Journal of vascular surgery
-
Comparative Study
One-year prospective quality-of-life outcomes in patients treated with angioplasty for symptomatic peripheral arterial disease.
Despite lower reported patency rates than open bypass, percutaneous transluminal angioplasty (PTA) may result in symptom relief, limb salvage, maintenance of ambulation and independent living, and overall improved quality of life. The goal of this study was to prospectively assess quality of life and functional outcomes after angioplasty and stenting in patients with chronic leg ischemia. ⋯ Despite inferior reconstruction patency rates when compared with the historical results of open bypass, PTA provides excellent functional outcomes with good patient satisfaction, especially for treating claudication. These findings support a more liberal use of PTA intervention for patients with vasculogenic claudication.
-
Comparative Study
Peripheral arterial disease versus other localizations of vascular disease: the ATTEST study.
Despite the increased cardiovascular morbidity and mortality risk of patients with peripheral arterial disease, previous worldwide studies have documented undertreatment of cardiovascular risk factors in such patients. ⋯ Patients with atherothrombotic disease recruited from primary care practices were not adequately tested and treated, especially the patients with peripheral arterial disease. To improve the medical management of patients with peripheral arterial disease, there is a need for epidemiologic and clinical education of physicians.
-
Comparative Study
Functional and cytoarchitectural spinal cord protection by ATL-146e after ischemia/reperfusion is mediated by adenosine receptor agonism.
ATL-146e protects the spinal cord from ischemia/reperfusion injury, presumably via adenosine A(2A) receptor activation, but this relationship remains unproven. We hypothesized that spinal cord functional and cytoarchitectural preservation from ATL-146e would be lost with simultaneous administration of the specific adenosine A(2A) antagonist ZM241385 (ZM), thus proving that adenosine A(2A) receptor activation is responsible for the protective effects of this compound. ⋯ ATL-146e preserves the spinal cord in terms of both cytoarchitecture and function after reperfusion of the ischemic spinal cord, but this preservation is not completely blocked by competitive adenosine A(2A) receptor antagonism. Although ATL-146e does seem to partially function through activation of the adenosine A(2A) receptor, the neuroprotective mechanism may not be limited to this particular receptor.
-
Carotid endarterectomy is the standard of care for most patients with severe extracranial carotid bifurcation disease. However, its safety and efficacy in patients with significant surgical risk are unclear. The ARCHeR (ACCULINK for Revascularization of Carotids in High-Risk patients) trial was performed to determine whether carotid artery stenting with embolic protection is a safe and effective alternative to endarterectomy in high-surgical-risk patients. ⋯ The ARCHeR results demonstrate that extracranial carotid artery stenting with embolic filter protection is not inferior to historical results of endarterectomy and suggest that carotid artery stenting is a safe, durable, and effective alternative in high-surgical-risk patients.
-
Popliteal arterial trauma carries the greatest risk of limb loss of any peripheral vascular injury. The purpose of this study was to analyze outcomes after popliteal arterial injuries and identify factors contributing to disability. ⋯ Popliteal vascular injury remains an uncommon but challenging clinical entity associated with significant rates of limb loss, functional disability, and mortality. Blunt vs penetrating mechanism and associated musculoskeletal injuries generally involve longer hospital stays, worse functional outcomes, and twice the amputation rate.