Critical limb ischemia (CLI) is the most severe form of peripheral arterial disease (PAD) which induces extremity rest pain, extremity gangrene or ulcers that mostly might lead to limb loss. One of the most common criteria of CLI is 50 mmHg or less systolic ankle arterial pressure. In this study, a custom made three-lumen catheter (9 Fr) including a distal inflatable balloon in between the inflow and outflow lumen holes was designed and fabricated based on the patented design of Hyper Perfusion Catheter. The proposed catheter design aims to increase ankle systolic pressure to 60 mmHg or more to promote healing and/or alleviating severe pain due to intractable ischemia for patients with CLI. To simulate the blood circulation of related anatomy, in vitro CLI model phantom was designed and constructed by using a modified hemodialysis circuit, a hemodialysis pump and a tube set for cardio-pulmonary bypass surgery. A blood mimicking fluid (BMF) with dynamic viscosity of 4.1 mPa.s was used at 22 ºC to prime the phantom. The data was collected by a custom-made circuit design in real time and all measurements were verified with commercial certificated medical devices. The results of in vitro CLI model phantom experiments have shown that it is feasible to elevate the pressure distal to the occlusion (representing ankle pressure) above 80 mmHg without affecting the systemic pressure.
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http://dx.doi.org/10.1016/j.medengphy.2023.103981 | DOI Listing |
The broad spectrum of clinical manifestations caused by peripheral arterial disease [PAD] and the morphologic heterogeneity of associated atherosclerotic lesions present a considerable management challenge. Endovascular interventions are recognized an effective treatment for PAD. Within this revascularization strategy the role of atherectomy debulking modalities continue to evolve.
View Article and Find Full Text PDFInt J Surg Case Rep
December 2024
Department of Vascular Surgery, Faculty of Medicine, Aleppo University Hospital, University of Aleppo, Aleppo, Syria.
Introduction And Importance: Leriche syndrome (LS), or aortoiliac occlusive disease, is a rare form of peripheral arterial disease leading to claudication, impotence, and diminished femoral pulses due to atheromatous obstruction of the infrarenal aorta and common iliac arteries. Early identification is crucial as untreated LS can result in severe complications. Treatment primarily involves surgical interventions, with endovascular options considered as alternatives.
View Article and Find Full Text PDFFEBS J
December 2024
School of Veterinary Medicine, Azabu University, Sagamihara, Japan.
Critical limb ischemia (CLI) is the most advanced stage of peripheral arterial disease, posing a high risk of mortality. Sphingomyelin, a sphingolipid synthesized by sphingomyelin synthases (SMSs) 1 and 2, plays an essential role in signal transduction as a component of lipid rafts. However, the role of sphingomyelin in the inflammation of ischemic skeletal muscles remains unclear.
View Article and Find Full Text PDFAust Vet J
December 2024
Centre for Veterinary Education, Sydney School of Veterinary Science, The University of Sydney, Sydney, Australia.
A 12-year-old Bengal cat with unclassified cardiomyopathy presented for signs consistent with aortic thromboembolism (ATE). It was treated with clopidogrel and rivaroxaban as antithrombotic therapy, combined with narcotic analgesia and frusemide. After initially making a clinical improvement, the cat's condition suddenly deteriorated, with a presumptive diagnosis of clostridial myonecrosis.
View Article and Find Full Text PDFLangenbecks Arch Surg
December 2024
Department of Plastic Reconstructive Surgery & Hand Microsurgery, Ningbo No. 6 Hospital, Ningbo, Zhejiang, China.
Objective: The key to increasing the success rate of limb preservation lies in timely restoration of the blood supply to the severed limb, This study examines the clinical effect of a disposable intravenous infusion device as a temporary vascular shunt device which can quickly restore blood circulation in the replantation of severed limbs.
Methods: A retrospective review of all amputated major limbs in our department from May 2005 to May 2022. Patients treated with intravenous infusion tubes as temporary vascular shunt devices were included in group A(shunt group ) and those who could not use temporary intravascular shunt devices were included in group B (no shunt group).
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