No abstract available.
Arterial Occlusive Diseases*

No abstract available.
Arterial Occlusive Diseases* ; Ischemia* ; Lower Extremity*

No abstract available.
Arterial Occlusive Diseases* ; Ischemia* ; Lower Extremity*

No abstract available.
Angiography ; Arterial Occlusive Diseases ; Lower Extremity

COVID-19 infection or vaccination is rarely associated with arterial occlusive disease of the extremities. The surgical department of a hospital in Johor, Malaysia, recorded a significant increase in the number of COVID-19-related acute limb ischaemia when the rates of COVID-19 were high both locally and internationally. The clinical presentation and management of acute limb ischaemia associated with COVID-19 infection or vaccination are largely underreported in Johor. Herein, we report a case series of 12 patients managed with strategies ranging from purely anticoagulation to catheter-directed thrombolysis and surgical embolectomy. This case series describes the clinical presentation, risk profiles, treatment approaches and limb outcomes of the patients. The amputation rate was high in view of unfavourable factors, including delayed presentation, high-risk factors and severe COVID-19. Three cases of potential COVID-19 vaccine-related acute limb ischaemia were included. COVID-19-related acute limb ischaemia can be minimised with heightened alert, preemptive optimisation with proper hydration and consideration for early prophylactic anticoagulation in high-risk cases.
COVID-19 ; Arterial Occlusive Diseases ; Mechanical Thrombolysis

The noninvasive vascular laboratory has become central to the evaluation of patients with peripheral arterial occlusive disease (PAOD) of the lower extremities. Most such patients have atherosclerosis as the cause of PAOD. Because noninvasive vascular laboratory techniques are widely available, relatively inexpensive, well-tolerated, and provide quantitative physiologic information, they are most commonly used as the first line objective modalities to confirm the diagnosis, establish the severity of ischemia, and estimate the anatomic level of involvement in patients that are suspected as having PAOD based on history and physical signs. This article focuses on the commonly used instruments, examination techniques, interpretive guidelines, and clinical application of each modality.
Arterial Occlusive Diseases ; Atherosclerosis ; Humans ; Ischemia ; Lower Extremity

PURPOSE: Hybrid procedure in lower extremity arterial disease is composed of open bypass and endovascular treatment. For proximal inflow bypass operations for distal lesions used to be performed 1 or 2 weeks after endovascular therapy. Since Aug 2005, all hybrid operations have been performed simultaneously in the operation room in our center. In this study, we compared the results of the staged hybrid operations with those of simultaneous procedures. METHODS: From Jan 1999 to Dec 2009, 115 endovascular treatments and 139 bypass operations were performed. 44 bypasses were performed 1 day to 14 days after angioplasty in inflow lesions (group I) and 95 bypasses were performed simultaneously in the operation room with mobile fluoroscopy (group II). In both groups, inflow procedures included 3 femoral balloon angioplasties, 3 femoral stents, 24 iliac balloon angioplasties and 85 iliac stents. Bypass operations were composed of 39 femorofemoral and 102 infrainguinal bypasses including 60 femoropopliteal and 42 other bypasses. RESULTS: The 3-year patency rate of bypass graft is 71.5%. There is no difference in either group. But in endovascular treatment lesion, the 3-year patency rate is 80% and that of the simultaneous group is higher than that of the staged group (P<0.05). CONCLUSION: Hybrid operation is a less invasive therapy for revascularization in multilevel peripheral arterial occlusive disease. With development of endovascular therapy, simultaneous hybrid operations become more efficient.
Angioplasty ; Arterial Occlusive Diseases ; Chimera ; Fluoroscopy ; Lower Extremity ; Stents ; Transplants

Iatrogenic femoral pseudoaneurysm (IPA) is a troublesome complication related to the femoral arterial access site used for invasive cardiovascular procedures. Several therapeutic strategies have been developed to treat this complication. They include surgical repair, ultrasound-guided compression repair, and minimally invasive percutaneous treatments (thrombin injection, coil embolization, and insertion of covered stents). Traditionally, surgical repair has been the main treatment for IPA, particularly when the size of the pseudoaneurysm is larger than 4 cm or when anticoagulation or GP-IIb/IIIa inhibitors are extensively used during the procedure. However, if the site of the pseudoaneurysm, such as deep femoral artery, was more deeply located, thrombin injection might be simpler or more useful compared to surgical ligation. Here, we report the successful treatment of huge IPA by percutaneous thrombin injection in a case complicated with giant pseudoaneurysm of deep femoral artery after the endovascular intervention for peripheral arterial occlusive disease.
Aneurysm, False ; Arterial Occlusive Diseases ; Femoral Artery ; Ligation ; Thrombin

PURPOSE: With the development of endovascular interventions, hybrid reconstructions, which include the combination endovascular procedure and open bypass surgery, have been increasingly used for the management of peripheral arterial occlusive disease (PAOD). The goal of this study is to present our results in the management of PAOD and to define the role of staged hybrid techniques in patients who need revascularization compared to other revascularization procedures, such as open or endovascular techniques. METHODS: We reviewed 104 patients who underwent arterial revascularization between January 2005 and June 2010, retrospectively. The data were divided into three groups by treatment modality: the open bypass group (n=47, 45.2%), the endovascular group (n=46, 44.2%), and the staged hybrid group (n=11, 10.6%), and were classified according to the Trans-Atlantic Society Consensus II (TASC II) A/B/C/D. Patients' characteristics, overall primary and secondary patency rates, and 30-day complications were compared between the three groups. RESULTS: Mean age was 69.6 years and 84.6% were male. There were more TASC II D lesions and multiple lesions in the hybrid group. There were no statistically significant differences in the 36-month mortality rate, primary patency rate, and secondary patency rate among the three groups (P=0.170, 0.838, and 0.767, respectively). CONCLUSION: Staged hybrid revascularization is an acceptable strategy in patients with PAOD, especially TASC II D and multiple lesions for suitable case with comparable patency, even though the number of cases was relatively small.
Arterial Occlusive Diseases ; Chimera ; Consensus ; Endovascular Procedures ; Humans ; Male ; Peripheral Arterial Disease ; Retrospective Studies

Antisense oligonucleotides (ASODN) for therapy is a genetic technology which is based on the base-complementary principle. DNA or RNA sequence synthesized by biotechnology is transferred into the target cells to form mRNA-DNA or mRNA-RNA double strand for inhibiting the expression of target genes. In this way we can control and treat some diseases. The development of antisense oligonucleotides drugs has opened a new area of genetic pharmacology. This paper reviews its classifications, mechanics and its wide application in the treatment of viral infection, tumor and cardiovascular diseases. At the same time we pose the problems that need solving.
Arterial Occlusive Diseases ; therapy ; Humans ; Neoplasms ; therapy ; Oligonucleotides, Antisense ; pharmacology ; therapeutic use ; Virus Diseases ; therapy