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Limb salvage

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https://www.readbyqxmd.com/read/28819879/lower-extremity-bypass-using-bovine-carotid-artery-graft-artegraft-an-analysis-of-124-cases-with-long-term-results
#1
Philip Lindsey, Angela Echeverria, Mathew Cheung, Elias Kfoury, Carlos F Bechara, Peter H Lin
INTRODUCTION: Although biological grafts have been utilized as a vascular conduit in leg bypass for many years, reports of a bovine carotid artery graft (BCAG) in lower extremity revascularization have been scarce. This study analyzed the outcome of lower leg bypass using BCAG. METHODS: A retrospective review of a prospectively collected database of all patients undergoing lower extremity bypass using BCAG from 2002 to 2017 was performed. Clinical outcomes including graft patency and limb salvage were evaluated...
August 17, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28819590/minimally-invasive-total-hip-replacement-in-an-ipsilateral-post-traumatic-above-knee-amputation-a-case-report
#2
Sanjeev Patnaik, Biswaranjan Nayak, Akshaya Kumar Sahoo, Nabin Kumar Sahu
INTRODUCTION: Total hip replacement (THR) is a highly successful operation in alleviating pain and improving the overall function of the hip, in end-stage arthritis of the hip, in otherwise fit patients. However, THR as a surgical option in post-traumatic hip arthritis with ipsilateral above-knee amputation is rarely reported. CASE REPORT: We are presenting a case report of a 30-year-old male, who had previously underwent an above-knee amputation due to road-traffic accident, presenting 24 h after the injury with segmental fracture femur and popliteal artery laceration, for which the limb could not be salvaged...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28807382/association-between-statin-therapy-and-amputation-free-survival-in-patients-with-critical-limb-ischemia-in-the-critisch-registry
#3
Konstantinos Stavroulakis, Matthias Borowski, Giovanni Torsello, Theodosios Bisdas
OBJECTIVE: Secondary prevention in patients with critical limb ischemia (CLI) is crucial for the reduction of cardiovascular morbidity and mortality. Nonetheless, current recommendations are extrapolated from other high-risk populations because of the lack of CLI-dedicated trials. The aim of this explorative study was to evaluate the association of statin therapy with the outcomes of CLI patients. METHODS: The First-Line Treatments in Patients With Critical Limb Ischemia (CRITISCH) registry is a prospective multicenter registry analyzing the effectiveness of all available treatment strategies in 1200 CLI patients...
August 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28806175/point-of-care-ultrasound-facilitated-detection-of-femoral-occlusive-septic-emboli-during-mitral-valve-surgery-a-case-report
#4
Melissa L Bellomy, Susan Eagle, Mias Pretorius, Ben R Barton, Yafen Liang
Acute lower extremity ischemia from septic emboli is a surgical emergency. Timely diagnosis and management are critical to improve patient outcome. However, traditional diagnostic modalities such as intraoperative angiogram are time-consuming, require special equipment and personnel, and introduce contrast exposure for critically ill patients. There are limited reports of utilization of point-of-care ultrasound to detect peripheral septic emboli. We present a case where femoral occlusive septic emboli were identified by point-of-care ultrasound after mitral valve replacement...
August 10, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28802537/psychosocial-reactions-to-upper-extremity-limb-salvage-a-cross-sectional-study
#5
Lindsay Sposato, Kathleen Yancosek, Josh Lospinoso, Jill Cancio
STUDY DESIGN: Descriptive cross-sectional survey study. INTRODUCTION: Limb salvage spares an extremity at risk for amputation after a major traumatic injury. Psychosocial recovery for individuals with lower extremity limb salvage has been discussed in the literature. However, to date, psychosocial reactions for individuals with upper extremity (UE) limb salvage have not been examined. PURPOSE OF THE STUDY: To determine which factors may influence psychosocial adaptation to UE limb salvage...
August 9, 2017: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/28799724/characteristics-and-clinical-outcomes-of-repeat-endovascular-therapy-after-infrapopliteal-balloon-angioplasty-in-patients-with-critical-limb-ischemia
#6
Norihiro Kobayashi, Keisuke Hirano, Masahiro Yamawaki, Motoharu Araki, Tsuyoshi Sakai, Yasunari Sakamoto, Shinsuke Mori, Masakazu Tsutsumi, Yohsuke Honda, Takahiro Tokuda, Kenji Makino, Shigemitsu Shirai, Yoshiaki Ito
OBJECTIVES: We clarified characteristics and clinical outcomes of critical limb ischemia (CLI) patients who underwent repeat endovascular therapy (EVT) for infrapopliteal lesions. BACKGROUND: High restenosis rate after infrapopliteal EVT remains a major concern. METHODS: Patients with CLI who underwent EVT between April 2007 and February 2014, were divided into the following three groups according to how often EVT was repeated: Group A, no repeat of EVT; Group B, EVT repeated once/twice; and Group C, EVT repeated ≥3 times...
August 11, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28793833/synergistic-therapeutic-effect-of-three-dimensional-stem-cell-clusters-and-angiopoietin-1-on-promoting-vascular-regeneration-in-ischemic-region
#7
Jungmi Kang, Jeong-Kee Yoon, Seung Ja Oh, Byung-Soo Kim, Sang-Heon Kim
Peripheral artery disease (PAD) is an ischemic disease characterized by reduced blood flow to the legs, feet, and hands. Human mesenchymal stem cells (MSCs) are an attractive cell source to treat PAD in regenerative medicine. However, in clinical applications, the use of adult stem cells has several limitations, such as low cell viability and low therapeutic efficiency. In the present study, we described an innovative method of culturing three-dimensional stem cell clusters (AngioclusterTM, AC), demonstrated the potential for ACs to differentiate into vascular cells, and assessed the synergistic effects of ACs and angiopoietin-1 (Ang-1) on angiogenesis in ischemic animal models...
August 10, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28774866/outcomes-of-infrapopliteal-angioplasty-for-limb-salvage-based-on-the-updated-tasc-ii-classification
#8
Hong Kuan Kok, Hamed Asadi, Mark Sheehan, Frank P McGrath, Mark F Given, Michael J Lee
PURPOSE: We aimed to evaluate limb salvage, defined as freedom from major amputation, and to identify predictors of major amputation in patients with infrapopliteal peripheral arterial disease (PAD) based on the updated 2015 TASC II anatomic classification treated by percutaneous transluminal angioplasty (PTA). METHODS: This was a retrospective study of infrapopliteal PTA procedures performed for PAD over a 4-year period. Patient demographics, medical comorbidities, risk factors, angiographic imaging, technical details, and clinical follow-up were analyzed to determine limb salvage rates, technical success, and all-cause mortality...
August 4, 2017: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
https://www.readbyqxmd.com/read/28756043/impact-of-angiosome-and-non-angiosome-targeted-peroneal-bypass-on-limb-salvage-and-healing-in-patients-with-chronic-limb-threatening-ischemia
#9
Jean-Baptiste Ricco, Mauro Gargiulo, Andrea Stella, Mohammad Abualhin, Enrico Gallitto, Mathieu Desvergnes, Romain Belmonte, Fabrice Schneider
BACKGROUND: Direct (DIR) or indirect (IND) revascularization of pedal angiosomes in patients with chronic limb-threatening ischemia (CLTI) has an unclear impact on limb salvage and healing. The aim of this study was to evaluate the outcomes of DIR and IND revascularization in patients with a peroneal bypass and tissue loss. METHODS: We conducted a retrospective study of a prospectively maintained database in two European university centers from 2004 to 2015. We extracted from this database all patients with CLTI and tissue loss who had received a bypass to the peroneal artery...
July 26, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28756018/epithelioid-sarcomas-how-important-is-loco-regional-control
#10
A Pradhan, R J Grimer, A Abudu, R M Tillman, S R Carter, L Jeys, P C Ferguson, A M Griffin, J S Wunder
AIMS: To investigate the impact of the method of treatment on the oncological outcomes in patients with epithelioid sarcomas managed at two international speciality sarcoma centres. METHODS: The databases of two centres were used to identify patients treated for epithelioid sarcomas between 1985 and 2012. Patient, tumor, treatment and outcome data was collected. RESULTS: There were 36 males and 18 females with a mean age of 38.3 years (range 9-79)...
July 19, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28753228/use-of-arterialized-saphenous-vein-venous-flow-through-flaps-as-a-temporizing-measure-for-hand-salvage-in-contaminated-wounds-presenting-with-limb-ischemia-a-case-series
#11
Julian Diaz-Abele, Bauback Safa, Rudolf F Buntic, Avinash Islur
BACKGROUND: Vascular injuries resulting in limb ischemia are traditionally treated acutely with autologous or prosthetic bypass grafts. Traumatic contaminated injuries with soft tissue and vascular segmental loss are challenging as prosthetic bypasses are at risk of erosion, infection, and occlusion; and autologous bypasses are at risk of desiccation, blow-out, infection, and clotting. We propose a novel approach to these injuries by using arterialized saphenous vein venous flow-through free flaps (S-VFTF) as an autologous bypass, and present the results of its application in a series of cases...
July 28, 2017: Microsurgery
https://www.readbyqxmd.com/read/28743226/endovascular-therapy-outcomes-and-intravascular-ultrasound-findings-in-thromboangiitis-obliterans-buerger-s-disease
#12
Osami Kawarada, Teruyoshi Kume, Shinobu Ayabe, Takako Nakaya, Michikazu Nakai, Kunihiro Nishimura, Teruo Noguchi, Yoshiaki Yokoi, Hisao Ogawa, Satoshi Yasuda
PURPOSE: To investigate outcomes of contemporary endovascular therapy and intravascular ultrasound (IVUS) findings in thromboangiitis obliterans (TAO) patients. METHODS: Between April 2007 and January 2016, 20 patients (mean age 45±8 years; 16 men) underwent endovascular therapy for TAO-related lesions in 25 consecutive limbs. Subjects exhibited a broad array of clinical symptoms, including critical limb ischemia (n=15) and claudication (10) in the lower (n=20) and upper (n=5) limbs...
August 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28742715/limb-salvage-options-in-growing-children-with-malignant-bone-tumors-of-the-lower-extremity-a-critical-analysis-review
#13
Carol D Morris, Rosanna L Wustrack, Adam S Levin
No abstract text is available yet for this article.
July 25, 2017: JBJS Reviews
https://www.readbyqxmd.com/read/28741197/axillobifemoral-bypasses-reappraisal-of-an-extra-anatomic-bypass-by-analysis-of-results-and-prognostic-factors
#14
D Dickas, F Verrel, J Kalff, A Koscielny
BACKGROUND: Axillobifemoral bypass (AFB) is method of second choice. It is reserved for patients at high operative risk or to bypass infected vessels or grafts. In this study, we analyzed prognostic factors for AFB patency and limb salvage rate to facilitate the choice of procedure. METHODS: Between Jan 2006 and Aug 2013, 45 patients underwent AFB surgery in our department, 24 for critical limb ischemia (CLI) and 23 for infection. Endpoints of study were graft occlusion, graft infection, amputation and patient's death...
July 24, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28739471/comparison-of-low-dose-catheter-directed-thrombolysis-with-and-without-pharmacomechanical-thrombectomy-for-acute-lower-extremity-ischemia
#15
Sagar S Gandhi, Joseph A Ewing, Emily Cooper, Jose Mauro Chaves, Bruce H Gray
INTRODUCTION: Catheter directed thrombolysis (CDT) and/or pharmacomechanical thrombectomy (PMT) can dissolve/remove thrombus; PMT alone, however, may require the adjunctive use of CDT. The aim of this study was to compare the use of CDT with and without PMT for the treatment of acute limb ischemia (ALI). METHODS: We retrospectively reviewed all patients with ALI who underwent CDT with or without PMT between January 2008 and April 2014 (N=99). Patients with incomplete medical charts were excluded (n=16)...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28739459/comparison-of-direct-and-less-invasive-techniques-for-the-treatment-of-severe-aorto-iliac-occlusive-disease
#16
Kimberly C Zamor, Andrew W Hoel, Irene B Helenowski, Adam W Beck, Joseph R Schneider, Karen J Ho
BACKGROUND: Severe aorto-iliac occlusive disease (AIOD) is traditionally treated with aorto-bifemoral (ABF) or aorto-unifemoral (AUF) bypass. However, cross-femoral bypass (CFB) and hybrid femoral endarterectomy and patch angioplasty with iliac stenting (EPS) have gained popularity as less invasive options. We sought to compare 1-year survival, primary patency, and major amputation rates between open surgical (ABF and AUF) and two less invasive reconstruction techniques (CFB and EPS) using a large, multicenter cohort...
July 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28737311/amniotic-band-syndrome-with-pseudoarthrosis-of-tibia-and-fibula-a-case-report
#17
A Ananthan, G Athalye Jape, J Du Plessis, P Annear, R Page, S Rao
Constriction of the lower limb by congenital amniotic band has been proposed to explain the development of pseudoarthrosis of tibia and fibula. We report a case of amniotic band syndrome in a preterm infant with pseudoarthrosis of tibia and fibula. Simple release of constriction band with Z-plasty resulted in the growth of mature bone, replacing the pseudoarthrosis and hence did not require surgical amputation. Our case confirms the potential for bone growth in ABS, once the constricting band is released. Early limb preserving surgery with release of the constricting band with an intention to salvage the limb appears appropriate...
May 10, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/28736080/the-effect-of-ankle-foot-orthosis-alignment-on-walking-in-individuals-treated-for-traumatic-lower-extremity-injuries
#18
Starr E Brown, Elizabeth Russell Esposito, Jason M Wilken
Limb salvage surgeries are performed to treat a variety of lower limb pathologies and traumatic injuries. Individuals who have undergone limb salvage surgeries may require an ankle foot orthosis (AFO) to compensate for limb impairments and restore walking ability. Understanding the effects of AFO design parameters on gait biomechanics is important to refine AFO prescription criteria. In this study sagittal plane kinematic and kinetic data, muscle activity and alignment preference were examined as individuals treated for traumatic lower extremity injuries (N=12) walked over level ground with Plantarflexed (PF), Neutral, and Dorsiflexed (DF) aligned AFOs...
July 5, 2017: Journal of Biomechanics
https://www.readbyqxmd.com/read/28715360/contemporary-management-of-subclavian-and-axillary-artery-injuries-a-western-trauma-association-multicenter-review
#19
Christine J Waller, Thomas H Cogbill, Kara J Kallies, Luis D Ramirez, Justin M Cardenas, S Rob Todd, Kayla J Chapman, Marshall A Beckman, Jason L Sperry, Vincent P Anto, Evert A Eriksson, Stuart M Leon, Rahul J Anand, Maura Pearlstein, Lisa Capano-Wehrle, Clay Cothren Burlew, Charles J Fox, Daniel C Cullinane, Jennifer C Roberts, Paul B Harrison, Gina M Berg, James M Haan, Kelly Lightwine
BACKGROUND: Subclavian and axillary artery injuries are uncommon. In addition to many open vascular repairs, endovascular techniques are used for definitive repair or vascular control of these anatomically challenging injuries. The aim of this study was to determine the relative roles of endovascular and open techniques in the management of subclavian and axillary artery injuries comparing hospital outcomes, and long-term limb viability. METHODS: A multicenter, retrospective review of patients with subclavian or axillary artery injuries from 1/1/2004-12/31/2014 was completed at 11 participating Western Trauma Association institutions...
July 15, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28712989/is-amputation-a-viable-treatment-option-in-lower-extremity-trauma
#20
Manuela Barla, Bertrand Gavanier, Mickaël Mangin, Joffrey Parot, Camille Bauer, Didier Mainard
INTRODUCTION: There is currently no consensus on how to treat patients with lower extremity trauma. Should amputation be performed early on to avoid complications or should the limb be saved at any price?The goal of this study was to show that early amputation is a viable treatment option in lower extremity trauma cases. MATERIAL AND METHODS: Twenty patients who underwent early amputation and 16 patients who underwent limb-salvage were included with a minimum follow-up of 1 year...
July 13, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
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