ESVM Guideline on peripheral arterial disease

Ulrich, Frank; Nikol, Sigrid; Belch, J. J. F.; Boc, Vinko; Brodmann, Marianne; Carpentier, P.; Chraim, Ali; Canning, Caitríona; Dimakakos, Evangelos; Gottsäter, Anders; Heiß, Christian; Mazzolai, Lucia; Maďarič, Juraj; Olinic, Dan-Mircea; Pécsvárady, Zsolt; Poredoš, Pavel; Quéré, Isabelle; Roztočil, K; Stanek, Agata; Vasić, Dragan; Visonà, Adriana; Wautrecht, Jean-Claude; Bulvas, M; Colgan, Mary-Paula; Dorigo, Walter; Houston, Graeme; Kahan, Thomas; Lawall, Holger; Lindstedt, Isak; Mahé, Guillaume; Martini, Romeo; Pernod, G.; Przywara, Stanisław; Righini, Marc; Schlager, Oliver; Terlecki, Piotr

doi:10.1024/0301-1526/a000834

Cited by 174 publications

(224 citation statements)

References 419 publications

(420 reference statements)

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“…The microcirculatory diagnostic has already proved to have a good prognostic value in clinical practice in not ICU patients. The nailfold capillaroscopy or transcutaneous oxygen pressure measurement (TcpO2) are routinely used, the first in the diagnostic pathway of the Raynaud's phenomenon, the latter in the selecting critical limb ischemia and predicting healing of skin lesions [61,62].…”

Section: Is the Beside Microcirculation Assessment A Compelling Needmentioning

confidence: 99%

The compelling arguments for the need of microvascular investigation in COVID-19 critical patients

Martini

2020

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The burden of pandemic COVID-19 is growing worldwide, as the continuous increases of contagion. Only 10-15% of the entire infected population has the necessity of intensive care unit (ICU) treatments. But, this relatively low rate of patients has absorbed almost the whole availability of ICU during few days, becoming at least in Italy, an emergency for the national health system. In COVID-19 ICU patients massive aggression of lung with severe pulmonary failure, as well as kidney and liver injuries, heart, brain, bowel and spleen damages with lymph nodes necrosis and even cutaneous manifestations have been observed. Moreover, increased levels of cytokines so-called "cytokines storm (CS), and overt intravascular disseminated coagulation have been also reported. The hypercoagulation and CS would speculate about a microvascular dysfunction. Unfortunately, no specific observations have been performed on microcirculatory dysfunction in COVID-19 patients. Hence the presumed pathophysiological pathways and models about a microvascular involvement can be gathered by sepsis models studies. But despite this lack of evidence, the COVID-19 has emphasized the compelling need for microcirculation monitoring at the bedside in ICU patients.

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Section: Is the Beside Microcirculation Assessment A Compelling Needmentioning

confidence: 99%

The compelling arguments for the need of microvascular investigation in COVID-19 critical patients

Martini

2020

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“…Peripheral arterial disease is a severe medical condition associated with high morbidity, mortality, and significant socioeconomic and social impacts. Increased incidence of renal failure, cardiovascular disease, diabetes mellitus with associated microangiopathy and retinopathy are documented in patients with PAD [1,2].…”

Section: Critical Limb Ischemiamentioning

confidence: 99%

Current Status of Cell-Based Therapy in Patients with Critical Limb Ischemia

Jalůvka

Ihnát

Maďarič

et al. 2020

IJMS

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(1) Background: The treatment of peripheral arterial disease (PAD) is focused on improving perfusion and oxygenation in the affected limb. Standard revascularization methods include bypass surgery, endovascular interventional procedures, or hybrid revascularization. Cell-based therapy can be an alternative strategy for patients with no-option critical limb ischemia who are not eligible for endovascular or surgical procedures. (2) Aims: The aim of this narrative review was to provide an up-to-date critical overview of the knowledge and evidence-based medicine data on the position of cell therapy in the treatment of PAD. The current evidence on the cell-based therapy is summarized and future perspectives outlined, emphasizing the potential of exosomal cell-free approaches in patients with critical limb ischemia. (3) Methods: Cochrane and PubMed databases were searched for keywords “critical limb ischemia and cell therapy”. In total, 589 papers were identified, 11 of which were reviews and 11 were meta-analyses. These were used as the primary source of information, using cross-referencing for identification of additional papers. (4) Results: Meta-analyses focusing on cell therapy in PAD treatment confirm significantly greater odds of limb salvage in the first year after the cell therapy administration. Reported odds ratio estimates of preventing amputation being mostly in the region 1.6–3, although with a prolonged observation period, it seems that the odds ratio can grow even further. The odds of wound healing were at least two times higher when compared with the standard conservative therapy. Secondary endpoints of the available meta-analyses are also included in this review. Improvement of perfusion and oxygenation parameters in the affected limb, pain regression, and claudication interval prolongation are discussed. (5) Conclusions: The available evidence-based medicine data show that this technique is safe, associated with minimum complications or adverse events, and effective.

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“…Most recently, the 2019 guidelines published by the European Society for Vascular Medicine (ESVM) take up the ongoing discussion on the meta-analysis by Katsanos et al [18]. Based on a secondary analysis of patient-level data from the LEVANT trial [29] and one of several available observational studies with routinely collected data, the authors concluded that the treatment of femoropopliteal lesions with coated balloons can be recommended as a standard of care (recommendation class II) [14].…”

Section: Introductionmentioning

confidence: 99%

Randomized controlled trials and real-world evidence for market access and surveillance of high-risk products—The example of paclitaxel

et al. 2020

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In 2018 and 2020, two meta-analyses using summary-level data from randomized controlled trials reported worse mortality following the application of paclitaxel-coated stents and balloons in femoropopliteal and crural arteries. These results initiated a heated global discussion concerning the validity of this association, while various observational studies using clinical and administrative registries proved the safety of coated devices. This article aimed to summarize the development and adoption of paclitaxel-coated balloons and stents for the treatment of peripheral arterial occlusive disease in clinical practice, research, and practice guidelines. It especially focusses on the European Unionʼs medical device regulation, which has far-reaching implications for the market approval and monitoring of high-risk medical devices.

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ESVM Guideline on peripheral arterial disease

Cited by 174 publications

References 419 publications

The compelling arguments for the need of microvascular investigation in COVID-19 critical patients

The compelling arguments for the need of microvascular investigation in COVID-19 critical patients

Current Status of Cell-Based Therapy in Patients with Critical Limb Ischemia

Randomized controlled trials and real-world evidence for market access and surveillance of high-risk products—The example of paclitaxel

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