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The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System: Risk stratification based on Wound, Ischemia, and foot Infection (WIfI)
Critical limb ischemia, first defined in 1982, was intended to delineate a subgroup of patients with a threatened lower extremity primarily because of chronic ischemia. It was the intent of the original authors that patients with diabetes be excluded or analyzed separately. The Fontaine and Rutherford Systems have been used to classify risk of amputation and likelihood of benefit from revascularization by subcategorizing patients into two groups: ischemic rest pain and tissue loss. Due to demographic shifts over the last 40 years, especially a dramatic rise in the incidence of diabetes mellitus and rapidly expanding techn...
Source: Journal of Vascular Surgery - October 14, 2013 Category: Surgery Authors: Joseph L. Mills, Michael S. Conte, David G. Armstrong, Frank B. Pomposelli, Andres Schanzer, Anton N. Sidawy, George Andros, Society for Vascular Surgery Lower Extremity Guidelines Committee Tags: Society for Vascular Surgery® document Source Type: research

Profile of peripheral vascular changes in crack-cocaine addicts receiving treatment at a Psychosocial Care Center for Alcohol and Drugs
Conclusions Crack users exhibit peripheral vascular disorders. Length of time since starting to use the drug had the greatest impact on this system, suggesting an association between crack use and reduced arterial flow.
Source: Jornal Vascular Brasileiro - July 19, 2016 Category: Surgery Source Type: research

The influence of diabetes mellitus on patency of arteriovenous fistulas for hemodialysis
ConclusionsThis study concluded that diabetic patients had shorter mean duration of AVF patency and lower rate of access survival to 24 months.
Source: Jornal Vascular Brasileiro - October 20, 2015 Category: Surgery Source Type: research

Initial experience with a reversal-of-flow cerebral protection device in carotid angioplasty
PURPOSE: To report initial findings with the GORE Flow Reversal System®, with a focus on major/minor adverse events in the 30 first postoperative days. METHODS: The first 24 patients submitted to carotid angioplasty using the GORE system, from June 2010 to May 2012, were retrospectively assessed with regard to indications, anatomic details, technical difficulties, and early clinical outcomes, including major (stroke, death, acute myocardial infarction) and minor (hematoma) adverse events. RESULTS: Systemic hypertension was present in 100% of the patients, diabetes mellitus in 58.3%, and coronary disease in 37.5%. Type II ...
Source: Jornal Vascular Brasileiro - April 14, 2013 Category: Surgery Source Type: research

Analysis of risk factors related to minor and major lower limb amputations at a tertiary hospital
Conclusions Lower limb amputations at different levels are related to different risk factors. Ischemia of greater severity and morbidity was associated with major amputations, while neuropathy and preserved perfusion were more often related to minor amputations.
Source: Jornal Vascular Brasileiro - May 9, 2017 Category: Surgery Source Type: research

Review of gestational diabetes mellitus effects on vascular structure and function
Vascular dysfunction has been described in women with a history of gestational diabetes mellitus. Furthermore, previous gestational diabetes mellitus increases the risk of developing Type 2 diabetes mellitus, a risk factor for cardiovascular disease. Factors contributing to vascular changes remain uncertain. The aim of this review was to summarize vascular structure and function changes found to occur in women with previous gestational diabetes mellitus and to identify factors that contribute to vascular dysfunction. A systematic search of electronic databases yielded 15 publications from 1998 to March 2014 that met the in...
Source: Diabetes and Vascular Disease Research - April 14, 2016 Category: Endocrinology Authors: Jensen, L. A., Chik, C. L., Ryan, E. A. Tags: Review Article Source Type: research

Anti-platelet and anti-coagulant therapy in peripheral arterial disease prior to surgical intervention.
CONCLUSION: Peripheral artery disease is a complex and multifactorial clinical condition. The use of dual anti-platelets, such as aspirin and clopidogrel, are the key in preventing major cardiovascular events as well as stroke and death. Utilization of anti-coagulation such as direct oral anti-coagulants' as additional parameters for the prevention of disease progression, is paramount. Eventually, the choice of either dual-antiplatelet therapy or combined anti-coagulation with anti-platelets should be carefully considered, particularly following the most recent published debatable studies. PMID: 30539687 [PubMed - as ...
Source: Vascular - December 12, 2018 Category: Surgery Authors: Harky A, Maskell P, Burgess M Tags: Vascular Source Type: research

Non-high-density lipoprotein cholesterol and treatment targets in vascular surgery patients
DISCUSSION: Among vascular surgery patients, over half did not meet non-HDL targets. These results suggest that we may be vastly under-performing adequate medical optimization with only about one-fourth of patients on a statin at their final encounter and approximately one-tenth of patients being treated with a high-intensity statin. With recent evidence supporting non-HDL as a valuable measurement for atherosclerotic risk, there is potential to optimize medical management beyond current high-intensity statin therapy. Further investigation is needed regarding the risk of adverse events between patients treated with these v...
Source: Vascular - September 16, 2022 Category: Surgery Authors: Drew J Braet Kian Pourak Vibav Mouli Itai Palmon Dan Dinh Nicholas H Osborne Chandu Vemuri Eric J Brandt Source Type: research

Empagliflozin decreases ageing-associated arterial stiffnening and decreases vascular fibrosis under normoglycemic conditions
In conclusion, empagliflozin decreased arterial stiffness in aged mice, indicating that SGLT2 inhibition could be a valuable strategy in mitigating vascular ageing. Further research is warranted to unravel the underlying, possibly region-specific, mechanisms.PMID:37619798 | DOI:10.1016/j.vph.2023.107212
Source: Vascular Pharmacology - August 24, 2023 Category: Drugs & Pharmacology Authors: C édric H G Neutel Callan D Wesley Melissa Van Praet Celine Civati Lynn Roth Guido R Y De Meyer Wim Martinet Pieter-Jan Guns Source Type: research

Counter-regulatory effects played by the ACE - Ang II - AT1 and ACE2 - Ang-(1-7) - Mas axes on the reactive oxygen species-mediated control of vascular function: perspectives to pharmacological approaches in controlling vascular complications.
Abstract The Renin-Angiotensin system plays an important role in the regulation of systemic blood pressure as well as in fluid and electrolyte balance. It is divided into two described axes, the ACE - Ang II - AT1 receptor, with Ang II as the main mediator, and the ACE2 - Ang-(1-7) - Mas receptor, with Ang-(1-7) responsible for the main effects. The main vascular effect induced by Ang II is contraction, while Ang-(1-7) includes relaxation in several vascular beds. Ang II also activates several cytokines that are important in the genesis of vascular inflammation and hypertrophy. In this context, Ang-(1-7) seems to ...
Source: VASA. Zeitschrift fur Gefasskrankheiten. Journal for Vascular Diseases - October 27, 2014 Category: Surgery Authors: Pernomian L, Pernomian L, Baraldi Araújo Restini C Tags: Vasa Source Type: research

Estrogen-Related Receptor γ Plays a Key Role in Vascular Calcification Through the Upregulation of BMP2 Expression.
CONCLUSIONS: The present results indicate that ERRγ plays a key role in vascular calcification by upregulating the BMP2 signaling pathway, suggesting that inhibition of ERRγ is a potential therapeutic strategy for the prevention of vascular calcification. PMID: 26404484 [PubMed - as supplied by publisher]
Source: Arteriosclerosis, Thrombosis and Vascular Biology - September 24, 2015 Category: Cardiology Authors: Kim JH, Choi YK, Do JY, Choi YK, Ha CM, Lee SJ, Jeon JH, Lee WK, Choi HS, Park KG, Lee IK Tags: Arterioscler Thromb Vasc Biol Source Type: research

Oligogalacturonic Acid Inhibits Vascular Calcification by Two Mechanisms: Inhibition of Vascular Smooth Muscle Cell Osteogenic Conversion and Interaction With Collagen.
CONCLUSIONS: Degree of polymerization of 8 inhibits vascular calcification development mainly by inhibition of osteogenic marker expression but also partly by masking the GFOGER sequence-thereby, preventing matrix vesicles from binding to COL1. PMID: 28522698 [PubMed - as supplied by publisher]
Source: Arteriosclerosis, Thrombosis and Vascular Biology - May 18, 2017 Category: Cardiology Authors: Hodroge A, Trécherel E, Cornu M, Darwiche W, Mansour A, Ait-Mohand K, Verissimo T, Gomila C, Schembri C, Da Nascimento S, Elboutachfaiti R, Boullier A, Lorne E, Courtois J, Petit E, Toumieux S, Kovensky J, Sonnet P, Massy ZA, Kamel S, Rossi C, Ausseil J Tags: Arterioscler Thromb Vasc Biol Source Type: research