Peripheral Vascular Disease and Lower Extremity Amputations: Still a Death Sentence? Statewide Analysis with Long-Term Follow-Up Data

Ten patients underwent Syme amputation for diabetic peripheral vascular disease between 1980 and 1986 and were observed postoperatively for an average of 5 years. Surgical wounds healed in only five of the 10 patients; they were then fitted for a permanent Syme's prosthesis. All failures resulted from the inability to heal the surgical incisions primarily. The clinical records of these patients were retrospectively analyzed for predictors of successful clinical outcome. The ischemic index, grade of the lesion, initial wound treatment, and presence of the infection at the time of amputation were not found to be reliable predictors of a successful level of amputation. Clinical assessment of both the vascular and nutritional status of the patient was necessary to predict a successful result at this level of amputation.

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Capsule Commentary on Piller et al., Characteristics and Long-Term Follow-Up of Participants With Peripheral Vascular Disease During ALLHAT

Journal of General Internal Medicine ◽

10.1007/s11606-014-2983-x ◽

2014 ◽

Vol 29 (11) ◽

pp. 1527-1527

Author(s):

Stephen K. Williams

Keyword(s):

Vascular Disease ◽

Peripheral Vascular Disease ◽

Peripheral Vascular ◽

Long Term Follow Up

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Long-term incidence and outcomes of obesity-related peripheral vascular disease after bariatric surgery

Langenbeck s Archives of Surgery ◽

10.1007/s00423-020-02066-9 ◽

2021 ◽

Author(s):

Osama Moussa ◽

Maddalena Ardissino ◽

Silvia Muttoni ◽

Ara Faraj ◽

Alice Tang ◽

...

Keyword(s):

Bariatric Surgery ◽

Vascular Disease ◽

Peripheral Vascular Disease ◽

Primary Endpoint ◽

Arterial Disease ◽

Venous Disease ◽

Peripheral Vascular ◽

Event Rates

Abstract Background and aims Patients with obesity are at high risk of suffering from arterial and venous peripheral vascular disease (PVD). Bariatric surgery is an effective strategy to achieve weight reduction for patients with obesity. The long-term impact of bariatric surgery on obesity-related morbidity is subject to increasing research interest. This study aimed to ascertain the impact of bariatric surgery on the long-term occurrence of PVD in patients with obesity. Methods The study population was extracted from the Clinical Practice Research Datalink, a nation-wide database containing primary and secondary care records of consenting patients. The intervention cohort was 2959 patients who had undergone bariatric surgery during follow-up; their controls were 2959 propensity-score-matched counterparts. The primary endpoint was development of any PVD: arterial or venous. Secondary endpoints were incident peripheral arterial disease alone, incident peripheral venous disease alone. Results Three hundred forty-six patients suffered a primary endpoint during follow-up. Bariatric surgery did not improve peripheral vascular disease rates as a whole, but it was associated with significantly lower event rates of arterial disease (HR = 0.560, 95%CI 0.327–0.959, p = 0.035) but higher event rates of venous disease (HR = 1.685, 95%CI 1.256–2.262, p < 0.001). Conclusions Bariatric surgery was associated with significantly reduced long-term occurrence of arterial disease but increased occurrence of venous disease in patients with obesity.

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Patient characteristics predict patency of early-cannulation arteriovenous grafts

Scientific Reports ◽

10.1038/s41598-021-87750-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

David B. Kingsmore ◽

Karen S. Stevenson ◽

S. Richarz ◽

Andrej Isaak ◽

Andrew Jackson ◽

...

Keyword(s):

Vascular Disease ◽

Peripheral Vascular Disease ◽

Vascular Access ◽

Demographic Data ◽

Univariate Analysis ◽

Patient Characteristics ◽

Peripheral Vascular ◽

Arteriovenous Grafts ◽

One Year

AbstractThere is a new emphasis on tailoring appropriate vascular access for hemodialysis to patients and their life-plans, but there is little known about the optimal use of newer devices such as early-cannulation arteriovenous grafts (ecAVG), with studies utilising them in a wide variety of situations. The aim of this study was to determine if the outcome of ecAVG can be predicted by patient characteristics known pre-operatively. This retrospective analysis of 278 consecutive ecAVG with minimum one-year follow-up correlated functional patency with demographic data, renal history, renal replacement and vascular access history. On univariate analysis, aetiology of renal disease, indication for an ecAVG, the number of previous tunnelled central venous catheters (TCVC) prior to insertion of an ecAVG, peripheral vascular disease, and BMI were significant associates with functional patency. On multivariate analysis the number of previous TCVC, the presence of peripheral vascular disease and indication were independently associated with outcome after allowing for age, sex and BMI. When selecting for vascular access, understanding the clinical circumstances such as indication and previous vascular access can identify patients with differing outcomes. Importantly, strategies that result in TCVC exposure have an independent and cumulative association with decreasing long-term patency for subsequent ecAVG. As such, TCVC exposure is best avoided or minimised particularly when ecAVG can be considered.

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240 Long-term pronostic value of peripheral vascular disease in patients undergoing isolated coronary artery bypass grafting

Archives of Cardiovascular Diseases Supplements ◽

10.1016/s1878-6480(10)70242-1 ◽

2010 ◽

Vol 2 (1) ◽

pp. 77

Author(s):

Batric Popovic ◽

Marc Antoine Arnould ◽

Christine Selton Suty ◽

Michael Angioi ◽

Jean Pierre Carteaux ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Vascular Disease ◽

Peripheral Vascular Disease ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Bypass Grafting ◽

Peripheral Vascular ◽

Artery Bypass Grafting

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The Safety of Ultrasound Guided Tenotomy for Upper and Lower Extremity Tendinopathies: A Retrospective Study

10.21203/rs.3.rs-32408/v1 ◽

2020 ◽

Author(s):

Benjamin Fick ◽

Daniel Stover ◽

Ruth Chimenti ◽

Mederic Hall

Keyword(s):

Lower Extremity ◽

Physical Function ◽

Complication Rate ◽

Plantar Fascia ◽

Safe Procedure ◽

Ultrasound Guided ◽

Short Term ◽

Long Term Follow Up

Abstract Background: Ultrasound guided tenotomy (USGT) is a minimally invasive treatment option for patients with chronic tendinopathy who fail to benefit from conservative exercise interventions. The complication rate and effectiveness of USGT remain poorly defined in the literature. Purpose: This study aimed to evaluate the risks associated with USGT and outcomes across upper extremity and lower extremity tendinopathy/fasciopathy sites. Methods Patients who had USGT at the elbow, patellar, or Achilles tendons or along the plantar fascia were identified by retrospective review of charts. Screening for complications (infection, tendon rupture, and hypersensitivity) and satisfaction with the procedure were assessed at routine short-term follow-up visits and at long-term follow-up via phone/email. Outcomes (pain, quality of life) were assessed using the region specific pain scales and the Short Form-12, respectively, at baseline prior to the procedure, short-term follow up, and long term follow up. Results: A total of 262 patients were identified through chart review. There was a low complication rate of 0.7% including one superficial wound infection and one case of wound hypersensitivity. Prior to USGT, the majority of patients reported moderate/daily pain that decreased by short-term and long-term follow-up to mild/occasional pain (p < 0.05). Additionally, most patients reported abnormally low physical function prior to USGT that was within normal range of physical function by long-term follow-up (p < 0.05). The majority of responders (63% at the plantar fascia to 92% at the Achilles midportion) reported being either ‘very satisfied’ or ‘somewhat satisfied’ with the procedure at short-term follow-up. Conclusions: This study found that USGT is a safe procedure with a low complication rate in a heterogeneous sample. Study findings provide preliminary evidence on the utility of USGT to reduce pain and improve function with a high rate of patient satisfaction.

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Impact of Cerebrovascular Disease on the Surgical Treatment of Idiopathic Normal Pressure Hydrocephalus

Neurosurgery ◽

10.1227/01.neu.0000230259.49167.95 ◽

2006 ◽

Vol 59 (3) ◽

pp. 545-552 ◽

Cited By ~ 17

Author(s):

Diego Spagnoli ◽

Lucia Innocenti ◽

Lorenzo Bello ◽

Mauro Pluderi ◽

Susanna Bacigaluppi ◽

...

Keyword(s):

Risk Factors ◽

Cerebrovascular Disease ◽

Vascular Disease ◽

Normal Pressure Hydrocephalus ◽

Normal Pressure ◽

Short Term ◽

Long Term Follow Up ◽

Short And Long Term

Abstract OBJECTIVE: The influence of cerebrovascular disease (CVD) on the short- and long-term results of surgery was evaluated in a series of consecutive patients with idiopathic normal-pressure hydrocephalus (iNPH). METHODS: Patients with suspected iNPH admitted to our department between June 1996 and June 2003 were evaluated with four clinical and handicap scales. CVD and risk factors for vascular disease were rated. All patients underwent intracranial pressure monitoring via a spinal catheter. Sixty-six patients received a ventriculoperitoneal shunt with a programmable valve. Prospective assessments were programmed at 2 weeks and 3 months after surgery (short-term follow-up). Long-term follow-up evaluations were arranged in June 2004 with patients and/or relatives and health/home care assistants. RESULTS: At the short-term follow-up examination, a significant clinical improvement was globally present in 89% of the patients (P < 0.05). CVD, such as leucoaraiosis or previous strokes, were present in 71% of the patients. Patients both with and without CVD and/or risk factors for vascular disease presented a significant improvement (P < 0.05) after shunting; 85 and 100% of the patients with and without CVD, respectively. At the long-term follow-up examination (mean, 52 ± 24.8 mo), 24% of the patients were dead and 8% had experienced stroke. Globally, 60% of the patients were still improved (P < 0.05); 52 and 79% of the patients with and without CVD, respectively. CONCLUSION: A high success rate in treatment of iNPH is possible in patients with and without CVD. Despite poorer short- and long-term treatment outcome of iNPH patients with CVD, a long-lasting improvement in their quality of life favors surgery.

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