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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

WIfI classification: the Society for Vascular Surgery lower extremity threatened limb classification system, a literature review
The objective of this study is to collect together the main points about the WIfI classification that have been discussed in the scientific literature. Most of the studies conducted for validation of this classification system prove its association with factors related to limb salvage, such as amputation rates, amputation-free survival, prediction of reintervention, amputation, and stenosis (RAS) events, and wound healing.
Source: Jornal Vascular Brasileiro - May 8, 2020 Category: Surgery Source Type: research

Trends of vascular surgery procedures in Marfan syndrome and Ehlers-Danlos syndrome.
CONCLUSIONS: Patients with Marfan syndrome and Ehlers-Danlos syndrome differ from other patients undergoing vascular surgical procedures, with a significantly higher proportion of aortic procedures including open aneurysm repair and thoracic endovascular aortic repair. While they are younger with fewer comorbidities, due to the unique pathogenesis of their underlying connective tissue disorder, there is an overall higher rate of procedural complications and increased length of stay and cost for Marfan syndrome patients undergoing aortic surgery. PMID: 32423364 [PubMed - as supplied by publisher]
Source: Vascular - May 18, 2020 Category: Surgery Authors: Jayarajan SN, Downing BD, Sanchez LA, Jim J Tags: Vascular Source Type: research

Results from the International Silver Graft Registry for high-risk patients treated with a metallic-silver impregnated vascular graft.
Abstract The purpose of this postmarket surveillance registry was to document the efficacy of a vascular prosthesis coated with metallic silver in high-risk patients undergoing vascular reconstructions. Patency (primary endpoint) and freedom from graft infection (secondary endpoint) data were assessed at a minimum of 12 months in patients with significant co-morbidity and/or confirmed graft infections or infected native vessels. Between November 2006 and December 2009, 230 patients with high-risk factors underwent aortic, peripheral and/or extra-anatomic reconstructions with Silver Graft(®) (SG) in six German, on...
Source: Vascular - March 18, 2013 Category: Surgery Authors: Zegelman M, Guenther G, Waliszewski M, Pukacki F, Stanisic MG, Piquet P, Passon M, Halloul Z, Tautenhahn J, Claeys L, Agostinho C, Simici D, Doebrich D, Mueller C, Balzer K Tags: Vascular Source Type: research

Ankle Brachial Pressure Index: An update for the vascular specialist and general practitioner.
CONCLUSIONS: A thorough understanding of the correct technique and associated limitations of ABPI measurement is essential in accurately generating and interpreting the data it provides. With this knowledge, the ABPI is an invaluable tool to help manage patients with peripheral arterial disease. Perhaps more importantly, ABPI can be used to identify and risk stratify patients with asymptomatic peripheral arterial disease, itself a major indicator of significant underlying cardiovascular disease. With the emergence of best medical therapy, targeted pharmacotherapy and lifestyle changes can reduce the risk of major cardiovas...
Source: Vascular - April 4, 2019 Category: Surgery Authors: Thurston B, Dawson J Tags: Vascular Source Type: research

Assessment of cardio-ankle vascular index in patients with abdominal aortic aneurysm: An observational study.
CONCLUSION: CAVI is increased in patients with AAA. Increased arterial stiffness may be a mechanical link between AAA, coronary artery disease and peripheral artery disease or a common mechanism effects the arterial stiffness, coronary artery disease, peripheral artery disease and AAA. Therefore, CAVI may be used as a valuable marker for risk stratification for the development of AAA in susceptible patients. PMID: 32757746 [PubMed - as supplied by publisher]
Source: Vascular - August 4, 2020 Category: Surgery Authors: Aykan AÇ, Çetin M, Kalaycıoğlu E, Menteşe Ü Tags: Vascular Source Type: research

Altered Sca-1+ Progenitor Cell Populations in Diabetic Mice Are Associated with Increased Neointimal Hyperplasia After Vascular Injury
Diabetic patients exhibit poor outcomes after vascular interventions, predominantly due to development of neointimal hyperplasia. While diabetic mice have been shown to have diminished Sca-1+ stem cells in their bone marrow, the role of Sca-1+ cells in the vasculature is unknown. We hypothesize that diabetic mice have diminished Sca-1+ stem cell populations in the arterial wall compared with wild type (WT) mice. We also hypothesize that vascular injury will alter the presence and distribution of Sca-1+ cells in the arterial wall.
Source: Journal of Vascular Surgery - October 28, 2013 Category: Surgery Authors: Jill R. Streams, Janet Martinez, Megan Flynn, Melina R. Kibbe Tags: Abstracts from the 2013 Midwestern Vascular Surgical Society Annual Meeting Source Type: research

Atherosclerotic vascular diseases have really the same risk factors? Comparison between large abdominal aortic aneurysm and obstructive non-coronary arterial disease.
Conclusions Patients with abdominal aortic aneurysm were mostly males with diastolic hypertension, impaired renal function and less diabetics, while patients with occlusive arteriopathy were more smokers, hypertensives and more hypertriglyceridemics. PMID: 28509621 [PubMed - as supplied by publisher]
Source: Vascular - January 1, 2017 Category: Surgery Authors: Tsialtas D, Bolognesi MG, Volpi R, Bolognesi R Tags: Vascular Source Type: research

Evaluation of Near-Instant Noninvasive Optical Imaging of Tissue Perfusion for Vascular Assessment
Noninvasive vascular tests are critical for identifying patients who would benefit from surgical revascularization, yet are highly limited in diabetic patients. This case study evaluated the potential of spatial frequency domain imaging (SFDI) as a noninvasive vascular testing modality for lower limb assessment.
Source: Journal of Vascular Surgery - August 22, 2017 Category: Surgery Authors: Craig Weinkauf, Kairavi Vaishnav, Brain Hoang, Amaan Mazhar, David J. Cuccia, David G. Armstrong Tags: Abstract from the 2017 Western Vascular Society Annual Meeting Source Type: research

Identification of new factors associated to walking impairment in patients with vascular-type claudication.
CONCLUSION: Buttock ischemia, heart rate and usual-pace are new variables associated to walking time. PMID: 30442076 [PubMed - as supplied by publisher]
Source: Vascular - November 15, 2018 Category: Surgery Authors: Mezdad T, Henni S, Feuilloy M, Chauvet P, Schang D, Abraham P Tags: Vascular Source Type: research

The Society for Vascular Surgery WIfI Classification System Predicts Wound Healing But Not Major Amputation in Patients With Diabetic Foot Ulcers Treated in a Multidisciplinary Setting
The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) threatened limb classification has been shown to correlate well with risk of major amputation and time to wound healing in heterogeneous diabetic and nondiabetic populations. Major amputation continues to plague the most severe stage 4 WIfI patients, with 1-year amputation rates of 40% to 64%. Our aim was to determine the association between WIfI class and wound healing time (WHT) and major amputation among patients with diabetic foot ulcers (DFUs) treated in a multidisciplinary setting.
Source: Journal of Vascular Surgery - August 23, 2016 Category: Surgery Authors: Caitlin W. Hicks, Nestoras Mathioudakis, Joseph K. Canner, Ronald L. Sherman, Kathryn F. Hines, Ying W. Lum, Bruce A. Perler, Christopher J. Abularrage Tags: Abstract from the 2016 Eastern Vascular Society Annual Meeting Source Type: research

The Society for Vascular Surgery Wound, Ischemia, and foot Infection Classification Predicts Wound Healing Better Than Angiosome-Directed Perfusion in Neuroischemic  Diabetic Foot Wounds
Previous studies have shown conflicting results in the wound healing outcomes based on angiosome-directed perfusion, but none have adjusted for wound characteristics. We have previously shown that the Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification correlates with wound healing in neuroischemic diabetic foot ulcers (DFUs) treated by a multidisciplinary team. The aim of this study was to compare WIfI classification vs angiosome-directed perfusion as a predictor of wound healing in patients presenting with DFU and peripheral arterial disease (PAD).
Source: Journal of Vascular Surgery - September 21, 2017 Category: Surgery Authors: M. Libby Weaver, Joseph K. Canner, Caitlin W. Hicks, Ronald L. Sherman, Kathryn F. Hines, Nestoras Mathioudakis, James H. Black, Christopher J. Abularrage Tags: Abstract from the 2017 Eastern Vascular Society Annual Meeting Source Type: research

Off-label prescriptions in diabetic foot
We describe off-label treatments for the diabetic foot reported in international scientific literature. This is a qualitative and descriptive bibliographical review based on the results of a search of the Medline international database. The criteria for review were publication between January 1985 and November 2013, and the MeSH (Medical Subject Heading) keywords "off-label use" OR "off-label" OR "off-label prescribing" plus "diabetic foot" were input on the search form. Nine studies were selected that contained information about off-label treatments for the diabetic foot. We conclude that the practice of off-label prescri...
Source: Jornal Vascular Brasileiro - November 5, 2014 Category: Surgery Source Type: research

Relevance of a skilled vascular surgeon and optimized facility practices in the long-term patency of arteriovenous fistulas: a prospective study.
CONCLUSIONS: Results suggest that a long-lasting, suitable AVF is feasible in almost all patients. The surgeon's skills and facility practices can have an important role in the long term outcome of AVF. PMID: 31063174 [PubMed - as supplied by publisher]
Source: Jornal Brasileiro de Nefrologia - May 8, 2019 Category: Urology & Nephrology Tags: J Bras Nefrol Source Type: research