scholarly journals Indications and Use of Hydrogen Peroxide during Microvascular Flap Reconstruction Surgery: A Literature and Procedural Use Review

2017 ◽  
Vol 02 (01) ◽  
pp. e23-e25
Author(s):  
E. Rodriguez-Collazo ◽  
D. Riddle ◽  
K. Schmidtke
Keyword(s):  
Hydrogen Peroxide ◽  
Arterial Disease ◽  
Tissue Loss ◽  
Flap Reconstruction ◽  
Muscle Belly ◽  
Reconstruction Surgery ◽  
Microvascular Flap ◽  
Peripheral Arterial

AbstractMicrovascular flap reconstruction surgery is a limb preservation procedure performed in an effort to maintain the integrity of the lower limb and avoid amputations. Individuals facing the prospect of amputation often have long-term diabetes with multiple comorbidities, including severe peripheral vascular disease; peripheral arterial disease; chronic ulcerations; and Charcot arthropathy. Long-term clinical research has shown that these patients are at much higher risk for secondary amputations after a first amputation is performed. According to Sohn et al, Charcot and ulcer groups had 4.1 and 4.7 amputations per 100 person-years, respectively. In patients younger than 65 years old at the end of follow-up, amputation risk, relative to patients with Charcot alone, was 7 times higher for patients with ulcer alone and 12 times higher for patients with Charcot and ulcer. Patients with infected hardware, suffering from acute ulcerative conditions, may also be candidates for this type of surgery due to extensive tissue loss secondary to infection. Microvascular flap reconstruction surgery is a highly technical surgery involving the use of orthoplastic techniques, which is performed under ×3.5 loupe magnification. Due to the inability to perform this procedure with the use of a tourniquet, visibility within the field is obfuscated from continuous blood flow along the dissected muscle belly. Hydrogen peroxide (H2O2) is an excellent alternative to tourniquet use. The use of H2O2 allows additional benefits, such as visual field clearance and antisepsis.

Long Term Outcome of Patients with Peripheral Arterial Disease and Tissue Loss Stratified to a Non-revascularization Approach

2015 ◽  
Vol 29 (5) ◽  
pp. 877
Author(s):  
Isabella Possagnolli ◽  
Christian Bianchi ◽  
Teruya Theodore ◽  
Chiriano Jason ◽  
Vicki Bishop ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Tissue Loss ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Peripheral Arterial

scholarly journals Long-term outcomes of peripheral arterial disease patients with significant coronary artery disease undergoing percutaneous coronary intervention

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251542
Author(s):  
Byoung Geol Choi ◽  
Ji-Yeon Hong ◽  
Seung-Woon Rha ◽  
Cheol Ung Choi ◽  
Michael S. Lee
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Peripheral Arterial Disease ◽  
Significant Coronary Artery Disease ◽  
Arterial Disease ◽  
Term Survival ◽  
Artery Disease ◽  
Peripheral Arterial

Background Patients with peripheral arterial disease (PAD) have known to a high risk of cardiac mortality. However, the effectiveness of the routine evaluation of coronary arteries such as routine coronary angiography (CAG) in PAD patients receiving percutaneous transluminal angioplasty (PTA) is unclear. Methods A total of 765 consecutive PAD patients underwent successful PTA and 674 patients (88.1%) underwent routine CAG. Coronary artery disease (CAD) was defined as angiographic stenosis ≥70%. Patients were divided into three groups; 1) routine CAG and a presence of CAD (n = 413 patients), 2) routine CAG and no CAD group (n = 261 patients), and 3) no CAG group (n = 91 patients). To adjust for any potential confounders that could cause bias, multivariable Cox-proportional hazards regression and propensity score matching (PSM) analysis was performed. Clinical outcomes were evaluated by Kaplan-Meier curved analysis at 5-year follow-up. Results In this study, the 5-year survival rate of patients with PAD who underwent PTA was 88.5%. Survival rates were similar among the CAD group, the no CAD group, and the no CAG group, respectively (87.7% vs. 90.4% vs. 86.8% P = 0.241). After PSM analysis between the CAD group and the no CAD group, during the 5-year clinical follow-up, there were no differences in the incidence of death, myocardial infarction, strokes, peripheral revascularization, or target extremity surgeries between the two groups except for repeat PCI, which was higher in the CAD group than the non-CAD group (9.3% vs. 0.8%, P<0.001). Conclusion PAD patients with CAD were expected to have very poor long-term survival, but they are shown no different long-term prognosis such as mortality compared to PAD patients without CAD. These PAD patients with CAD had received PCI and/or optimal medication treatment after the CAG. Therefore a strategy of routine CAG and subsequent PCI, if required, appears to be a reasonable strategy for mortality risk reduction of PAD patients. Our results highlight the importance for evaluation for CAD in patients with PAD.

scholarly journals Medication Underuse During Long-Term Follow-Up in Patients With Peripheral Arterial Disease

2009 ◽  
Vol 2 (4) ◽  
pp. 338-343 ◽  
Author(s):  
Sanne E. Hoeks ◽  
Wilma J.M. Scholte op Reimer ◽  
Yvette R.B.M. van Gestel ◽  
Olaf Schouten ◽  
Mattie J. Lenzen ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Long Term Follow Up ◽  
Peripheral Arterial

scholarly journals Vasoactive Biomarkers Associated With Long-Term Incidence of Symptomatic Peripheral Arterial Disease and Mortality

Angiology ◽  
2021 ◽  
pp. 000331972098773
Author(s):  
Ardwan Dakhel ◽  
Gunnar Engström ◽  
Olle Melander ◽  
Stefan Acosta ◽  
Shahab Fatemi ◽  
...  
Keyword(s):  
Cohort Study ◽  
Peripheral Arterial Disease ◽  
Proportional Hazards ◽  
Arterial Disease ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Regression ◽  
Proportional Hazards Regression ◽  
Peripheral Arterial

We evaluated if plasma biomarkers can predict incident peripheral arterial disease (PAD) and mortality in a longitudinal cohort study. Men (n = 3618) and women (n = 1542) were included in the Malmö Preventive Project and underwent analysis of: C-terminal endothelin-1 (CT-proET-1), N-Terminal prosomatostatin (NT-proSST), midregional proatrial natriuretic peptide (MR-proANP), procalcitonin (PCT), and copeptin. Participants were followed up for incident PAD and mortality until December 31, 2016. Median follow-up was 11.2 years (interquartile range 9.4-12.2). Cumulative incidence of PAD was 4.3% (221/5160), 4.5% in men (164/3618) and 3.7% in women (57/1542; P = .174). In an adjusted Cox proportional hazards regression model, higher CT-proET-1 (hazard ratio [HR] 1.8; 95% confidence interval [CI] 1.4-2.3), NT-proSST (HR 1.5; 95% CI 1.2-2.0), and MR-proANP (HR 1.7; 95% CI 1.3-2.3) were independently associated with incident PAD, and higher CT-proET-1 (HR 1.3; 95% CI 1.2-1.5), NT-proSST (HR 1.2; 95% CI 1.1-1.3), MR-proANP (HR 1.4; 95% CI 1.3-1.6), PCT (HR 1.1; 95% CI 1.0-1.2), and copeptin (HR 1.2; 95% CI 1.1-1.4) were independently associated with mortality. Increased levels of CT-proET-1, NT-proSST, and MR-proANP were independently associated with incident PAD, whereas all the vasoactive biomarkers were independently associated with mortality during follow-up.

scholarly journals Priporočila za odkrivanje in zdravljenje periferne arterijske bolezni

2017 ◽  
Vol 86 (3-4) ◽  
Author(s):  
Aleš Blinc ◽  
Matija Kozak ◽  
Mišo Šabovič ◽  
Vinko Boc ◽  
Pavel Poredoš ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Therapeutic Procedures ◽  
Long Term Follow Up ◽  
Peripheral Arterial

In the article, recommendations for the diagnostics in suspected peripheral arterial disease are presented together with  therapeutic procedures and long- term follow up of the affected patients.

scholarly journals Long-term incidence of cancer after index treatment for symptomatic peripheral arterial disease – a health insurance claims data analysis

VASA ◽  
2020 ◽  
Vol 49 (6) ◽  
pp. 493-499
Author(s):  
Mark Kaschwich ◽  
Frederik Peters ◽  
Sandra Hischke ◽  
Henrik C. Rieß ◽  
Max Gansel ◽  
...  
Keyword(s):  
Claims Data ◽  
Arterial Disease ◽  
Incident Cancer ◽  
Insurance Claims Data ◽  
Health Insurance Claims Data ◽  
Health Insurance Claims ◽  
Peripheral Arterial ◽  
Index Treatment

Summary: Background: Cancer as a concomitant condition in symptomatic peripheral arterial disease (PAD) patients could have an impact on further therapy and the long-term prognosis of these patients. Aim of this study was to investigate whether there is an increased incidence of cancer in PAD patients and to quantify the corresponding effect size. Materials and methods: Between January 1st, 2008 and December 31st, 2017, we analysed health insurance claims data from Germany’s second-largest insurance fund, BARMER. Symptomatic PAD patients suffering from intermittent claudication (IC) or chronic limb-threatening ischaemia (CLTI) were stratified by gender at index treatment. PAD patients were then followed until an incident cancer diagnosis was recorded. To adjust for age and gender, standardized incidence ratios (SIR) were computed using the 2012 German standard population as reference. Results: 96,528 PAD patients (47% female, 44% IC, mean age 72 years) were included in the current study. When compared to the overall population, female and male PAD patients have a significantly increased risk of incident cancer of the lung (SIR 3.5 vs. 2.6), bladder (SIR 3.2 vs. 4.0), pancreas (SIR 1.4 vs. 1.6), and colon (SIR 1.3 vs. 1.3). During ten years of follow-up, some 7% of males and 4% of females developed lung cancer. For bladder, colon and pancreas cancer, the cumulative hazards were 1% vs. 3.2%, 2.2% vs. 2.8%, and 0.7% vs. 0.9%, respectively. Conclusions: Patients suffering from symptomatic PAD face a markedly higher risk for incident cancer in the long-term follow-up. The cancer risk increased continuously for certain types and PAD was strongly associated with cancer of the lung, bladder, pancreas, and colon. Taking these results into account, PAD patients could benefit from secondary and tertiary screening. These results also emphasize the impact of common risk factors such as tobacco smoke as target for health prevention.

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