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Diagnostics
Special Issues
Critical Limb Threatening Ischemia in the COVID Era
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Critical Limb Threatening Ischemia in the COVID Era

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (15 May 2023) | Viewed by 4162

Special Issue Editor

Dr. Francesco Stilo

E-Mail Website
Guest Editor
Unit of Vascular Surgery, Head of Vascular Surgery Research Unit, Department of Medicine and Surgery, Universitary Hospital Foundation Campus Bio-Medico, Rome, Italy
Interests: inflammation; vascular–endovascular surgery; biomarkers; ultrasounds

Special Issue Information

Dear Colleagues,

Critical limb-threating ischemia (CLTI) is a fascinating field of research; in fact, this disease is associated with mortality, amputation, and impaired quality of life.

The evaluation and management of CLTI represent our goals to improve pivotal research.

Haemodynamic testing, imaging patterns, and inflammatory molecules are all potential biomarkers that can be considered to update our understanding and treatment of limb ischemia.

In this field, all of these factors are involved, and we should try to apply all possible strategies when approaching these concerns.

The same pathology could be treated via different operations (open vs. endovascular or hybrid solutions) to promote the healing of ulcers. Moreover, we have to study the inflammatory process underlyng infections.

We have to focus on midterm outcomes and on life expectancy as well as limb salvage, covering habits, risk factors, and postoperative rehabilitation.

The importance of multidisciplinary teams in good-quality referral centers for amputation prevention has to be demonstrated.

Finally, since these patients present a chronic disease, we aim to promote a proper diagnostic flow-chart and follow-up after treatment by focusing on all of these aspects.

Dr. Francesco Stilo
Guest Editor

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • biomarkers
  • blood flow
  • vascular pharmacology
  • tissue oxygenation
  • imaging techniques
  • ultrasound
  • inflammation
  • vascular–endovascular surgery
  • wound healing
  • cell therapy
  • metabolism
  • coagulation

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Published Papers (2 papers)

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14 pages, 7906 KiB  
Article
Symptomatic Popliteal Artery Aneurysms in Recently SARS-CoV-2-Infected Patients: The Microangiopathic Thrombosis That Undermines Treatment
by Laura Capoccia, Wassim Mansour, Luca di Marzo, Sabrina Grimaldi and Alessia Di Girolamo
Diagnostics 2023, 13(4), 647; https://doi.org/10.3390/diagnostics13040647 - 9 Feb 2023
Cited by 2 | Viewed by 1657
Abstract
Background: Arterial and venous thrombosis are complications in SARS-CoV-2-infected patients. The microangiopathic thrombosis in affected patients can compromise results in urgent limb revascularizations. Aim of our study is to report on the incidence of symptoms development in patients affected by popliteal artery aneurysm [...] Read more.
Background: Arterial and venous thrombosis are complications in SARS-CoV-2-infected patients. The microangiopathic thrombosis in affected patients can compromise results in urgent limb revascularizations. Aim of our study is to report on the incidence of symptoms development in patients affected by popliteal artery aneurysm (PAA) and to analyze the effect of COVID-19 infection on outcomes. Methods: Data on patients surgically treated for PAA from the massive widespread of COVID-19 vaccine (March 2021) to March 2022 were prospectively collected. Factors considered for analysis were: presence of symptoms, aneurysm diameter and length, time from symptom onset and hospital referral, ongoing or recently COVID-19 infection. Outcomes measures were: death, amputation, and neurological deficit. Results: Between March 2021 and March 2022, 35 patients were surgically treated for PAA. Among them 15 referred to our hospital for symptomatic PAA and were urgently treated. Urgent treatments included both endovascular procedures and open surgeries. Nine out of 15 symptomatic patients had an ongoing or recently recovered COVID-19 infection. COVID-19 infection was strongly associated to symptoms development in patients affected by PAA and to surgical failure in those patients (OR 40, 95% CI 2.01–794.31, p = 0.005). Conclusion: In our series, presence of COVID-19 infection was strongly associated to ischemic symptoms onset and to complications after urgent treatment in symptomatic patients. Full article
(This article belongs to the Special Issue Critical Limb Threatening Ischemia in the COVID Era)
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11 pages, 3699 KiB  
Technical Note
Extravascular Ultrasound (EVUS) to Assess the Results of Peripheral Endovascular Procedures
by Stefano Fazzini, Federico Francisco Pennetta, Valerio Turriziani, Simona Vona, Andrea Ascoli Marchetti and Arnaldo Ippoliti
Diagnostics 2023, 13(7), 1356; https://doi.org/10.3390/diagnostics13071356 - 6 Apr 2023
Cited by 4 | Viewed by 1823
Abstract
Contrast arteriography (CA) is considered the gold standard to evaluate any phase in peripheral arterial disease (PAD) interventions, from diagnostics to final results. Nevertheless, duplex ultrasonography (DUS) mostly used for the pre/postoperative phase and follow-up control, could be a potential intraoperative adjunctive imaging [...] Read more.
Contrast arteriography (CA) is considered the gold standard to evaluate any phase in peripheral arterial disease (PAD) interventions, from diagnostics to final results. Nevertheless, duplex ultrasonography (DUS) mostly used for the pre/postoperative phase and follow-up control, could be a potential intraoperative adjunctive imaging tool to assess the effects of endovascular revascularization in patients with iliac and femoropopliteal lesions. The PAD “duplex-assisted” protocol includes a preoperative DUS control followed by an intraoperative and a postoperative control. The most important parameters are pulsed doppler spectral analysis and waveform changes, which are impossible to detect with intravascular ultrasound (IVUS). By using a similar acronym, the intraoperative DUS has been previously described as extravascular ultrasound (EVUS). B-mode imaging, color flow, and peak systolic velocity (PSV) are considered. EVUS could be very useful to evaluate the effects of endovascular treatment, mainly in cases of unclear CAs, severe calcifications and/or dissections. In the context of the “leaving nothing behind” strategy, EVUS can drive the physician to evaluate the absence of flow-limiting dissections and decide which target lesion should be treated with antirestenotic therapy, further vessel preparation, or stenting. The EVUS protocol could be a safe and feasible option to improve the completion assessment of endovascular PAD treatment. A better ultrasound waveform is a sign of improved luminal gain and compliance, which is extremely important to finalize the results of new peripheral device technology, such as intravascular lithotripsy. Full article
(This article belongs to the Special Issue Critical Limb Threatening Ischemia in the COVID Era)
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