronic limb threatening ischaemia: Retrospective cohort study." PLOS ONE 15, no. 6 (June 11, 2020): e0234271. http://dx.doi.org/10.1371/journal.pone.0234271.

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34

Vos, Cornelis G., and Jean-Paul P. M. de Vries. "Is Regional Anaesthesia During Bypass Surgery in High Risk Patients With Chronic Limb Threatening Ischaemia the Columbus Egg?" European Journal of Vascular and Endovascular Surgery 58, no. 2 (August 2019): 214. http://dx.doi.org/10.1016/j.ejvs.2019.04.011.

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35

Elbadawy, Ahmed, Haitham Ali, and Mahmoud Saleh. "Midterm Outcomes of Common Femoral Endarterectomy Combined with Inflow and Outflow Endovascular Treatment for Chronic Limb Threatening Ischaemia." European Journal of Vascular and Endovascular Surgery 59, no. 6 (June 2020): 947–55. http://dx.doi.org/10.1016/j.ejvs.2020.02.028.

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36

Baubeta Fridh, Erik, Manne Andersson, Marcus Thuresson, Birgitta Sigvant, Björn Kragsterman, Saga Johansson, Pål Hasvold, Joakim Nordanstig, and Mårten Falkenberg. "Editor's Choice – Impact of Comorbidity, Medication, and Gender on Amputation Rate Following Revascularisation for Chronic Limb Threatening Ischaemia." European Journal of Vascular and Endovascular Surgery 56, no. 5 (November 2018): 681–88. http://dx.doi.org/10.1016/j.ejvs.2018.06.003.

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37

Tang, Tjun Y., Muhammad S. B. Sulaiman, Shereen X. Y. Soon, Charyl J. Q. Yap, Ankur Patel, and Tze T. Chong. "Slow-flow phenomena following lower limb paclitaxel- and sirolimus-coated balloon angioplasty in the setting of chronic limb threatening ischaemia—a case series." Quantitative Imaging in Medicine and Surgery 12, no. 3 (March 2022): 2058–65. http://dx.doi.org/10.21037/qims-21-633.

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38

Nickinson, Andrew T. O., Briana Coles, Tanya J. Payne, Robert S. M. Davies, Kamlesh Khunti, and Rob D. Sayers. "Is Socio-economic Deprivation Associated with One Year Post-operative Mortality Following Major Amputation for Chronic Limb Threatening Ischaemia?" European Journal of Vascular and Endovascular Surgery 61, no. 6 (June 2021): 1026–27. http://dx.doi.org/10.1016/j.ejvs.2021.02.020.

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Ipema, Jetty, Stefan G. H. Heinen, Annemiek J. B. Janssens, Fons H. Potters, Çagdas Ünlü, Jean-Paul P. M. de Vries, and Daniel A. F. van den Heuvel. "Repeatability, and Intra-Observer and Interobserver Agreement of Two Dimensional Perfusion Angiography in Patients with Chronic Limb Threatening Ischaemia." European Journal of Vascular and Endovascular Surgery 61, no. 6 (June 2021): 980–87. http://dx.doi.org/10.1016/j.ejvs.2021.02.014.

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40

Chew, Claire Alexandra, Julian Chi Leung Wong, Charyl Jia Qi Yap, Shereen Xue Yun Soon, and Tjun Yip Tang. "Safety and efficacy of combined antiplatelet and low-dose rivaroxaban in patients with chronic limb threatening ischaemia in Singapore." Annals of the Academy of Medicine, Singapore 51, no. 9 (September 26, 2022): 580–82. http://dx.doi.org/10.47102/annals-acadmedsg.202282.

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41

Valdes, Diego Caicedo, Clara V. Álvarez Villamarín, and Jesús Devesa Múgica. "TNF-α Mediates Inflammation and Damage in Patients with Chronic Limb Threatening Ischaemia: Molecular Insights from the GHAS Trial." EJVES Vascular Forum 54 (2022): e53. http://dx.doi.org/10.1016/j.ejvsvf.2021.12.075.

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42

Kabuli, Mahsa, AmirReza Akbari, and Benyamin Alam. "Comments on: Two-year clinical outcomes following lower limb endovascular revascularisation for chronic limb-threatening ischaemia at a tertiary Asian vascular centre in Singapore." Singapore Medical Journal 63, no. 8 (2022): 488. http://dx.doi.org/10.4103/singaporemedj.smj-2022-141.

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43

van Reijen, N. S., K. Ponchant, D. T. Ubbink, and M. J. W. Koelemay. "The Prognostic Value of the WIfI Classification in Patients with Chronic Limb Threatening Ischaemia: A Systematic Review and Meta-Analysis." Journal of Vascular Surgery 70, no. 4 (October 2019): 1380. http://dx.doi.org/10.1016/j.jvs.2019.08.003.

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44

Wijeyaratne, Mandika, Rezni Cassim, Andrew Bradbury, Arch Hyrin, Buddima Jayawickrema, Amila Weerasekera, Malinatha Hettiarachchi, Chamendra Sirimanna, and Charith Galapaththy. "Clinical Outcomes Following Lower Extremity Vein Bypass for Chronic Limb Threatening Ischaemia (CLTI) at the University of Colombo, Sri Lanka." European Journal of Vascular and Endovascular Surgery 60, no. 4 (October 2020): 560–66. http://dx.doi.org/10.1016/j.ejvs.2020.06.039.

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45

Tang, Tjun Yip, Shaun Qing Wei Lee, Sze Ling Chan, Charyl Jia Qi Yap, Shereen Xue Yun Soon, Tze Tec Chong, Edward Tieng Chek Choke, and Bryan P. Y. Yan. "Utility of a novel high pressure non-compliant balloon for tibial atherosclerotic lesions in Asian patients with chronic limb threatening ischaemia." Vasa 49, no. 6 (October 2020): 475–82. http://dx.doi.org/10.1024/0301-1526/a000888.

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Summary: Background: The aim was to evaluate the safety and efficacy of a high pressure, non-compliant balloon in the treatment of infrapopliteal occlusive disease in Asian patients with chronic limb threatening ischaemia (CLTI) from Singapore. Patients and methods: Prospective, multi-centre, single arm, non-randomized study. Immediate technical success, 6-month primary vessel patency (determined by Duplex ultrasonography), limb salvage, one-year clinically driven target lesion re-intervention (TLR) and amputation free survival (AFS) were the efficacy endpoints of interest. Results: 86 patients (63% males, mean age 68.9 ± 9.9 years) were enrolled over a 15-month period. Diabetes mellitus (DM) and end-stage renal failure (ESRF) were present in 94% and 38% of patients respectively. All had some degree of tissue loss at baseline (Rutherford scale 5 and 6 = 91% and 9% respectively). Of the 86 legs, 72% had 3 crural vessel disease and 84% had moderate/severe vessel wall calcification. 90% had > = 1 TASC D tibial lesion. Acute technical success was 89%. One month mortality was 3.5% and one-year freedom from TLR was 91%. 6-month tibial patency was 73%. 54/66 (82%) patients had at least one target treated tibial artery open at 6 months. A lower baseline toe pressure (OR 1.03, 95%CI 1.00–1.05) and elastic recoil post angioplasty (OR 0.20, 95%CI 0.05–0.79) were associated with a worse 6 month tibial patency. One-year AFS was 67%. 47/66 (71%) patients had a clinical improvement of at least one Rutherford class at 6 months and 52/59 (88%) experienced complete wound healing at 12 months. Conclusions: Use of a high pressure non-compliant balloon is safe and efficacious in treating highly complex infra-popliteal atherosclerotic lesions in an otherwise challenging population of CLTI patients with a high incidence of DM and ESRF. It is associated with highly satisfactory acute technical success, 6-month target lesion patency and one-year limb salvage.
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46

Watson, Emma, Bernadeta Bridgwood, Prakash Saha, Matthew Bown, Ruth Benson, Vanessa Lawrence, Claire Le Boutillier, Daniel Lasserson, Sarah Messeder, and Athanasios Saratzis. "A Community and Hospital cAre Bundle to improve the medical treatment of severe cLaudIcation and critical limb iSchaemia (CHABLIS)." NIHR Open Research 2 (November 28, 2022): 58. http://dx.doi.org/10.3310/nihropenres.13341.1.

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Background: Patients with peripheral artery disease (PAD) often do not receive optimal best medical therapy (BMT). Through interaction with patients and haealthcare-professionals (HCPs) we developed the LEaflet Gp letter Structured checklist (LEGS) complex clinical intervention to support HCPs provide guideline-compliant PAD BMT. Methods: This was a prospective multicentre study assessing the feasibility and fidelity of delivering the LEGS intervention in primary and secondary care over 6 months. Intervention fidelity was scored based on the proportion of intervention components used correctly at discharge, 30 days, and 6 months. Results: Overall, 129 individuals were screened and 120 took part (33% female, 74% with chronic limb threatening ischaemia; 93% recruitment rate). Of those, 118 (98% retention rate) completed follow-up. Mean intervention fidelity score at discharge (primary outcome measure) was 63% [95% Confidence Interval (CI): 39-68%, SD: 5%], exceeding the success criteria set at 60% by a panel of HCPs and patients. This, however, declined to 51% at 6 months. Eight patients (6.7%) died (all cardiovascular deaths), 4 (3.3%) had a major lower limb amputation, 12 (10%) had a cardiovascular event, and 13 (11%) were admitted due to limb ischaemia at 6 months. Incomplete lipid therapy prescriptions and LEGS intervention documents not received by primary care CHPs were the most common reasons for not complying with the LEGS intervention. Conclusion: The LEGS intervention can be delivered in PAD care pathways across different hospitals, primary, and community healthcare settings with acceptable fidelity, to streamline and improve PAD BMT short and medium term.
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47

Tang, TjunYip, RuiEn Lee, and CharylJia Qi Yap. "Response to comments on: Two-year clinical outcomes following lower limb endovascular revascularisation for chronic limb-threatening ischaemia at a tertiary Asian vascular centre in Singapore." Singapore Medical Journal 63, no. 8 (2022): 488. http://dx.doi.org/10.4103/singaporemedj.smj-2022-142.

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48

Kodama, Akio, Lewis Meecham, Matthew Popplewell, Gareth Bate, Michael S. Conte, and Andrew W. Bradbury. "Editor's Choice – Relationship Between Global Limb Anatomic Staging System (GLASS) and Clinical Outcomes Following Revascularisation for Chronic Limb Threatening Ischaemia in the Bypass Versus Angioplasty in Severe Ischaemia of the Leg (BASIL)-1 Trial." European Journal of Vascular and Endovascular Surgery 60, no. 5 (November 2020): 687–95. http://dx.doi.org/10.1016/j.ejvs.2020.06.042.

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49

Wübbeke, L. F., C. C. L. M. Naves, J. W. H. C. Daemen, M. J. Jacobs, and B. M. Mees. "Mortality and Major Amputation after Revascularisation in Octogenarians Versus Non-Octogenarians with Chronic Limb Threatening Ischaemia: A Systematic Review and Meta-Analysis." Journal of Vascular Surgery 72, no. 3 (September 2020): 1146–47. http://dx.doi.org/10.1016/j.jvs.2020.07.054.

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50

van Reijen, Nick S., Kevin Ponchant, Dirk T. Ubbink, and Mark J. W. Koelemay. "Editor's Choice – The Prognostic Value of the WIfI Classification in Patients with Chronic Limb Threatening Ischaemia: A Systematic Review and Meta-Analysis." European Journal of Vascular and Endovascular Surgery 58, no. 3 (September 2019): 362–71. http://dx.doi.org/10.1016/j.ejvs.2019.03.040.

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