Wound Healing and Wound Location in Critical Limb Ischemia Following Endovascular Treatment

Kobayashi, Noboru; Hirano, Keisuke; Nakano, Masataka; Muramatsu, Toshiya; Tsukahara, Reiko; Ito, Yoshiaki; H, Ito

doi:10.1253/circj.cj-14-0171

Cited by 24 publications

(18 citation statements)

References 36 publications

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“…A revascularization strategy involving repeat EVT is only one factor associated with wound healing, in addition to systemic factors, such as the clinical state of the tissue defect, presence of infection, and wound management strategy . In our previous study, wound healing could not be always achieved even though visible blood flow to the wound was achieved, depending on the wound location . It should therefore be stressed that wound healing cannot be achieved with successful revascularization alone, so it is important point to perform optimal total care, including wound management, before restenosis occurs, as this strategy may reduce the need for repeat EVT.…”

Section: Discussionmentioning

confidence: 95%

Characteristics and clinical outcomes of repeat endovascular therapy after infrapopliteal balloon angioplasty in patients with critical limb ischemia

Kobayashi

Hirano

Yamawaki

et al. 2017

Cathet Cardio Intervent

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Section: Discussionmentioning

confidence: 95%

Characteristics and clinical outcomes of repeat endovascular therapy after infrapopliteal balloon angioplasty in patients with critical limb ischemia

Kobayashi

Hirano

Yamawaki

et al. 2017

Cathet Cardio Intervent

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“…Finding an appropriate animal model for ischemic wound study has been a major challenge to scientists as well as clinicians [15,18,40]. The choice of animal models to mimic the human condition is based on a compromise of cost, ease of use, reproducibility, and reliability of the data [25].…”

Section: Discussionmentioning

confidence: 99%

“…The rat model has the advantages of ease of use, low cost, small size, and easy attainability [148]. However, wound healing in rats has been subjected to scrutiny because of their ability to heal infected wounds and the high rate of inter animal variability [25]. This rat skin wound model has a molecular profile similar to that of chronic human wounds [109].…”

Section: Discussionmentioning

confidence: 99%

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Comparison and Evaluation of Seven Animal Models of Ischemic Skin Wound: A Review Article

Bayat

Chien

2019

JPRI

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Focusing on pathophysiology, prevention, and treatment of ischemic wounds is apriority for medical and basic scientists in order to develop new clinical approaches. However it is not always easy for researchers to choose optimal animal models for their particular assessments. This review provides concise information on all currently available ischemic animal models, including rabbits’ ear ischemic models, axial skin flaps (axial pattern flaps), burns, ischemic limbs, localized ischemic wounds, pressure ulcers, and skin flaps, along with their citations as a measure of their acceptance among other researchers. We searched the numerous databases consisting of PubMed, Scopus, Science Direct, and Google Scholar. Key words included ischemic wound, skin, and animals alone or in combination. Some important features of the seven types of ischemia as well as their results are presented in Tables 1 -7. Table eight presents the results of entire groups of ischemic animal models, with their number of papers, number of wounds, and total and average Google Scholar citations, and web of science citations. We found that rabbits’ ear ischemic models, localized ischemic wounds, and pressure ulcers have the highest total and average citations amongst the studied groups. It was concluded that the rabbits’ ear ischemic model, rat pressure ulcer models, and localized ischemic wound models, have made the greatest contribution to our understanding of the pathophysiology of the ischemic wounds and increased production of new therapeutic protocols based on the citations reported by Google scholar and the web of science databases between 1977 and 2017.

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“…According to the clinical results of EVT reported by Kobayashi et al, the healing rate of an ulcer in the toe is 75%, whereas in heel tissue loss cases, the healing rate is 52%, and in cases of extensive tissue loss located somewhere other than the heel, the rate is 13%, showing a marked decrease in the ulcer healing rate. 41 This highlights the possibility that EVT has a limited role in extensive tissue loss. To derive parameters conducive to the choice of revascularization method, patient background and wound treatment procedures should be aligned to some extent, and EVT and bypass should be compared.…”

Section: Impact Of Pedal Arch Quality and The Arterial-arterial Connementioning

confidence: 98%

Ulcer Healing After Peripheral Intervention

Azuma

Koya

Uchida

et al. 2014

Circ J

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Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp panied by an increase in renal diseases, and the incidence of peripheral arterial disease (PAD) among dialysis patients is also increasing. In Japan, 50% of CLI patients have endstage renal disease (ESRD). 7 Furthermore, populations are aging rapidly in advanced countries; in other words, disease duration is increasing among DM and ESRD patients, in turn, increasing the risk of triggering and advancing arterial diseases. In this patient group, vascular disease is also accompanied by microangiopathy, which causes CLI with tissue loss.Analysis of the factors that impair the ulcer healing process in highly heterogeneous CLI patient groups is complicated. To establish a revascularization strategy after properly determining the healing vs. impairing factors, it is essential to gather ample data on post-revascularization ulcer healing. However, such reports are few, and even the guidelines do not provide revascularization procedural options from the viewpoint of ulcer healing.This review organized the reported factors that impair ulcer healing and identified those that clearly have a major effect on revascularization outcome and limb prognosis. We highlight the factors that are useful in planning revascularization strategies from the viewpoint of ulcer healing. dvancements in endovascular treatment (EVT) for critical limb ischemia (CLI) have enabled vascular surgeons, cardiologists and radiologists to participate in revascularization procedures. However, the number of experts in post-revascularization ulcer management has not caught up with the increasing number of revascularization procedures. Moreover, both education and knowledge regarding ulcer healing are insufficient for physicians performing revascularization. The treatment guideline for diabetic foot ulcers is well-established, 1 but evidence supporting strategies for the complete healing of ischemic ulcers after revascularization remains scant.Among the many studies that have reported limb salvage, complete ulcer healing was reported in only 17 studies (0.9%) according to a literature search from 1985 to 2005. 2 However, ulcer healing after revascularization is a major concern among patients, and the expected healing period is important in terms of health economics and the patient's quality of life (QOL). 3,4 Furthermore, information clarifying stubborn ulcers is meaningful for preventing the onset of ulcers and to educate the medical personnel who may potentially make an early discovery of such ulcers.In particular, there has been a tremendous worldwide increase in the number of patients with diabetes mellitus (DM) and the percentage of CLI patients with DM is increasing markedly, currently accounting for 70%. 5, 6 The increase in DM is accom- Complete ulcer healing is one of the most important goals of treatment for critical limb ischemia; however, it is still difficult to inform patients of the time to ulcer healing before performing revascularization. The tim...

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Wound Healing and Wound Location in Critical Limb Ischemia Following Endovascular Treatment

Cited by 24 publications

References 36 publications

Characteristics and clinical outcomes of repeat endovascular therapy after infrapopliteal balloon angioplasty in patients with critical limb ischemia

Characteristics and clinical outcomes of repeat endovascular therapy after infrapopliteal balloon angioplasty in patients with critical limb ischemia

Comparison and Evaluation of Seven Animal Models of Ischemic Skin Wound: A Review Article

Ulcer Healing After Peripheral Intervention

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