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Below knee amputation

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https://www.readbyqxmd.com/read/28100126/everolimus-eluting-stent-for-patients-with-critical-limb-ischemia-and-infrapopliteal-arterial-occlusive-disease
#1
Alessia Giaquinta, Ardita Vincenzo, Ester De Marco, Massimiliano Veroux, Pierfrancesco Veroux
BACKGROUND: Critical limb ischemia (CLI), despite revascularization, may result in minor or major amputations with devastating psychological effects and a negative impact on patient survival. Randomized clinical trials demonstrated that drug-eluting stents improve 1-year primary patency and decrease target lesion revascularization, compared to standard angioplasty and bare-metal stents, in patients with short occlusive below-the-knee lesions. OBJECTIVES: This prospective clinical study was designed to evaluate if one straight-line flow revascularization to the foot, using Xience-Prime Everolimus-Eluting Stent (EES), is an effective treatment of patients in Rutherford-Becker category 4 to 5 with distal popliteal and proximal tibial arteries long occlusive lesions up to 10 cm...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28081030/ultrasound-findings-of-young-and-traumatic-amputees-with-lower-extremity-residual-limb-pain-in-turkey
#2
Koray Aydemir, Yasin Demir, Ümüt Güzelküçük, Kutay Tezel, Bilge Yilmaz
OBJECTIVE: The current study was designed to document clinical and ultrasound (US) findings of patients with residual limb pain (RLP) after amputation and to investigate the relationship between these findings. MATERIALS AND METHODS: A chart review was performed to identify demographic and clinical data including the age (current and at the time of injury), time since amputation, gender, reason for amputation, affected limb number, side and level of limb loss, and ultrasonographic findings of young and traumatic amputees with RLP...
January 9, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28068847/case-study-survey-of-patient-satisfaction-with-prosthesis-quality-and-design-among-below-knee-prosthetic-leg-socket-users
#3
Nurhanisah Mohd Hawari, Mohammad Jawaid, Paridah Md Tahir, Raja Ahmad Azmeer
The aim of this case study was to explore patient satisfaction with the quality of prosthetic leg sockets intended for persons with lower limb amputations. A qualitative study based on in-depth interviews, preceded by a questionnaire session, was carried out with patients from the Rehabilitation Center and Hospital in Malaysia. Twelve out-patient and in-patient amputees with lower limb amputations, specifically below-knee amputations, were chosen randomly. The analysis of patients' narratives aimed to identify the functional and esthetic characteristics of currently used prosthetic leg sockets and any problems related to them...
January 10, 2017: Disability and Rehabilitation. Assistive Technology
https://www.readbyqxmd.com/read/28057998/cisplatin-and-bleomycin-induced-acute-peripheral-vascular-stenosis-in-patient-with-testicular-cancer
#4
Tayyar Alp Ozkan, Ufuk Aydin, Derih Ay, I Oguz Ozden Cebeci
After cisplatin and bleomycin-containing chemotherapy (CTx) for testicular cancer, part of the patients may develop acute or long-term cardiovascular toxicity. In the present case, we reported that a 58-year-old male patient presenting with testicular tumors who developed acute peripheral arterial disease during combination CTx with bleomycin, etoposide, and cisplatin. Superficial femoral artery occlusion not responded to structure thrombolytic and anticoagulators treatment. Left lower extremity was amputated below knee...
October 2016: Urology Annals
https://www.readbyqxmd.com/read/28049004/microcirculatory-assessment-of-arterial-below-knee-stumps-near-infrared-spectroscopy-vs-transcutaneous-oxygen-tension-a-preliminary-study-in-prosthesis-users
#5
Davy Laroche, José-Luis Barnay, Bastien Tourlonias, Cyril Orta, Christine Obert, Jean-Marie Casillas
OBJECTIVES: To examine metrological properties of near-infrared spectroscopy (NIRS) vs. transcutaneous oxygen tension (TcPO2) for microcirculatory assessment of vascular transtibial stumps at the stabilized period of prosthesis fitting, as a preliminary step before exploring its ability to predict stump healing, considering the previously identified limits of TcPO2 (borderline area between 15 and 35 mmHg). DESIGN: Prospective single-centre observational study. SETTING: University-based rehabilitation center...
December 31, 2016: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28045669/long-term-outcomes-of-successful-endovascular-therapy-via-the-retrograde-approach-for-below-the-knee-chronic-total-occlusion-in-patients-with-critical-limb-ischemia-after-a-failed-antegrade-approach
#6
Junya Matsumi, Takuma Takada, Noriaki Moriyama, Tomoki Ochiai, Kazuki Tobita, Koki Shishido, Kazuya Sugitatsu, Shingo Mizuno, Futoshi Yamanaka, Masato Murakami, Yutaka Tanaka, Saeko Takahashi, Takeshi Akasaka, Shigeru Saito
OBJECTIVE: This study evaluated long-term results following successful endovascular therapy (EVT) for chronic total occlusion (CTO) below the knee (BTK) using the retrograde approach after a failed antegrade approach. METHODS: Nineteen patients (19 limbs) with critical limb ischemia (CLI) who underwent successful EVT for BTK-CTO using the retrograde approach after a failed antegrade approach during 2010-2014 were studied. RESULTS: Mean duration of the follow-up period was 25...
January 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28040088/restoration-of-long-bone-defects-treated-with-the-induced-membrane-technique-protocol-and-outcomes
#7
Peter V Giannoudis, Paul J Harwood, Theodoros Tosounidis, Nikolaos K Kanakaris
This prospective study was undertaken at a regional tertiary referral centre to evaluate the results of treatment of bone defects managed with the induced membrane (IM) technique. Inclusion criteria were patients with bone defects secondary to septic non-union, chronic osteomyelitis and acute fracture with bone loss. Pathological fractures with bone loss were excluded. Data collection included patient demographics, pathology, previous surgical intervention, size of bone defect, type of graft implanted, time-to-union and complications/reinterventions...
December 2016: Injury
https://www.readbyqxmd.com/read/28038786/epidemiologic-data-of-trauma-related-lower-limb-amputees-a-single-center-10-year-experience
#8
Evren Yaşar, Fatih Tok, Serdar Kesikburun, A Mustafa Ada, Bayram Kelle, A Salim Göktepe, Kamil Yazıcıoğlu, A Kenan Tan
OBJECTIVE: The aim of this study is three fold: 1) to introduce epidemiologic data of patients with trauma-related amputations as a 10-year experience of a rehabitation center; 2) to determine comorbidities and secondary conditions of lower limb loss; 3) to determine the rehospitalization reasons for lower limb amputee patients. MATERIALS AND METHODS: This retrospective study was conducted in a tertiary rehabilitation center in Turkey. Clinical and demographic data of amputees including sex, age, employment status, time since amputation, time after amputation to first hospitalization, length of hospitalization, how many times the patient was hospitalized, reason for hospitalization, stump complications, comorbid conditions, amputation level and K classifacation were documented...
December 23, 2016: Injury
https://www.readbyqxmd.com/read/28032037/surgical-apgar-score-predicts-early-complication-in-transfemoral-amputees-retrospective-study-of-170-major-amputations
#9
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/28004988/biosynthetic-grafts-to-replace-infected-prosthetic-vascular-bypasses-a-single-center-experience
#10
Ingolf Töpel, Theresa Stigler, Isabelle Ayx, Thomas Betz, Christian Uhl, Markus Steinbauer
BACKGROUND: There are only a few options to replace infected infrainguinal synthetic vascular grafts in the absence of suitable autologous veins. To use a biosynthetic vascular graft (Omniflow(®)II) might be a valuable alternative. METHODS: We retrospectively analyzed the clinical course of 29 patients who underwent replacement of an infected infrainguinal vascular prosthesis (Szilagyi 3) by an Omniflow(®)II graft. RESULTS: Because of the lack of suitable autologous veins, 15 above-knee femoro-popliteal, 5 below-knee femoro-popliteal, and 9 femoro-tibial bypasses were replaced with biosynthetic grafts...
December 22, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27986272/predictors-of-amputation-in-high-energy-forefoot-and-midfoot-injuries
#11
Zachary M Working, Iain Elliott, Lucas S Marchand, Lance G Jacobson, Angela P Presson, Ami Stuart, David L Rothberg, Thomas F Higgins, Erik N Kubiak
INTRODUCTION: High energy injuries to the midfoot and forefoot are highly morbid injury groups that are relatively unstudied in the literature. Patients sustaining injuries of this region are challenging to counsel at the time of injury because so little is known about the short and long term results of these injuries. The purpose of this study was to investigate injury specific factors that were predictive of amputation in patients sustaining high energy midfoot and forefoot injuries...
December 10, 2016: Injury
https://www.readbyqxmd.com/read/27935893/-results-of-using-various-methods-of-autovenous-femoropopliteal-bypass-grafting-below-the-knee-joint-fissure
#12
B S Sukovatykh, L N Belikov, M B Sukovatykh, D V Sidorov, M A Inarkhov, E B Inokhodova
The objective of the study was to improve therapeutic outcomes in patients presenting with lower limb critical ischaemia by means of optimizing the technique of femoropopliteal bypass grafting. The authors analysed the results of comprehensive examination and treatment of a total of 90 patients presenting with critical lower limb ischaemia on the background of atherosclerotic lesions of arteries of the femoropopliteal and crural segments. Depending on the technology of performing femoropopliteal bypass grafting, the patients were subdivided into three groups each consisting of 30 subjects...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/27928034/below-knee-endovascular-interventions-have-better-outcomes-compared-to-open-bypass-for-patients-with-critical-limb-ischemia
#13
Caitlin W Hicks, Alireza Najafian, Alik Farber, Matthew T Menard, Mahmoud B Malas, James H Black, Christopher J Abularrage
Both open surgery and endovascular peripheral interventions have been shown to effectively improve outcomes in patients with peripheral arterial disease, but minimal data exist comparing outcomes performed at and below the knee. The purpose of this study was to compare outcomes following infrageniculate lower extremity open bypass (LEB) versus peripheral vascular intervention (PVI) in patients with critical limb ischemia. Using data from the 2008-2014 Vascular Quality Initiative, 1-year primary patency, major amputation, and mortality were compared among all patients undergoing LEB versus PVI at or below the knee for rest pain or tissue loss...
December 6, 2016: Vascular Medicine
https://www.readbyqxmd.com/read/27926681/influence-of-immediate-and-delayed-lower-limb-amputation-compared-with-lower-limb-salvage-on-functional-and-mental-health-outcomes-post-rehabilitation-in-the-u-k-military
#14
Peter Ladlow, Rhodri Phillip, Russell Coppack, John Etherington, James Bilzon, M Polly McGuigan, Alexander N Bennett
BACKGROUND: Medical practitioners face difficult decisions over whether to amputate or to salvage a lower limb that has undergone trauma. To our knowledge, there has been little evidence reporting the impact of different surgical decisions on functional and mental health outcomes following intensive rehabilitation that might inform decision-making. METHODS: This study is a retrospective, independent-group comparison of rehabilitation outcomes from a U.K. military complex trauma rehabilitation center...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27910185/drug-eluting-balloon-angioplasty-for-below-the-knee-lesions-in-end-stage-renal-disease-patients-with-critical-limb-ischemia-midterm-results
#15
Burak Teymen, Süleyman Aktürk
BACKGROUND: The 1-year restenosis rate after standard balloon angioplasty (BA) of long lesions in below-the-knee arteries may be as high as 70%. Our aim was to investigate the efficacy and safety of paclitaxel drug-eluting balloon (DEB) for treatment of below the knee lesions in end stage renal disease patients (ESRD) with critical limb ischemia (CLI). METHODS: Our study is a retrospective, single-center study. Inclusion criteria were ESRD, critical limb ischemia (Rutherford class 4 or higher) and significant stenosis or occlusion of at least 1 below-the-knee vessel...
December 2, 2016: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/27909207/below-knee-amputation-failure-and-poor-functional-outcomes-are-higher-than-predicted-in-contemporary-practice
#16
Jesse A Columbo, Brian W Nolan, Ryland S Stucke, Eva M Rzucidlo, Karen L Walker, Richard J Powell, Bjoern D Suckow, David H Stone
OBJECTIVE: The perceived functional benefit of below-knee amputation (BKA) must be carefully weighed against the need for potential reinterventions. This study sought to examine the contemporary clinical and functional outcomes of patients undergoing BKA in the endovascular era. METHODS: All patients who underwent BKA from January 2008 to December 2014 at a single tertiary medical center were retrospectively reviewed. Demographics, comorbidities, ambulation status, and transcutaneous oximetry (TcPO2) values were recorded...
November 2016: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27871493/diabetes-does-not-worsen-outcomes-following-infrageniculate-bypass-or-endovascular-intervention-for-patients-with-critical-limb-ischemia
#17
Caitlin W Hicks, Alireza Najafian, Alik Farber, Matthew T Menard, Mahmoud B Malas, James H Black, Christopher J Abularrage
OBJECTIVE: Both open surgery and endovascular peripheral interventions have been shown to effectively improve outcomes in patients with peripheral arterial disease, but minimal data exist comparing outcomes performed at and below the knee among patients with diabetes (DM) specifically. The purpose of this study is to compare outcomes following open bypass (lower extremity bypass [LEB]) and peripheral vascular intervention (PVI) at and below the knee in patients with DM vs patients without DM (non-DM) with critical limb ischemia...
December 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27849466/descriptive-characteristics-and-amputation-rates-with-use-of-intrepid-dynamic-exoskeleton-orthosis
#18
Owen Hill, Lakmini Bulathsinhala, Susan L Eskridge, Kimberly Quinn, Daniel J Stinner
Advancements in ankle-foot orthotic devices, such as the Intrepid Dynamic Exoskeletal Orthosis (IDEO), are designed to improve function and reduce pain of the injured lower extremity. There is a paucity of research detailing the demographics, injury patterns and amputation outcomes of patients who have been prescribed an IDEO. The purpose of this study was to describe the demographics, presenting diagnosis and patterns of amputation in patients prescribed an IDEO at the Center for the Intrepid (CFI). The study population was comprised of 624 service members who were treated at the CFI and prescribed an IDEO between 2009 and 2014...
November 2016: Military Medicine
https://www.readbyqxmd.com/read/27843662/neck-of-femur-fracture-in-a-patient-with-a-chronic-osteomyelitis-of-the-ipsilateral-foot
#19
Anne-Carolin Döring, Anne J H Vochteloo, Kees van Doorn, Rianne M H A Huis In 't Veld, Anil Peters
This case report describes a successful two-stage treatment in a 75-year-old male with a displaced neck of femur fracture, also suffering from an active chronic osteomyelitis of the ipsilateral calcaneus. In our case, a below-knee amputation was performed first, followed by total hip arthroplasty two weeks later. At 15-month follow-up, full recovery of the prefracture level of activities of daily living without significant impairment was obtained. Only a few cases of total hip arthroplasty in amputees have been published, but the indication for surgery was mainly traumatic or advanced osteoarthritis...
2016: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/27793622/tibioperoneal-occlusive-disease-a-review-of-below-the-knee-endovascular-therapy-in-patients-with-critical-limb-ischemia
#20
Kathryn B Muir, Patrick R Cook, Maxwell R Sirkin, Gilbert Aidinian
BACKGROUND: Tibioperoneal occlusive disease is one of the most difficult disease processes to successfully treat. Previous studies have attempted to address the outcomes of tibial interventions in this patient population; however, the majority of these study cohorts are composed of patients who have undergone concomitant aortoiliac or femoral procedures. Our objective was to present the outcomes of patients treated with endovascular intervention for isolated below-the-knee atherosclerotic disease causing critical limb ischemia (CLI)...
January 2017: Annals of Vascular Surgery
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