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https://www.readbyqxmd.com/read/29147171/recent-progress-of-bypass-surgery-to-the-dialysis-dependent-patients-with-critical-limb-ischemia
#1
Nobuyoshi Azuma, Shinsuke Kikuchi, Hiroko Okuda, Keisuke Miyake, Atsuhiro Koya
According to expansion of dialysis-dependent population, more than half of patients with critical ischemic limbs are dialysis-dependent in Japan. Although patients with end-staged renal disease are well-known as poor life prognosis, well-managed dialysis patients in Japan can survive much longer compared to dialysis patients in the United States and Europe. Therefore, some dialysis patients can enjoy the long-term benefits of bypass surgery. To decide the indication of bypass surgery, patient's general condition, nutrition status, and vein availability are more important rather than arterial disease anatomy...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29147165/outcomes-of-popliteal-to-distal-bypass-combined-with-femoropopliteal-artery-endovascular-treatment-for-critical-limb-ischemia
#2
Yoshihiko Tsuji, Ikuro Kitano, Koji Sugimoto
Objective: The aim of this study was to evaluate outcomes of combined popliteal-to-distal bypass and endovascular treatment (EVT) for femoropopliteal lesions in patients with critical limb ischemia (CLI). Patients and Methods: We reviewed data of 14 CLI patients who were treated by popliteal-to-distal bypass combined with femoropopliteal EVT. The femoropopliteal lesions included 3 TASC II-A, 8 TASC II-B, and 3TASC II-C but no TASC II-D, and balloon dilatation was performed in 9 cases and a stent was placed in 5 cases...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29147164/a-series-of-210-peripheral-arterial-disease-below-knee-amputations-and-predictors-for-subsequent-above-knee-amputations
#3
Jing Ting Wu, Maggie Wong, Zhiwen Joseph Lo, Wei-En Wong, Sriram Narayanan, Glenn Wei Leong Tan, Sadhana Chandrasekar
Objective: To review patient characteristics and outcomes after peripheral arterial disease (PAD)-related below-knee amputation (BKA), and identify risk factors predicting subsequent above-knee amputation (AKA). Materials and Methods: A retrospective study of 210 BKAs between May 2008 and December 2015. Results: The mean age of the study population was 66 years. Most of the patients had cardiovascular comorbidities, and 33% had end-stage renal failure (ESRF); 89% were American Society of Anesthesiologists 3 or 4...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29147155/endovascular-stent-graft-repair-of-a-persistent-sciatic-artery-aneurysm
#4
Hayato Fukuda, Seiji Onitsuka, Shohei Yoshida, Yuichiro Hirata, Shinichi Hiromatsu, Hiroyuki Tanaka
Persistent sciatic artery (PSA) is a rare anomaly that may cause various symptoms, such as aneurysm, rupture, thromboembolism, and sciatica. Direct surgery can be performed to treat PSA aneurysm (PSAA), but is associated with complications; e.g., anatomical problems such as sciatic nerve injury. Herein we report a case of a 74-year-old woman with acute limb ischemia that developed from a distal embolism caused by a thrombus in the left PSAA; favorable results were obtained for her by treatment with a stent-graft after rapid anticoagulation therapy for limb salvage...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29145297/therapeutic-effect-of-neoadjuvant-chemotherapy-combined-with-curettage-to-treat-distal-femoral-osteosarcoma-a-case-report
#5
Qi Lai, Conglin Ye, Tian Gao, Jun Xiao, An Xie, Xuqiang Liu, Xiaolong Yu, Jun Liu, Min Dai, Hucheng Liu, Bin Zhang
RATIONALE: Osteosarcoma is the most common malignant bone tumor in children and adolescents. Metastasis occurs early, the mortality rate is high, and the tumor results in a tremendous physical, mental, and economic burden on patients. Therefore, the treatment of osteosarcoma has been important for orthopedic surgeons. However, treatment has always been a difficult problem globally. PATIENT CONCERN: We present the case of a 22-year-old girl with increasing local pain in the distal left thigh...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29126421/peroneal-artery-perforator-flap-for-the-treatment-of-chronic-lower-extremity-wounds
#6
Liang Cheng, Xiaqing Yang, Tingxiang Chen, Zhijie Li
BACKGROUND: Reconstruction of chronic lower extremity wounds remains challenging. These wounds are mainly associated with diabetes mellitus, infections, and osteomyelitis. Although several reconstructive techniques are available, the peroneal artery perforator flap has unique advantages. METHODS: In this study, we discuss our experiences with peroneal artery perforator flaps in 55 patients who had suffered from chronic lower limb wounds. The size of the defect, comorbidities, etiology, flap size, and complications were recorded and analyzed based on a retrospective chart review...
November 10, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29121693/short-term-results-of-eluvia%C3%A2-paclitaxel-eluting-stent-in-external-iliac-and-femoropopliteal-lesions
#7
Maxime Elens, Robert Verhelst, Julien Possoz, Stefano Mastrobuoni, Valerie Lacroix, Parla Astarci
INTRODUCTION: The aim of this study was to independently evaluate the real-world performances of Eluvia™ paclitaxel drug-eluting stents (DES) (Boston Scientific, Marlborough, Massachusetts) for the treatment of external iliac and femoropopliteal artery lesions. MATERIALS AND METHODS: We prospectively collected, and retrospectively reviewed, data for all patients who underwent an endovascular treatment with an Eluvia™ DES for the treatment of an external iliac or femoropopliteal lesion...
November 9, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29107761/improved-limb-salvage-for-patients-with-vascular-disease-and-tissue-loss-associated-with-new-model-of-provision-targeted-at-the-diabetic-foot
#8
Dean T Williams, Anna Powell-Chandler, Quratulain Qureshi, Aeliya Zaidi, Christopher J Whitaker
AIMS: The establishment of a vascular surgeon-led emergency diabetic foot service in 2006 has evolved to provide lower limb wound care for patients with and without diabetes. We aimed to determine whether the service was associated with sustained, improved limb salvage rates for the whole population, analyse key aspects of service provision and compare outcomes against published studies. METHODS: The vascular unit serves a largely rural population of approximately 240,000...
October 28, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29103890/large-osseous-defect-reconstruction-using-a-custom-three-dimensional-printed-titanium-truss-implant
#9
Eric So, Vincent H Mandas, Lee Hlad
Treatment of large osseous defects remains a difficult surgical challenge. Autografts and allografts have been known to undergo late collapse, because these options are not specifically designed to withstand the high loads of the foot and ankle. The inability to achieve the correct shape for reconstruction further limits their application. Large osseous defects will result during salvage after failed Lapidus bunionectomy, explantation of failed total ankle replacements, and nonunion of Evans calcaneal osteotomy...
November 2, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29100807/predictors-of-delayed-wound-healing-after-successful-isolated-below-the-knee-endovascular-intervention-in-patients-with-ischemic-foot-ulcers
#10
Sushant Kumar Das, Yi Feng Yuan, Mao Quan Li
OBJECTIVE: The purpose of this study was to explore the predictors of delayed wound healing and their use in risk stratification for endovascular treatment (EVT) of patients with critical limb ischemia (CLI) due to isolated below-the-knee lesions. METHODS: Wound healing rates were analyzed retrospectively in patients who underwent successful below-the-knee percutaneous transluminal balloon angioplasty for CLI with tissue loss between May 2008 and June 2013. We also analyzed the independent predictors of delayed wound healing and their use in risk stratification...
October 31, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29096337/viability-of-permanent-pmma-spacer-with-combined-free-fasciocutaneous-tissue-transfer-for-failed-charcot-reconstruction-a-38-month-prospective-case-report
#11
Tammer Elmarsafi, John S Steinberg, Paul J Kim, Christopher E Attinger, Karen K Evans
INTRODUCTION: Charcot Neuroarthropathy is a complex lower extremity pathology which predisposes the afflicted limb to ulcerations, osteomyelitis, and risk of major amputation. Charcot Neuroarthropathy often requires osseous reconstruction, which can be complicated with osteomyelitis and hardware infection. When soft tissue and osseous deficits must be concomitantly addressed, the use of PMMA spacers can be combined with free tissue transfers. PRESENTATION OF CASE: 71year old Caucasian male with Diabetic Charcot Neuroarthopathy underwent osseous reconstruction with internal hardware...
October 4, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29092990/multiple-limb-salvage-attempts-for-diabetic-foot-infections-is-it-worth-it
#12
C C Hong, J H Tan, S H Lim, A Nather
AIMS: Limb salvage for diabetic foot infections often require multiple procedures. Some patients will eventually end up with below knee amputation (BKA) when all limb salvage attempts fail. We seek to study the patients' ability to return to normal life, functional status, prosthesis usage and perspectives on multiple limb salvage procedures that culminated in BKA to review if they would undertake a similar path if their situation was repeated. PATIENTS AND METHODS: A total of 41 patients who underwent BKA between July 2011 and June 2013 were reviewed...
November 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/29081066/long-term-outcomes-of-cement-in-cement-technique-for-revision-endoprosthesis-surgery
#13
Nicholas M Bernthal, Vishal Hegde, Stephen D Zoller, Howard Y Park, Jason H Ghodasra, Daniel Johansen, Frederick Eilber, Fritz C Eilber, Chandhanarat Chandhanayingyong, Jeffrey J Eckardt
BACKGROUND AND OBJECTIVE: Cemented endoprosthetic reconstruction after resection of primary bone sarcomas has been a standard-of-care option for decades. With increased patient survival, the incidence of failed endoprostheses requiring revision surgery has increased. Revision of cemented endoprotheses by cementing into the existing cement mantle (CiC) is technically demanding. METHODS: This is a retrospective review of our endoprosthesis database of 512 consecutive cemented endoprosthetic reconstructions performed for oncologic diagnoses between 1980 and 2014...
October 29, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29079240/traumatic-complex-hawkins-type-iv-talar-fracture-a-case-report
#14
Jessica L Herzog, Kevin J Blue, David B Hahn, Matthew H Paden, Paul A Stone
Fracture-dislocations of the talus are one of the most complex injuries involving the foot and ankle. These injuries are often accompanied by additional traumatic orthopedic injuries, avascular necrosis, and infection. When approaching limb reconstruction and salvage, the overall prognosis and functionality of the limb are key factors to consider. In the present report, we draw attention to the importance of a multidisciplinary team approach for formulating a treatment plan that incorporates the talar injury and associated injuries or pathologic features...
November 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29077505/rate-of-and-factors-associated-with-ambulation-after-unilateral-major-lower-limb-amputation-at-an-urban-us-tertiary-care-hospital-with-a-multidisciplinary-limb-salvage-team
#15
Laura E Sansosti, Amanda Crowell, Eric T Choi, Andrew J Meyr
BACKGROUND: One relatively universal functional goal after major lower-limb amputation is ambulation in a prosthesis. This retrospective, observational investigation sought to 1) determine what percentage of patients successfully walked in a prosthesis within 1 year after major limb amputation and 2) assess which patient factors might be associated with ambulation at an urban US tertiary-care hospital. METHODS: A retrospective medical record review was performed to identify consecutive patients undergoing major lower-limb amputation...
September 2017: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/29074815/hyperbaric-oxygen-therapy-in-the-treatment-of-ischemic-lower-extremity-ulcers-in-patients-with-diabetes-results-of-the-damo2cles-multicenter-randomized-clinical-trial
#16
Katrien T B Santema, Robert M Stoekenbroek, Mark J W Koelemay, Jim A Reekers, Laura M C van Dortmont, Arno Oomen, Luuk Smeets, Jan J Wever, Dink A Legemate, Dirk T Ubbink
OBJECTIVE: Conflicting evidence exists on the effects of hyperbaric oxygen therapy (HBOT) in the treatment of chronic ischemic leg ulcers. The aim of this trial was to investigate whether additional HBOT would benefit patients with diabetes and ischemic leg ulcers. RESEARCH DESIGN AND METHODS: Patients with diabetes with an ischemic wound (n = 120) were randomized to standard care (SC) without or with HBOT (SC+HBOT). Primary outcomes were limb salvage and wound healing after 12 months, as well as time to wound healing...
October 26, 2017: Diabetes Care
https://www.readbyqxmd.com/read/29069847/the-effect-of-pathological-fractures-on-the-prognosis-of-patients-with-osteosarcoma-a-meta-analysis-of-14-studies
#17
Yifei Zhou, Qian Lu, Jifeng Xu, Ruijian Yan, Junkun Zhu, Juntao Xu, Xuesheng Jiang, Jianyou Li, Fengfeng Wu
Osteosarcoma is a leading cause of malignant tumor related death. We conducted a meta-analysis to evaluate the association between pathological fractures and prognosis in patients with osteosarcoma. We searched PubMed, Web of Science, and Embase for studies published until May 15, 2017. Crude and adjusted relative risk (RR) with 95% confidence intervals were used to compare data between the case and control groups. Fourteen studies and 3910 patients were included in the final meta-analysis. No statistically significant difference was detected between the pathological fracture and non-pathological fracture groups in local recurrences analysis (RR = 1...
September 22, 2017: Oncotarget
https://www.readbyqxmd.com/read/29068941/discussion-not-all-gustilo-type-iiib-fractures-are-created-equal-arterial-injury-impacts-limb-salvage-outcomes
#18
COMMENT
L Scott Levin
No abstract text is available yet for this article.
November 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29068940/not-all-gustilo-type-iiib-fractures-are-created-equal-arterial-injury-impacts-limb-salvage-outcomes
#19
John T Stranix, Z-Hye Lee, Adam Jacoby, Lavinia Anzai, Tomer Avraham, Vishal D Thanik, Pierre B Saadeh, Jamie P Levine
BACKGROUND: Open tibia fractures are commonly stratified by the Gustilo classification, an orthopedic grading system that does not incorporate the presence of arterial injury when limb perfusion is intact. In the authors' experience, however, the presence of arterial injury appears to negatively impact microsurgical outcomes. METHODS: In a retrospective review of 806 lower extremity reconstructions between 1979 and 2016, 361 soft-tissue flaps performed for Gustilo type IIIB/C coverage met inclusion criteria...
November 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29068573/en-bloc-resection-and-prosthesis-implantation-to-treat-malignant-fibrous-histiocytoma-of-the-humerus
#20
Jun Sun, Ru-Ming Zhang, Yu-Xin Zheng
BACKGROUND: Malignant fibrous histiocytoma (MFH) of the bone is a rare tumor. Most studies comparing limb salvage and amputation have reported that limb salvage had no adverse effect on the long-term survival of patients. This study evaluates the oncological outcomes of limb salvage procedures that were used for 15 patients with MFH of the humerus. OBJECTIVES: The aim of this study was to assess the functional and oncological outcomes of patients with malignant fibrous histiocytoma of the humerus after en bloc resection and prosthesis implantation...
August 2017: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
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