2024
Clinician perspectives regarding CYP2C19 genotype testing in patients with critical limb ischemia: A Delphi approach.
Regan C, Scierka L, Dardik A, Tonnessen B, Iyad Ochoa Chaar C, Ionescu C, Aboian E, Cardella J, Nassiri N, Guzman R, Attaran R, Nagpal S, Shah S, Smolderen K, Mena-Hurtado C. Clinician perspectives regarding CYP2C19 genotype testing in patients with critical limb ischemia: A Delphi approach. Vascular 2024, 17085381241246318. PMID: 38669051, DOI: 10.1177/17085381241246318.Peer-Reviewed Original ResearchDual antiplatelet therapyPeripheral arterial diseaseCYP2C19 testingCYP2C19 mutationsHeterogeneity of treatment effectsPeripheral vascular interventionsConsensus statementKnowledge questionsAntiplatelet therapyGenetic testingVascular surgeryAcademic health systemBarriers to implementationInterquartile rangeCYP2C19 genotype testingVascular diseaseInterventional cardiologyModified Delphi methodPatient's metabolic statusManagement of patientsCritical limb ischemiaPerceived barriersPeripheral vascular diseaseArterial vascular diseaseClinician perspectives
2022
Variability in 30-day major amputation rates following endovascular peripheral vascular intervention for critical limb ischemia
Provance JB, Spertus JA, Jones PG, Hoffman MA, Bunte MC, Vogel TR, Mena-Hurtado C, Smolderen KG. Variability in 30-day major amputation rates following endovascular peripheral vascular intervention for critical limb ischemia. Vascular Medicine 2022, 27: 350-357. PMID: 35603755, DOI: 10.1177/1358863x221098097.Peer-Reviewed Original ResearchConceptsPeripheral vascular interventionsCritical limb ischemiaMedian risk ratioEndovascular peripheral vascular interventionsMajor amputation ratePatient-level factorsAmputation ratePVI procedureLimb ischemiaRisk ratioVascular interventionsNational electronic health record databaseElectronic health record databasePredictors of amputationRate of amputationMixed effects Poisson regression modelHealth record databaseEffects Poisson regression modelPoisson regression modelsCLI carePrevious amputationClinical factorsCLI treatmentBlack raceDiagnosis codesThe shifting care and outcomes for patients with endangered limbs – Critical limb ischemia (SCOPE-CLI) registry overview of study design and rationale
Scierka LE, Mena-Hurtado C, Shishehbor MH, Spertus JA, Nagpal S, Babrowski T, Bunte MC, Politano A, Humphries M, Chung J, Kirksey L, Alabi O, Soukas P, Parikh S, Faizer R, Fitridge R, Provance J, Romain G, McMillan N, Stone N, Scott K, Fuss C, Pacheco CM, Gosch K, Harper-Brooks A, Smolderen KG, Consortium O. The shifting care and outcomes for patients with endangered limbs – Critical limb ischemia (SCOPE-CLI) registry overview of study design and rationale. IJC Heart & Vasculature 2022, 39: 100971. PMID: 35198727, PMCID: PMC8850321, DOI: 10.1016/j.ijcha.2022.100971.Peer-Reviewed Original ResearchCritical limb ischemiaTreatment preferencesPeripheral artery diseaseProspective observational registryPatient-centered outcomesPatterns of carePoor wound healingHealth status outcomesProcess of careCLI careObservational registryLimb ischemiaPatient characteristicsArtery diseaseVascular centersVital statusMean agePatient preferencesPatient's perspectiveSevere formPatientsPsychosocial factorsStatus outcomesHealth statusCare experiences
2021
Guideline-Directed Medical Therapy in Patients with Chronic Kidney Disease Undergoing Peripheral Vascular Intervention
Jelani QU, Llanos-Chea F, Bogra P, Trejo-Paredes C, Huang J, Provance JB, Turner J, Anantha-Narayanan M, Sheikh AB, Smolderen KG, Mena-Hurtado C. Guideline-Directed Medical Therapy in Patients with Chronic Kidney Disease Undergoing Peripheral Vascular Intervention. American Journal Of Nephrology 2021, 52: 845-853. PMID: 34706363, DOI: 10.1159/000519484.Peer-Reviewed Original ResearchConceptsComorbid chronic kidney diseaseGuideline-directed medical therapyPeripheral vascular interventionsCritical limb ischemiaMedian odds ratioMedical therapyPrescription ratesVascular interventionsHigh riskUse of GDMTAdjusted median odds ratioVascular Quality Initiative databaseAngiotensin-converting enzyme inhibitorAngiotensin receptor blockersChronic kidney diseaseLower prescription ratesPoor clinical outcomeCKD groupCKD statusAntiplatelet therapyReceptor blockersLimb ischemiaLimb outcomesClinical outcomesMedical managementPrevalence of Mental Health Burden Among Men and Women Hospitalized With Critical Limb Ischemia: Insights From the National Inpatient Sample
Harris K, Arham A, Mena-Hurtado C, Burg M, Smolderen K. Prevalence of Mental Health Burden Among Men and Women Hospitalized With Critical Limb Ischemia: Insights From the National Inpatient Sample. Journal Of Vascular Surgery 2021, 74: e163-e164. DOI: 10.1016/j.jvs.2021.06.247.Peer-Reviewed Original ResearchLack of Guideline-Directed Medical Therapy in Patients Undergoing Endovascular Procedures for Critical Limb Ischemia
Llanos-Chea F, Jelani QU, Trejo-Paredes C, Curtis JP, Parzynski CS, Huang J, Faridi KF, Turner J, Smolderen KG, Mena-Hurtado C. Lack of Guideline-Directed Medical Therapy in Patients Undergoing Endovascular Procedures for Critical Limb Ischemia. Journal Of The American College Of Cardiology 2021, 77: 1374-1375. PMID: 33706882, DOI: 10.1016/j.jacc.2020.12.063.Peer-Reviewed Original ResearchMeSH KeywordsAgedAged, 80 and overAngiotensin Receptor AntagonistsAngiotensin-Converting Enzyme InhibitorsCohort StudiesEndovascular ProceduresFemaleGuideline AdherenceHumansHydroxymethylglutaryl-CoA Reductase InhibitorsIschemiaMaleMiddle AgedPeripheral Arterial DiseasePlatelet Aggregation InhibitorsConceptsCritical limb ischemiaLimb ischemiaMedical therapyEndovascular proceduresLack of guidelinesIschemiaPatientsTherapyContemporary Trends in Hospital Admissions and Outcomes in Patients With Critical Limb Ischemia
Anantha-Narayanan M, Doshi RP, Patel K, Sheikh AB, Llanos-Chea F, Abbott JD, Shishehbor MH, Guzman RJ, Hiatt WR, Duval S, Mena-Hurtado C, Smolderen KG. Contemporary Trends in Hospital Admissions and Outcomes in Patients With Critical Limb Ischemia. Circulation Cardiovascular Quality And Outcomes 2021, 14: e007539. PMID: 33541110, DOI: 10.1161/circoutcomes.120.007539.Peer-Reviewed Original ResearchConceptsLength of stayMajor amputationCost of hospitalizationHospital mortalitySurgical interventionEndovascular interventionBlack raceHigh-risk patient profileNational Inpatient Sample dataHigher major amputationMore endovascular interventionsRisk patient profileCritical limb ischemiaOpen surgical interventionMultivariable regression analysisHierarchical multivariable regression analysisCLI cohortHospital admissionLimb ischemiaPrimary outcomeRevascularization proceduresSecondary outcomesAtherosclerotic diseaseMale sexFemale sex
2020
Prognostic Value of Radiotracer-Based Perfusion Imaging in Critical Limb Ischemia Patients Undergoing Lower Extremity Revascularization
Chou TH, Alvelo JL, Janse S, Papademetris X, Sumpio BE, Mena-Hurtado C, Sinusas AJ, Stacy MR. Prognostic Value of Radiotracer-Based Perfusion Imaging in Critical Limb Ischemia Patients Undergoing Lower Extremity Revascularization. JACC Cardiovascular Imaging 2020, 14: 1614-1624. PMID: 33221224, PMCID: PMC8113329, DOI: 10.1016/j.jcmg.2020.09.033.Peer-Reviewed Original ResearchConceptsCritical limb ischemiaLower extremity revascularizationDiabetes mellitusSPECT/CTPrognostic valuePerfusion responseAmputation outcomesExtremity revascularizationFoot perfusionCritical limb ischemia patientsAmputation-free survivalIncidence of amputationSubsequent clinical outcomesRegional perfusion abnormalitiesSingle photon emissionIschemia patientsLimb ischemiaClinical outcomesFoot ulcersPerfusion abnormalitiesCT perfusionRevascularizationRadiotracer uptakePatientsPerfusion imagingSystematic review and meta-analysis of outcomes of lower extremity peripheral arterial interventions in patients with and without chronic kidney disease or end-stage renal disease
Anantha-Narayanan M, Sheikh AB, Nagpal S, Jelani QU, Smolderen KG, Regan C, Ionescu C, Ochoa Chaar CI, Schneider M, Llanos-Chea F, Mena-Hurtado C. Systematic review and meta-analysis of outcomes of lower extremity peripheral arterial interventions in patients with and without chronic kidney disease or end-stage renal disease. Journal Of Vascular Surgery 2020, 73: 331-340.e4. PMID: 32889074, DOI: 10.1016/j.jvs.2020.08.032.Peer-Reviewed Original ResearchConceptsCKD/end-stage renal diseaseEnd-stage renal diseaseNormal renal functionChronic kidney diseaseTarget lesion revascularizationLong-term mortalityPeripheral arterial diseaseRenal functionPAD interventionsMajor amputationRenal diseaseKidney diseaseOdds ratioNormal renal function groupIntervention typeRenal function groupCritical limb ischemiaPeripheral arterial interventionsConfidence intervalsPooled odds ratioOpen surgical approachMultivariable regression analysisCase-control matchingRandom-effects modelEvidence-based strategiesImpact of Kidney Disease on Peripheral Arterial Interventions: A Systematic Review and Meta-Analysis
Anantha-Narayanan M, Sheikh AB, Nagpal S, Smolderen KG, Turner J, Schneider M, Llanos-Chea F, Mena-Hurtado C. Impact of Kidney Disease on Peripheral Arterial Interventions: A Systematic Review and Meta-Analysis. American Journal Of Nephrology 2020, 51: 527-533. PMID: 32570255, DOI: 10.1159/000508575.Peer-Reviewed Original ResearchConceptsCKD/ESRDCritical limb ischemiaPAD interventionsMajor amputationEarly mortalitySystematic reviewCKD/ESRD patientsPeripheral arterial disease interventionsHigher major amputationOutcomes of patientsPeripheral arterial interventionsSuch comorbid conditionsESRD patientsLimb ischemiaArterial interventionsComorbid conditionsRandomized trialsKidney diseasePatient populationESRDObservational studyRisk populationsFunnel plotPatientsMeta-Analysis
2019
Review of the Current Basic Science Strategies to Treat Critical Limb Ischemia
Haghighat L, Ionescu CN, Regan CJ, Altin SE, Attaran RR, Mena-Hurtado CI. Review of the Current Basic Science Strategies to Treat Critical Limb Ischemia. Vascular And Endovascular Surgery 2019, 53: 316-324. PMID: 30808262, DOI: 10.1177/1538574419831489.Peer-Reviewed Original ResearchConceptsCritical limb ischemiaLimb ischemiaDevelopment of CLIMolecular therapyPoor surgical candidatesImpairment of angiogenesisSurgical candidatesMicrovascular changesNovel imaging modalityTreatment optionsMorbid diseaseTranslational medicine studiesTherapyMedicine studiesImaging modalitiesIschemiaDiseasePatientsPathophysiologyArteriogenesisImpairmentTrialsMultidisciplinary Care for Critical Limb Ischemia: Current Gaps and Opportunities for Improvement
Armstrong EJ, Alam S, Henao S, Lee AC, DeRubertis BG, Montero-Baker M, Mena C, Cua B, Palena LM, Kovach R, Chandra V, AlMahameed A, Walker CM. Multidisciplinary Care for Critical Limb Ischemia: Current Gaps and Opportunities for Improvement. Journal Of Endovascular Therapy 2019, 26: 199-212. PMID: 30706755, DOI: 10.1177/1526602819826593.Peer-Reviewed Original ResearchConceptsCritical limb ischemiaCare of patientsComplex patient populationMultidisciplinary careLimb ischemiaPatient populationIschemic rest painLimb-related morbidityPeripheral artery diseaseFacets of careRest painArterial insufficiencyRevascularization strategyArtery diseaseTimely referralSingle medical specialtyOptimal treatmentPatient outcomesSocietal guidelinesWound careTreatment teamMultiple specialtiesPatientsCareMedical specialties
2018
Radiotracer Imaging Allows for Noninvasive Detection and Quantification of Abnormalities in Angiosome Foot Perfusion in Diabetic Patients With Critical Limb Ischemia and Nonhealing Wounds
Alvelo JL, Papademetris X, Mena-Hurtado C, Jeon S, Sumpio BE, Sinusas AJ, Stacy MR. Radiotracer Imaging Allows for Noninvasive Detection and Quantification of Abnormalities in Angiosome Foot Perfusion in Diabetic Patients With Critical Limb Ischemia and Nonhealing Wounds. Circulation Cardiovascular Imaging 2018, 11: e006932. PMID: 29748311, PMCID: PMC5951395, DOI: 10.1161/circimaging.117.006932.Peer-Reviewed Original ResearchMeSH KeywordsAnkle Brachial IndexCase-Control StudiesCritical IllnessDiabetic FootHumansIschemiaMicrocirculationOrganophosphorus CompoundsOrganotechnetium CompoundsPerfusion ImagingPredictive Value of TestsRadiopharmaceuticalsRegional Blood FlowSingle Photon Emission Computed Tomography Computed TomographyWound HealingConceptsCritical limb ischemiaAnkle-brachial indexStandardized uptake valueSPECT/CT imagingDiabetic patientsHealthy subjectsSPECT/CTFoot perfusionUptake valueLimb ischemiaMicrovascular perfusionSkeletal muscle microvascular perfusionCT imagingDiabetic CLI patientsMuscle microvascular perfusionPeripheral artery diseaseSingle photon emissionIntraclass correlation coefficientAngiosome perfusionCLI subjectsCLI patientsArtery diseaseDiabetes mellitusCT perfusionVascular territories
2017
Management of Isolated Atherosclerotic Stenosis of the Common Femoral Artery: A Review of the Literature
Halpin D, Erben Y, Jayasuriya S, Cua B, Jhamnani S, Mena-Hurtado C. Management of Isolated Atherosclerotic Stenosis of the Common Femoral Artery: A Review of the Literature. Vascular And Endovascular Surgery 2017, 51: 220-227. PMID: 28376704, DOI: 10.1177/1538574417702773.Peer-Reviewed Original ResearchConceptsCommon femoral endarterectomyTarget lesion revascularizationCommon femoral arteryCFA stenosisEndovascular therapyEndovascular studiesPrimary patencyAtherosclerotic stenosisTechnical successEndovascular interventionFemoral arteryGood short-term patencyFurther trial dataFirst-line therapyPercentage of patientsCritical limb ischemiaStandard of careNumber of patientsShort-term patencyLower ratesHigh rateEndovascular literatureFemoropopliteal systemLesion revascularizationLimb ischemiaRADIOTRACER IMAGING ALLOWS FOR ASSESSMENT OF SERIAL CHANGES IN ANGIOSOME FOOT PERFUSION FOLLOWING REVASCULARIZATION AND PREDICTS LIMB SALVAGE OUTCOMES IN PATIENTS WITH CRITICAL LIMB ISCHEMIA
Buckley J, Mena-Hurtado C, Jeon S, Papademetris X, Blume P, Sumpio B, Sinusas A, Stacy M. RADIOTRACER IMAGING ALLOWS FOR ASSESSMENT OF SERIAL CHANGES IN ANGIOSOME FOOT PERFUSION FOLLOWING REVASCULARIZATION AND PREDICTS LIMB SALVAGE OUTCOMES IN PATIENTS WITH CRITICAL LIMB ISCHEMIA. Journal Of The American College Of Cardiology 2017, 69: 1393. DOI: 10.1016/s0735-1097(17)34782-4.Peer-Reviewed Original ResearchCritical limb ischemiaLimb ischemiaFoot perfusionSerial changesRevascularizationIschemiaPatientsPerfusion
2015
Tools of the Trade: Adjunctive Tools for Lesion Crossing in Critical Limb Ischemia
Goldsweig A, Hasan F, Mena C. Tools of the Trade: Adjunctive Tools for Lesion Crossing in Critical Limb Ischemia. Medical Equipment Insights 2015, 6: mei.s18479. DOI: 10.4137/mei.s18479.Peer-Reviewed Original ResearchCritical limb ischemiaTrue lumenReentry deviceLimb ischemiaLesion crossingAtherectomy devicesAdjunctive toolChronic total occlusionDistal true lumenLives of patientsMechanical atherectomy devicesCrossing deviceTotal occlusionMechanical atherectomyOrbital atherectomyLaser atherectomyFurther interventionCause painTissue damageAtherectomyVessel lumenIschemiaAtheroma
2014
Randomized Controlled Study of Excimer Laser Atherectomy for Treatment of Femoropopliteal In-Stent Restenosis Initial Results From the EXCITE ISR Trial (EXCImer Laser Randomized Controlled Study for Treatment of FemoropopliTEal In-Stent Restenosis)
Dippel EJ, Makam P, Kovach R, George JC, Patlola R, Metzger DC, Mena-Hurtado C, Beasley R, Soukas P, Colon-Hernandez PJ, Stark MA, Walker C, Investigators E. Randomized Controlled Study of Excimer Laser Atherectomy for Treatment of Femoropopliteal In-Stent Restenosis Initial Results From the EXCITE ISR Trial (EXCImer Laser Randomized Controlled Study for Treatment of FemoropopliTEal In-Stent Restenosis). JACC Cardiovascular Interventions 2014, 8: 92-101. PMID: 25499305, DOI: 10.1016/j.jcin.2014.09.009.Peer-Reviewed Original ResearchMeSH KeywordsAgedAlloysAmputation, SurgicalAngioplasty, BalloonAtherectomyChronic DiseaseCombined Modality TherapyConstriction, PathologicFemaleFemoral ArteryHumansLaser TherapyLasers, ExcimerLimb SalvageMaleMiddle AgedPeripheral Arterial DiseasePopliteal ArteryProspective StudiesProsthesis DesignRecurrenceStentsTime FactorsTreatment OutcomeUnited StatesVascular PatencyConceptsPercutaneous transluminal angioplastyTarget lesion revascularizationExcimer laser atherectomyLaser atherectomyAdjunctive percutaneous transluminal angioplastyMajor adverse event rateChronic peripheral artery diseaseLesion lengthLifestyle-limiting claudicationPrimary safety endpointRutherford class 1Target lesion lengthPrimary efficacy endpointMajor adverse eventsPeripheral artery diseaseAdverse event ratesCritical limb ischemiaFemoropopliteal ISRLesion revascularizationEfficacy endpointSafety endpointAdverse eventsLimb ischemiaTransluminal angioplastyArtery disease