{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:37:40Z","timestamp":1790746660345,"version":"4.1.0"},"reference-count":28,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2017,9,11]],"date-time":"2017-09-11T00:00:00Z","timestamp":1505088000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clinical Hemorheology and Microcirculation"],"published-print":{"date-parts":[[2017,11,16]]},"abstract":"<jats:sec>\n                    <jats:title>AIMS:<\/jats:title>\n                    <jats:p>Critical limb ischemia (CLI) patients are characterized by intractable pain in spite of medication, non-healing ulcers, and gangrene. The objective of this study was to investigate whether or not isovolemic hemodilution treatment can reduce the rate of major amputations in CLI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>28 patients were studied who had tissue loss on Rutherford Grade III, Category 5 or 6. The subjects were divided into two arms: standard-of-care, conventional therapy (CT) ( n\u200a=\u200a15) as a control group and hemodilution therapy (HT) ( n\u200a=\u200a13) as a study group. For the HT group, weekly isovolemic hemodilution was performed over 4 consecutive weeks, removing 250\u200aml of whole blood with the infusion of hydroxyl-ethyl starch solution. Blood viscosity, hematocrit, hemoglobin, ankle-brachial index, VA pain scale, time-to-amputation from admission, and survival time were measured.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      The mean Hct gradually decreased from 36.6 to 35.1, whereas the WBV at a shear rate of 1 s\n                      <jats:sup>\u20131<\/jats:sup>\n                      significantly decreased from 18.2 to 10.5 during the same period. Subsequently, tissue oxygen delivery index, defined as the ratio of Hct to WBV at a shear rate of 1 s\n                      <jats:sup>\u20131<\/jats:sup>\n                      , increased from 24.4 to 37.0 by 51.7%, suggesting improvements in oxygen delivery in the patients. The average rate of lower limb major amputation in the control group was 93% (14\/15), whereas that in the study group was 31% (4\/13) ( p\u200a=\u200a0.001). Amputation-free median survival time and amputation-free 5-year survival rate in the control group were 1.2 months and 7%, while those in the study group were 30.2 months and 44% ( p\u200a=\u200a0.001). There were no adverse effects from repetitive hemodilution in the study group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Isovolemic hemodilution treatment of CLI patients was found to be well-tolerated and reduced the rate of major amputation resulting from the deterioration of CLI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3233\/ch-120108","type":"journal-article","created":{"date-parts":[[2017,9,12]],"date-time":"2017-09-12T11:12:57Z","timestamp":1505214777000},"page":"197-208","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Reduced amputation rate with isovolemic hemodilution in critical limb ischemia patients"],"prefix":"10.1177","volume":"67","author":[{"given":"Doosang","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Thoracic and Cardio-Vascular Surgery, Veterans Health Service Medical Center, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel J.","family":"Cho","sequence":"additional","affiliation":[{"name":"Rheovector LLC, King of Prussia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young I.","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering and Mechanics, Drexel University, Philadelphia, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,9,11]]},"reference":[{"key":"ref001","doi-asserted-by":"publisher","DOI":"10.1097\/01.RVI.0000240426.53079.46"},{"key":"ref002","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2006.09.024"},{"key":"ref003","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2009.08.073"},{"key":"ref004","unstructured":"HallettJW, MillsJL, EarnshawJJ, ReekersJA. 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