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Below knee amputation

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https://www.readbyqxmd.com/read/28920529/surgical-interventions-for-organ-and-limb-ischemia-associated-with-primary-and-secondary-antiphospholipid-antibody-syndrome-with-arterial-involvement
#1
Carlos A Hinojosa, Javier E Anaya-Ayala, Karla Bermudez-Serrato, Ramón García-Alva, Hugo Laparra-Escareno, Adriana Torres-Machorro, Rene Lizola
OBJECTIVE: The association of antiphospholipid antibody syndrome (APS) and hypercoagulability is well known. Arterial compromise leading to ischemia of organs and/or limbs in patients with APS is uncommon, frequently unrecognized, and rarely described. We evaluated our institutional experience. METHODS: Retrospective review was conducted. From August 2007 to September 2016, 807 patients with diagnosis of APS were managed in our Institution. Patients with primary and secondary APS who required interventions were examined...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28899563/treating-osteomyelitis-of-major-limb-amputations-with-a-modified-lautenbach-technique
#2
Juliet M Clutton, Oliver Donaldson, Anthony Perera, Rhidian Morgan-Jones
INTRODUCTION: Major lower limb amputation significantly increases the energy cost of walking for patients. Complications such as osteomyelitis may require further surgery, and can lead to shortening of the stump. In these cases, the aim should be to treat infection without shortening the limb further. We present a series of patients with established osteomyelitis of the amputation stump, managed using a modified Lautenbach technique. METHOD: Six patients with either above or below knee amputations, in the practice of a single orthopaedic surgeon, were studied...
September 1, 2017: Injury
https://www.readbyqxmd.com/read/28898514/risk-of-lower-extremity-amputations-in-patients-with-type-2-diabetes-mellitus-treated-with-sglt2-inhibitors-in-the-united-states-a-retrospective-cohort-study
#3
Zhong Yuan, Frank J DeFalco, Patrick B Ryan, Martijn J Schuemie, Paul E Stang, Jesse A Berlin, Mehul Desai, Norm Rosenthal
AIMS: To examine the incidence of amputation in patients with type 2 diabetes mellitus (T2DM) treated with sodium glucose co-transporter 2 inhibitors (SGLT2i) overall, and canagliflozin specifically, compared with non-SGLT2i antihyperglycemic agents (AHAs). MATERIALS AND METHODS: Patients with T2DM newly exposed to SGLT2i or non-SGLT2i AHAs were identified using the Truven MarketScan database. The incidence of below-knee lower extremity (BKLE) amputation was calculated for patients treated with SGLT2i, canagliflozin, or non-SGLT2i AHAs...
September 12, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28887250/analysis-of-patients-undergoing-major-lower-extremity-amputation-in-the-vascular-quality-initiative
#4
Joshua Gabel, Brice Jabo, Sheela Patel, Sharon Kiang, Christian Bianchi, Jason Chiriano, Theodore Teruya, Ahmed M Abou-Zamzam
BACKGROUND: Despite an aggressive climate of limb salvage and revascularization, 7% of patients with peripheral artery disease undergo major lower extremity amputation (LEA). The purpose of this study was to describe the current demographics and early outcomes of patients undergoing major LEA in the Vascular Quality Initiative (VQI). METHODS: The VQI amputation registry was reviewed to identify patients who underwent major LEAs. Patient factors, limb characteristics, procedure type, and intraoperative variables were analyzed by level of amputation...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28884985/staged-endovascular-repair-of-critical-limb-ischemia-in-high-risk-patients-the-procedural-and-clinical-outcomes
#5
Guang Liu, Chaoyi Cui, Minyi Yin, Kaichuang Ye, Xaiobing Liu, Jinbao Qin, Huihua Shi, Xintian Huang, Min Lu, Xinwu Lu, Weimin Li, Mier Jiang
PURPOSE: To retrospectively evaluate the procedural and clinical outcomes after staged angioplasty in high-risk, chronic, critical limb ischemia (CLI) patients. METHODS: Between 2013 and 2015, 29 patients (29 limbs) (mean age 77 years) were treated by staged revascularization procedures in (i) the iliac artery-DFA alone or with the femoropopliteal artery followed by (ii) the femoropopliteal artery and a below-the-knee artery. All patients had long-segment iliofemoral artery and below-the-knee artery (TASCII D) occlusions with abnormal serum myoglobin and ischemic lesions...
September 7, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28865844/factors-affecting-lifespan-following-below-knee-amputation-in-diabetic-patients
#6
S Beyaz, Ü Ö Guler, G Ş Bagir
INTRODUCTION: Untreatable foot problems in diabetics may require lower extremity amputation, which has a high level of patient mortality. This high mortality rate is worse than most malignancies. The present study aimed to identify parameters that can be used to estimate survival in DM patients undergoing below-knee amputations for diabetic foot problems. MATERIALS AND METHODS: A total of 470 patients (299 males, 171 females) with a mean age of 64.32 years who underwent below-knee amputation for diabetic foot problems between 2004 and 2014 were enrolled in the study...
August 30, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28861592/increased-alertness-better-than-posture-prioritization-explains-dual-task-performance-in-prosthesis-users-and-controls-under-increasing-postural-and-cognitive-challenge
#7
Charla L Howard, Bonnie Perry, John W Chow, Chris Wallace, Dobrivoje S Stokic
Sensorimotor impairments after limb amputation impose a threat to stability. Commonly described strategies for maintaining stability are the posture first strategy (prioritization of balance) and posture second strategy (prioritization of concurrent tasks). The existence of these strategies was examined in 13 below-knee prosthesis users and 15 controls during dual-task standing under increasing postural and cognitive challenge by evaluating path length, 95% sway area, and anterior-posterior and medial-lateral amplitudes of the center of pressure...
August 31, 2017: Experimental Brain Research. Experimentelle Hirnforschung. Expérimentation Cérébrale
https://www.readbyqxmd.com/read/28856323/serratia-liquefaciens-infection-of-a-previously-excluded-popliteal-artery-aneurysm
#8
A Coelho, M Lobo, V Martins, R Gouveia, P Sousa, J Campos, R Augusto, N Coelho, A Canedo
INTRODUCTION: Popliteal artery aneurysms (PAAs) are rare in the general population, but they account for nearly 70% of peripheral arterial aneurysms. There are several possible surgical approaches including exclusion of the aneurysm and bypass grafting, or endoaneurysmorrhaphy and interposition of a prosthetic conduit. The outcomes following the first approach are favorable, but persistent blood flow in the aneurysm sac has been documented in up to one third of patients in the early post-operative setting...
2017: EJVES Short Rep
https://www.readbyqxmd.com/read/28852581/one-year-primary-patency-of-infrapopliteal-angioplasty-using-drug-eluting-balloons-single-center-experience-at-king-hussein-medical-center
#9
Sizeph Edward Haddad, Jan Mohammad Shishani, Izzeddin Qtaish, Mohammad Abdelmajeed Rawashdeh, Belal Saleh Qtaishat
OBJECTIVE: Conventional percutaneous transluminal angioplasty (PTA) for long lesions in the below-the-knee (BTK) arteries in patients presenting with critical limb ischemia (CLI) has high restenosis rates at 1 year. Our goal is to evaluate whether paclitaxel drug-eluting balloons (DEB) have higher 1 year primary patency rates compared to conventional PTA. METHODS: This is a single-center, prospective, randomized trial that was conducted from June 2013 to December 2015...
2017: Journal of Clinical Imaging Science
https://www.readbyqxmd.com/read/28852347/marjolin-s-ulcer-of-the-tibia-with-pelvic-lymph-node-metastasis
#10
Craig C Akoh, Justin Chang, Joseph Buckwalter
Marjolin's ulcer, a form of squamous cell carcinoma, is a rare complication of a chronic wound infection. To date, there have not been any detailed reports of lymphatic spread of Marjolin's ulcer from an extremity. This report describes a 44-year old male with a history of an open tibia fracture at age 15, who presented with chronic osteomyelitis, increasing bloody wound drainage, and an enlarging vascular exophytic masses in the region of drainage. Biopsy of the mass showed squamous cell carcinoma. Initial staging with computed tomography (CT) was negative for metastatic disease...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28844303/calcaneal-ewing-s-sarcoma-with-skip-metastases-to-tarsals-and-lymph-node-involvement-a-case-report
#11
Koray Şahin, Serkan Bayram, Ahmet Salduz
Ewing's sarcoma (ES) represents the second most common primary malignant tumor of bone of children and occurs rarely in the bones of the foot. Dissemination to regional lymph nodes and skip metastases to adjacent bones are thought to be uncommon. We report a case of a 19-year-old female with the diagnosis of ES of the right calcaneus. Six months earlier, she had presented to the hospital with a history of ankle sprain and was treated with analgesics and ice application. Despite the treatment, the pain over the ankle persisted, her foot swelled progressively, and a mass evolved on the lateral side of the foot...
August 22, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28831328/a-unique-application-of-negative-pressure-wound-therapy-used-to-facilitate-patient-engagement-in-the-amputation-recovery-process
#12
Jessica Wise, Alicia White, Daniel J Stinner, John R Fergason
Amputation rates during recent military conflicts were at an all-time high, but medical treatment of those amputations and attitudes of service members to get back to duty are also surging ahead. We present the cases of an active duty rescue C130 pilot with an above-the-knee amputation and a retired army sergeant with a below-the-knee amputation. Successful rehabilitation was augmented in both cases by using negative pressure incorporated in a custom prosthetic socket to accelerate incision closure, improve self-efficacy in wound care, and self-management, ultimately leading to faster recovery times, full engagement of the rehabilitation process, and return to active duty...
August 1, 2017: Advances in Wound Care
https://www.readbyqxmd.com/read/28822943/sound-side-joint-contact-forces-in-below-knee-amputee-gait-with-an-esar-prosthetic-foot
#13
Mohammad Taghi Karimi, Firooz Salami, Amir Esrafilian, Daniel W W Heitzmann, Merkur Alimusaj, Cornelia Putz, Sebastian I Wolf
The incidence of knee and hip joint osteoarthritis in subjects with below knee amputation (BK) appears significantly higher compared to unimpaired subjects, especially in the intact side. However, it is controversial if constant higher loads on the sound side are one of the major factors for an increased osteoarthritis (OA) incidence in subjects with BK, beside other risk factors, e.g. with respect to metabolism. The aim wasto investigate joint contact forces (JCF) calculated by a musculoskeletal model in the intact side and to compare it with those of unimpaired subjects and to further elucidate in how far increased knee JCF are associated with increased frontal plane knee moments...
August 8, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28813975/a-lightweight-robotic-ankle-prosthesis-with-non-backdrivable-cam-based-transmission
#14
Tommaso Lenzi, Marco Cempini, Jeremy Newkirk, Levi J Hargrove, Todd A Kuiken
Below-knee level amputation significantly impacts the ability of an individual to ambulate. Transtibial amputees are typically prescribed energetically passive ankle-foot prostheses that behave as a spring or controlled damper, and therefore cannot fully replace the function of the missing limb. More recently, fully-powered devices have been proposed to more closely match the power generation ability of intact limbs. However, these fully-powered devices are significantly heavier than passive devices, thus increasing the stress on the socket-residual limb interface...
July 2017: IEEE ... International Conference on Rehabilitation Robotics: [proceedings]
https://www.readbyqxmd.com/read/28759543/endovascular-repair-of-peripheral-arterial-disease-midterm-results-from-a-single-center
#15
Kemal Korkmaz, Hikmet Selcuk Gedik, Ali Baran Budak, Serdar Gunaydin, Kerim Cagli
OBJECTIVE: One thousand consecutive patients who underwent endovascular repair in an 8-year period were studied retrospectively to evaluate technical success, freedom from reinterventions, early clinical outcome, and risk factors for restenosis/occlusion. METHODS: Mean ± SD Rutherford class was 3.29 ± 0.8. A total of 755 patients have claudication, 423 from rest pain, and 569 from ischemic ulceration. RESULTS: A total of 552 men and 448 women (mean ± SD = 69...
July 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28707423/a-universal-drug-delivery-catheter-for-the-treatment-of-infrapopliteal-arterial-disease-results-from-the-multi-center-first-in-human-study
#16
Frank Bunch, Craig Walker, Elias Kassab, Jeffrey Carr
OBJECTIVE: The objective of this study was to assess the feasibility, safety and initial efficacy of paclitaxel administration using a novel drug delivery catheter for the prevention of restenosis in infrapopliteal de novo and restenotic lesions. BACKGROUND: Restenosis continues to be a great challenge after percutaneous revascularization procedures for peripheral arterial disease, particularly for below-the-knee applications. METHODS: A prospective, multicenter first-in-human registry of a novel delivery catheter delivering liquid paclitaxel was conducted in 10 patients...
July 14, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28697694/midterm-outcomes-from-a-pilot-study-of-percutaneous-deep-vein-arterialization-for-the-treatment-of-no-option-critical-limb-ischemia
#17
Steven Kum, Yih Kai Tan, Michiel A Schreve, Roberto Ferraresi, Ramon L Varcoe, Andrej Schmidt, Dierk Scheinert, Jihad A Mustapha, Darryl M Lim, Derek Ho, Tjun Y Tang, Vlad-Adrian Alexandrescu, Pramook Mutirangura
PURPOSE: To report the initial clinical experience with percutaneous deep vein arterialization (PDVA) to treat critical limb ischemia (CLI) via the creation of an arteriovenous fistula. METHODS: Seven patients (median age 85 years; 5 women) with CLI and no traditional endovascular or surgical revascularization options (no-option CLI) were recruited in a pilot study to determine the safety of PDVA. All patients were diabetic; 4 had Rutherford category 6 ischemia...
July 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28690998/results-of-infrainguinal-bypass-with-a-composite-graft-combining-polytetrafluoroethylene-and-vein-graft-in-absence-of-appropriate-saphenous-vein-graft
#18
Myung Jae Jin, Ui Jun Park, Hyoung Tae Kim, Young-Nam Roh
PURPOSE: Use of a composite graft combining a polytetrafluoroethylene graft with an autogenous vein is an option for limb salvage in the absence of an adequate single segment vein graft. We aimed to investigate the results of infrainguinal bypass with a composite graft. MATERIALS AND METHODS: We retrospectively reviewed 11 infrainguinal arterial bypasses on 11 limbs which underwent surgery from March 2012 to November 2016. RESULTS: Critical limb ischemia was common (63...
June 2017: Vascular Specialist International
https://www.readbyqxmd.com/read/28685661/treatment-of-infrainguinal-arterial-thromboembolic-acute-occlusions-with-the-aspirex-%C3%A2-mechanical-thrombectomy-device
#19
Burak Teymen, Süleyman Aktürk
OBJECTIVE: In this study, we investigated the safety and effectiveness of the Aspirex(®) mechanical thrombectomy system for the treatment of acute infrainguinal arterial thromboembolic occlusions. METHODS: We retrospectively identified consecutive patients at our clinic with infrainguinal thromboembolic acute occlusions treated with the Aspirex(®) mechanical thrombectomy device. Primary end points included technical success, defined as the complete revascularization of the acutely occluded vessel, and clinical success, defined as the absence of amputation within 60 d...
July 7, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28674266/pilot-cohort-study-assessing-the-efficacy-of-endovascular-revascularization-in-the-restoration-of-peripheral-sensory-disturbance-in-patients-with-critical-limb-ischemia
#20
Kentaro Jujo, Katsumi Saito, Issei Ishida, Yuho Furuki, Eiji Shibahashi, Kensuke Shimazaki, Haruki Sekiguchi, Yuichiro Minami, Junichi Yamaguchi, Hiroshi Ogawa, Nobuhisa Hagiwara
BACKGROUND: Sensory disturbance (SD) is a common consequence of peripheral nerve damage associated with diabetes and severe ischemia. Progression of SD places patients at high risk for lower extremity ulcers and amputations. SD has been thought to be progressive and irreversible, and possibly caused by microvascular dysfunction. The aim of this study was to determine whether endovascular revascularization (EVR) induces quantifiable changes in SD in chronic critical limb ischemia (CLI) patients with neuropathy...
July 1, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
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