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https://www.readbyqxmd.com/read/28342514/angiosome-directed-revascularization-in-patients-with-critical-limb-ischemia
#1
REVIEW
Hidde Jongsma, Joost A Bekken, George P Akkersdijk, Sanne E Hoeks, Hence J Verhagen, Bram Fioole
OBJECTIVE: Direct revascularization (DR), according to the angiosome concept, provides direct blood flow to the site of tissue loss in patients with critical limb ischemia (CLI). DR may lead to improved outcomes; however, evidence for this is controversial. This systematic review and meta-analysis investigated the outcomes of surgical and endovascular DR compared with indirect revascularization (IR) in patients with CLI. METHODS: A systematic review was undertaken using the Cochrane Collaboration specified tool, and a meta-analysis was done according to the MOOSE (Meta-analysis of Observational Studies in Epidemiology) criteria...
April 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28261156/a-decision-tree-analysis-of-diabetic-foot-amputation-risk-in-indian-patients
#2
Prasad Umesh Kasbekar, Pranay Goel, Shailaja Prakash Jadhav
AIM: The aim of this study is to create an evidence-based tool that guides the risk of amputation in diabetic foot patients. MATERIALS AND METHODS: Hospital records of 301 diabetic foot patients were examined retrospectively for explanatory variables of foot amputation decisions. The study included all patients with a lower limb ulcer with a known history of diabetes mellitus or those diagnosed post-admission. The dataset was analyzed, and a risk scoring system was constructed using the decision tree algorithm, C5...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28236922/preoperative-frailty-is-predictive-of-complications-after-major-lower-extremity-amputation
#3
Zachary B Fang, Frances Y Hu, Shipra Arya, Theresa W Gillespie, Ravi R Rajani
OBJECTIVE: Preoperative clinical frailty is increasingly used as a surrogate for predicting postoperative outcomes. Patients undergoing major lower extremity amputation (LEA) carry a high risk of perioperative morbidity and mortality, including high 30-day mortality and readmission rates. We hypothesized that preoperative frailty would be associated with an increased risk of postoperative mortality and readmission. METHODS: A retrospective review was performed for all patients who underwent transfemoral or transtibial amputation for any indication within a multi-institution system during a 5-year period...
March 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28236080/what-are-the-frequency-associated-factors-and-mortality-of-amputation-and-arthrodesis-after-a-failed-infected-tka
#4
Min-Sun Son, Edmund Lau, Javad Parvizi, Michael A Mont, Kevin J Bozic, Steven Kurtz
BACKGROUND: For patients with failed surgical treatment of an infected TKA, salvage operations such as arthrodesis or above-knee amputation (AKA) may be considered. Clinical and institutional factors associated with AKA and arthrodesis after a failed TKA have not been investigated in a large-scale population, and the utilization rate and trend of these measures are not well known. QUESTIONS/PURPOSES: (1) How has the frequency of arthrodesis and AKA after infected TKA changed over the last 10 years? (2) What clinical or institutional factors are associated with patients undergoing arthrodesis or AKA? (3) What is the risk of mortality after arthrodesis or AKA? METHODS: The Medicare 100% National Inpatient Claims Database was used to identify 44,466 patients 65 years of age or older who were diagnosed with an infected TKA and who underwent revision between 2005 and 2014 based on International Classification of Diseases, 9(th) Revision, Clinical Modification codes...
February 24, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28194186/safety-and-effectiveness-of-bone-marrow-cell-concentrate-in-the-treatment-of-chronic-critical-limb-ischemia-utilizing-a-rapid-point-of-care-system
#5
Venkatesh Ponemone, Saniya Gupta, Dalip Sethi, Manish Suthar, Monika Sharma, Richard J Powell, Kenneth Lee Harris, Nungshi Jungla, Priyadarshini Arambam, Upendra Kaul, Ashok Seth, Suhail Bukhari
Critical limb ischemia (CLI) is the end stage of lower extremity peripheral vascular disease (PVD) in which severe obstruction of blood flow results in ischemic rest pain, ulcers and/or gangrene, and a significant risk of limb loss. This open-label, single-arm feasibility study evaluated the safety and therapeutic effectiveness of autologous bone marrow cell (aBMC) concentrate in revascularization of CLI patients utilizing a rapid point-of-care device. Seventeen (17) no-option CLI patients with ischemic rest pain were enrolled in the study...
2017: Stem Cells International
https://www.readbyqxmd.com/read/28176831/association-between-cytokine-response-the-lrinec-score-and-outcome-in-patients-with-necrotising-soft-tissue-infection-a-multicentre-prospective-study
#6
Marco Bo Hansen, Lars Simon Rasmussen, Mattias Svensson, Bhavya Chakrakodi, Trond Bruun, Martin Bruun Madsen, Anders Perner, Peter Garred, Ole Hyldegaard, Anna Norrby-Teglund
Early assessment of necrotising soft tissue infection (NSTI) is challenging. Analysis of inflammatory markers could provide important information about disease severity and guide decision making. For this purpose, we investigated the association between cytokine levels and the Laboratory Risk Indicator for Necrotising Fasciitis (LRINEC)-score, disease severity and mortality in NSTI patients. In 159 patients, plasma was analysed for IL-1β, IL-6, IL-10 and TNF-α upon admission. The severity of NSTI was assessed by SAPS, SOFA score, septic shock, microbial aetiology, renal replacement therapy and amputation...
February 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28140457/assessment-and-validation-of-a-novel-angiographic-scoring-system-for-peripheral-artery-disease
#7
D R Morris, T P Singh, J V Moxon, A Smith, F Stewart, R E Jones, J Golledge
BACKGROUND: Angiography is used routinely in the assessment of lower-limb arteries, but there are few well validated angiographic scoring systems. The aim of this study was to develop and validate a novel angiographic scoring system for peripheral artery disease. METHODS: An angiographic scoring system (the ANGIO score) was developed and applied to a sample of patients from a single vascular surgical department who underwent CT angiography of the lower limbs. The reproducibility of the ANGIO score was compared with those of the Bollinger and Trans-Atlantic inter-Society Consensus (TASC) IIb systems in a series of randomly selected patients...
January 31, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28090010/long-term-outcomes-after-percutaneous-lower-extremity-arterial-interventions-with-atherectomy-vs-balloon-angioplasty%C3%A3-propensity-score-matched-registry
#8
Adam Janas, Piotr P Buszman, Krzysztof P Milewski, Szymon Wiernek, Ksenia Janas, Maciej Pruski, Wojciech Wojakowski, Aleksandra Błachut, Wojciech Picheta, Pawel Buszman, Stefan Kiesz
BACKGROUND: The impact of endovascular revascularization of the lower extremity arteries with atherectomy (AT) compared with percutaneous transluminal angioplasty (PTA) is still unclear. Therefore, the aim of the study was to compare long-term outcomes after percutaneous PTA and AT in patients requiring endovascular revascularization.Methods and Results:This was a single-center, retrospective registry of obstructive and symptomatic PAD patients who underwent endovascular revascularization...
February 24, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28073665/predictive-ability-of-the-society-for-vascular-surgery-wound-ischemia-and-foot-infection-wifi-classification-system-after-first-time-lower-extremity-revascularizations
#9
Jeremy D Darling, John C McCallum, Peter A Soden, Raul J Guzman, Mark C Wyers, Allen D Hamdan, Hence J Verhagen, Marc L Schermerhorn
OBJECTIVE: The Society for Vascular Surgery (SVS) Wound, Ischemia and foot Infection (WIfI) classification system was proposed to predict 1-year amputation risk and potential benefit from revascularization. Our goal was to evaluate the predictive ability of this scale in a real-world selection of patients undergoing a first-time lower extremity revascularization for chronic limb-threatening ischemia (CLTI). METHODS: From 2005 to 2014, 1336 limbs underwent a first-time lower extremity revascularization for CLTI, of which 992 had sufficient data to classify all three WIfI components (wound, ischemia, and foot infection)...
March 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28071959/tenfold-risk-increase-of-major-cardiovascular-events-after-high-limb-amputation-with-non-compliance-for-secondary-prevention-measures
#10
Evgeniya V Shalaeva, Hugo Saner, Bakhtiyor B Janabaev, Aleksandra V Shalaeva
Background The aim of the study was to evaluate the impact of compliance with lifestyle recommendations and medication on 1-year prevention of major adverse cardiovascular events (MACE) in patients with type 2 diabetes (T2D) after trans-femoral amputation (TFA). Methods In this prospective single-center interventional cohort study, 179 consecutive T2D patients with symptomatic coronary artery disease (CAD) underwent 1-year follow-up examination after TFA in 2013. Lower limb and coronary artery CT angiography were provided before surgery; physical examination and laboratory tests were performed at baseline and every month after TFA for 1 year...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28066525/the-effect-of-transfemoral-interface-design-on-gait-speed-and-risk-of-falls
#11
Jason T Kahle, Tyler D Klenow, William J Sampson, M Jason Highsmith
Falls and diminished walking capacity are impairments common in persons with transfemoral amputation (TFA). Reducing falls and optimizing walking capacity through such means as achieving a more normal gait speed and community ambulation should be considered when formulating the prosthetic prescription. Because walking capacity and balance confidence are compromised with TFA, these outcomes should be considered when evaluating interfaces for transfemoral prosthetic users. The purpose of this study was to compare the effect of TFA interface design on walking capacity and balance confidence A retrospective cohort design was utilized involving unilateral TFA patients who used ischial ramus containment (IRC) and High-Fidelity (HiFi) interfaces (independent variables)...
September 2016: Technology and Innovation
https://www.readbyqxmd.com/read/28059972/endovascular-versus-open-revascularization-for-peripheral-arterial-disease
#12
Jason T Wiseman, Sara Fernandes-Taylor, Sandeep Saha, Jeffrey Havlena, Paul J Rathouz, Maureen A Smith, K Craig Kent
OBJECTIVE: The aim of this study was to determine whether endovascular or open revascularization provides an advantageous approach to symptomatic peripheral arterial disease (PAD) over the longer term. SUMMARY OF BACKGROUND DATA: The optimal revascularization strategy for symptomatic lower extremity PAD is not established. METHODS: We evaluated amputation-free survival, overall survival, and relative rate of subsequent vascular intervention after endovascular or open lower extremity revascularization for propensity-score matched cohorts of Medicare beneficiaries with PAD from 2006 through 2009...
February 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28054925/the-wound-trend-scale-a-retrospective-review-of-utility-and-predictive-value-in-the-assessment-and-documentation-of-lower-leg-ulcers
#13
Noreen A Campbell, Donna L Campbell, Andrea Turner
Wound assessment is essential to manage wound care. The Wound Trend Scale (WTS) is a paper-and-pen instrument comprised of 14 parameters designed to guide assessment of findings relevant to lower leg ulcer management and includes an infection screen and cues for physician consultation. To determine its clinical utility, predictive value, and reliability, data were retrospectively analyzed from a random sampling of medical records of patients seen at a Foot and Leg Clinic between January 1, 2007 and December 31, 2008...
December 2016: Ostomy/wound Management
https://www.readbyqxmd.com/read/28032037/surgical-apgar-score-predicts-early-complication-in-transfemoral-amputees-retrospective-study-of-170-major-amputations
#14
Christian Wied, Nicolai B Foss, Morten T Kristensen, Gitte Holm, Thomas Kallemose, Anders Troelsen
AIM: To assess whether the surgical apgar score (SAS) is a prognostic tool capable of identifying patients at risk of major complications following lower extremity amputations surgery. METHODS: This was a single-center, retrospective observational cohort study conducted between January 2013 and April 2015. All patients who had either a primary transtibial amputation (TTA) or transfemoral amputation (TFA) conducted at our institution during the study period were assessed for inclusion...
December 18, 2016: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28002371/polymicrobial-periprosthetic-joint-infections-outcome-of-treatment-and-identification-of-risk-factors
#15
Timothy L Tan, Michael M Kheir, Dean D Tan, Javad Parvizi
BACKGROUND: The treatment outcomes of periprosthetic joint infection are frequently dependent on characteristics of the causative organism. The objective of this comparative study was to investigate the prevalence of and risk factors for development of polymicrobial periprosthetic joint infection, and the outcome of surgical treatment of these patients. METHODS: All patients with polymicrobial, monomicrobial, or culture-negative periprosthetic joint infection treated from 2000 to 2014 were identified at a single institution...
December 21, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27996340/geographic-variation-as-a-risk-factor-for-digital-ulcers-in-systemic-sclerosis-patients-a-multicentre-registry
#16
Ejr Souza, C S Muller, Amc Horimoto, R A Rezende, I Guimarães, H A Mariz, A T Dantas, I P Da Costa, Apt Del-Rio, J Sekiyama, C B Kahwage, C Kayser
OBJECTIVE: To evaluate the influence of geographic variation on the risk of digital ulcer (DU) development in systemic sclerosis (SSc) patients. METHODS: This cross-sectional, multicentre study evaluated patients with SSc from centres located in different geographic regions of Brazil (subtropical and tropical climate zones). Demographic and clinical data were collected. RESULTS: The study included 141 patients with SSc (26 from the subtropical and 115 from the tropical zone)...
December 20, 2016: Scandinavian Journal of Rheumatology
https://www.readbyqxmd.com/read/27909134/what-is-the-morbidity-of-a-non-invasive-growing-prosthesis
#17
M M Gilg, C L Gaston, M C Parry, L Jeys, A Abudu, R M Tillman, S R Carter, R J Grimer
AIMS: Extendible endoprostheses have been available for more than 30 years and have become more sophisticated with time. The latest generation is 'non-invasive' and can be lengthened with an external magnetic force. Early results have shown a worryingly high rate of complications such as infection. This study investigates the incidence of complications and the need for further surgery in a cohort of patients with a non-invasive growing endoprosthesis. PATIENTS AND METHODS: Between 2003 and June 2014, 50 children (51 prostheses) had a non-invasive growing prosthesis implanted for a primary bone sarcoma...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27903472/endovascular-treatment-of-popliteal-artery-aneurysms-a-word-of-caution-after-long-term-follow-up
#18
Cosimo Maraglino, Gianluca Canu, Renzo Ambrosi, Franco Briolini, Riccardo Gotti, Pietro Cefalì, Fabio Calliari, Paolo Ferrero, Franco Terraneo
BACKGROUND: The aim of this work was to evaluate the long-term patency of endografting in the treatment of popliteal artery aneurysms (PAAs) and to identify which factors may be predictors of graft occlusion. METHODS: All the patients who underwent endovascular repair of PAA were analyzed from 2006 until 2014 on the basis of symptoms, comorbidities, limb salvage, and long-term patency. The predictive value of the different variables was assessed in univariate analysis for primary patency and, for factors resulted significant, a multivariate analysis was performed...
November 27, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27901322/risk-factors-analysis-of-thromboembolectomy-for-acute-thromboembolic-lower-extremity-ischemia-in-native-arteries
#19
Gabriele Piffaretti, Alessandro Angrisano, Marco Franchin, Massimo Ferrario, Nicola Rivolta, Alessandro Bacuzzi, Patrizio Castelli, Matteo Tozzi
BACKGROUND: Aim of this study is to report the results of thromboembolectomy (ThEmb) for acute thromboembolic lower limb ischemia (ATLI) in native arteries and to create a predictive score for amputation-free survival (AFS) at 30 days. METHODS: It is a single center, retrospective analysis of a four years period. All patients had ThEmb: adjunctive procedures included femoral and/or popliteal endarterectomy in 30 (18.3%) cases, PTA- stent in 24 (14.6%), and femoral endarterectomy plus PTA-stent in 12 (7...
November 30, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27898155/balance-confidence-and-activity-of-community-dwelling-patients-with-transtibial-amputation
#20
Alena Mandel, Kailan Paul, Ruby Paner, Michael Devlin, Steve Dilkas, Tim Pauley
The purpose of this study was to examine the relationship between balance confidence and community-based physical activity. Twenty-two community-dwelling patients with right or left unilateral transtibial amputation who reported no falls in the past 6 mo completed the Activities-Specific Balance Confidence Scale (ABC) and wore a StepWatch Activity Monitor for 7 consecutive d in the community. Subjects were subsequently stratified as low ( <3,000 steps/d) or high (>/=3,000) steps/d) activity groups. Balance confidence was significantly lower among the low activity weekday group (LAG, 70...
2016: Journal of Rehabilitation Research and Development
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