6,665 results match your criteria major amputation


Characteristics of phantom limb pain in U.S. civilians and service members.

Scand J Pain 2021 Sep 17. Epub 2021 Sep 17.

Uniformed Services University of the Health Sciences, Bethesda, MD, USA.

Objectives: The population of Americans with limb loss is on the rise, with a different profile than in previous generations (e.g., greater incidence of amputation due to diabetes). Read More

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September 2021

[Are there alternatives to dual antiplatelet therapy after stenting of peripheral arteries?]

Angiol Sosud Khir 2021 ;27(3):22-27

Department of Vascular Surgery, Interregional Clinical and Diagnostic Centre, Kazan, Russia.

It is estimated that more than 200 million people worldwide suffer peripheral artery disease and the rate of amputations remains at a high level. The basis of treatment is timely revascularization wherein the fraction of interventions performed endovascularly has steadily been growing both in Russia and abroad. Nevertheless, the parameters of long-term patency of endovascular reconstructions of the infrainguinal segment are still inferior to open interventions. Read More

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September 2021

Patterns and outcomes of high-voltage versus low-voltage pediatric electrical injuries: an 8-year retrospective analysis of a tertiary-level burn center.

J Burn Care Res 2021 Sep 15. Epub 2021 Sep 15.

University of Health Sciences, Adana City Training and Research Hospital, Department of General Surgery, Burn Center, Adana, Turkey.

Introduction: Although electrical injuries (EIs) are rare traumas in the pediatric age group, they are considered one of the most devastating injuries. We aimed to evaluate the patterns and outcomes of pediatric high-voltage (HVI) vs. low-voltage injuries (LVIs), admitted to the burn center within the efforts of determining evidence-based data for contributing to burn prevention strategies. Read More

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September 2021

Three-Year Clinical Outcomes of the Innova™ Self-Expanding Nitinol Stent for the Treatment of Femoropopliteal Lesions.

Cardiovasc Intervent Radiol 2021 Sep 14. Epub 2021 Sep 14.

Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.

Purpose: To report the 3-year results of Innova™ stent implantation for the treatment of femoropopliteal (FP) lesions in a real-world setting.

Methods: This single-arm, retrospective, multicenter clinical study analyzed 481 lesions from 453 consecutive patients with symptomatic peripheral artery diseases (Rutherford category 1-6) who underwent endovascular therapy with implantation of Innova™ self-expanding nitinol stent for FP lesions. The primary outcome measure was the 3-year restenosis rate based on doppler-ultrasound or angiographic criteria. Read More

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September 2021

Isolation and characterization of bacteria from diabetic foot ulcer: amputation, antibiotic resistance and mortality rate.

Int J Diabetes Dev Ctries 2021 Sep 10:1-9. Epub 2021 Sep 10.

Clinical Pharmacy and Practice, Faculty of Pharmacy and Medical Sciences, Hebron University, P.O Box 40, Hebron, West Bank 00972 Palestine.

Background: Diabetic foot ulcer (DFU) is one of the most serious complications of diabetes mellitus with devastating outcomes. Poorly treated DFU leads to osteomyelitis, gangrene and limb amputation. There is an increased risk of mortality for the amputees and increased number of bacterial resistance in survived patients. Read More

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September 2021

[Multidisciplinary unit specialized in the treatment of diabetic foot: Evaluation and results].

Rehabilitacion (Madr) 2021 Sep 11. Epub 2021 Sep 11.

Servicio de Rehabilitación, Hospital Universitario Morales Meseguer, Murcia, España.

Introduction: In this study the evaluation of the care process of the diabetic foot will be carried out after the implementation of an intra-hospital clinical pathway and a multidisciplinary consultation.

Objectives: Evaluate the influence on factors related to the care, amputations, and rehabilitation of the amputee patient.

Methodology: Retrospective study, in which the comparison of three periods has been made. Read More

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September 2021

An explainable machine learning model for predicting in-hospital amputation rate of patients with diabetic foot ulcer.

Int Wound J 2021 Sep 14. Epub 2021 Sep 14.

Department of Endocrinology and Metabolism, Chongqing Emergency Medical Center, Chongqing Key Laboratory of Emergency Medicine, Chongqing University Central Hospital, Chongqing University, Chongqing, China.

Diabetic foot ulcer (DFU) is one of the most serious and alarming diabetic complications, which often leads to high amputation rates in diabetic patients. Machine learning is a part of the field of artificial intelligence, which can automatically learn models from data and better inform clinical decision-making. We aimed to develop an accurate and explainable prediction model to estimate the risk of in-hospital amputation in patients with DFU. Read More

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September 2021

Patient survival and limb salvage after shark attack with major vascular injury: A case report.

Authors:
Ayman Khalil

Chin J Traumatol 2021 Aug 4. Epub 2021 Aug 4.

Department of General and Vascular Surgery, AMC Hospital, Hurghada, Red Sea, Egypt. Electronic address:

Shark attacks are rare unique pathological processes. Some of them represent devastating injuries with a high morbidity and significant mortality. Related published articles are limited. Read More

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World regional differences in outcomes for patients with peripheral artery disease: Insights from the EUCLID trial.

Vasc Med 2021 Sep 13:1358863X211038620. Epub 2021 Sep 13.

Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.

Regional variations exist in the epidemiology of peripheral artery disease (PAD), in comorbidities, use of secondary prevention, and outcomes. Large studies of these variations in worldwide populations are rare. The EUCLID (Examining Use of tiCagreLor In peripheral artery Disease) trial included 13,885 patients with PAD from four geographical regions (Central/South America, Europe, Asia, North America) and compared monotherapy with ticagrelor and clopidogrel. Read More

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September 2021

Pediatric Replantation after Traumatic Amputation at the Distal Forearm: Rehabilitation Protocol and Outcomes.

J Hand Microsurg 2021 Jul 13;13(3):169-172. Epub 2020 Apr 13.

Division of Plastic and Reconstructive Surgery, Department of Surgery, Rutgers New Jersey Medical School, New Jersey, United States.

Major limb replantation is a formidable task, especially in the pediatric setting. While meticulous microsurgical technique is required in the operating room, the authors aim to highlight the importance of postoperative rehabilitation therapy for optimal function. We highlight the case of a 12-year-old boy who suffered complete traumatic amputation through the distal left forearm. Read More

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The Potential Benefits and Costs of an Intensified Approach to Low Density Lipoprotein Cholesterol Lowering in People with Abdominal Aortic Aneurysm.

Eur J Vasc Endovasc Surg 2021 Sep 7. Epub 2021 Sep 7.

Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia; Centre for Molecular Therapeutics, The Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Queensland, Australia; The Department of Vascular and Endovascular Surgery, Townsville University Hospital, Townsville, Queensland, Australia. Electronic address:

Objective: The aims of this study were to assess the incidence of major vascular events (MVE) and peripheral vascular events (PVE) in people with a small asymptomatic abdominal aortic aneurysm (AAA) and model the theoretical benefits and costs of an intensified low density lipoprotein cholesterol (LDL-C) lowering programme.

Methods: A total of 583 participants with AAAs measuring 30 - 54 mm were included in this study. The control of LDL-C and prescription of lipid lowering drugs were assessed by dividing participants into approximately equal tertiles depending on their year of recruitment into the study. Read More

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September 2021

The Influence of Socioeconomic Status on Outcomes of Lower Extremity Arterial Reconstruction.

J Vasc Surg 2021 Sep 7. Epub 2021 Sep 7.

Department of Health Policy and Management, University of Maryland School of Public Health, College Park, MD 20742.

Objective: While it has been shown that patient socioeconomic status (SES) is associated with the surgical treatments chosen for severe peripheral arterial disease (PAD), the association between SES and outcomes of arterial reconstruction have not been well studied. The objective of this study was to determine if SES is associated with outcomes following lower extremity arterial reconstruction.

Methods: Patients 40 years and older who had surgical revascularization for severe lower extremity PAD were identified in the Nationwide Readmissions Database, 2010 - 2014. Read More

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September 2021

A nationwide cohort investigation on pay-for-performance and major adverse limb events in patients with diabetes.

Prev Med 2021 Sep 8;153:106787. Epub 2021 Sep 8.

Department of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taiwan. Electronic address:

A retrospective cohort study was conducted using claims data from Taiwan's National Health Insurance program to assess the effect of diabetic pay-for-performance (P4P) program on major adverse limb events (MALE) and major adverse cardiovascular events (MACE) in patients with type 2 diabetes mellitus (T2DM). This study included patients with T2DM who had completed or not completed a 1-year P4P program from 2002 to 2013. Propensity-score matching was used to balance the baseline characteristics between groups. Read More

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September 2021

Participation in a Chronic Limb Threatening Ischemia Randomized Trial Is Inversely Correlated With Regional Amputation Rate in Limb Threatening Ischemia Patients.

Ann Surg 2021 10;274(4):621-626

Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University, Boston, MA.

Objective: The National Health Service demonstrated that regions of the United Kingdom with the highest number of patients enrolled in research studies had the lowest risk-adjusted mortality when patients were admitted to the hospital. Our goal was to investigate if this correlation was evident for patients with chronic limb threatening ischemia (CLI) treated in the United States (US). Accordingly, we examined correlations among sites participating in the Best Endovascular versus best Surgical Therapy in patients with Critical (BEST-CLI) trial, a multicenter, National Institute of Health-sponsored, international randomized controlled trial (RCT) comparing revascularization strategies in patients with CLI, and regional rates of major amputation from CLI. Read More

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October 2021

Impact of Hospital Procedural Volume on Outcomes After Endovascular Revascularization for Critical Limb Ischemia.

JACC Cardiovasc Interv 2021 Sep;14(17):1926-1936

Division of Cardiology, Baylor College of Medicine, Houston, Texas, USA. Electronic address:

Objectives: The aim of this study was to evaluate the interaction between hospital endovascular lower extremity revascularization (eLER) volume and outcomes after eLER for critical limb ischemia (CLI).

Background: There is a paucity of data on the relationship between hospital procedural volume and outcomes of eLER for CLI.

Methods: The authors queried the Nationwide Readmission Database (2013-2015) for hospitalized patients who underwent eLER for CLI. Read More

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September 2021

Foot Revascularization Avoids Major Amputation in Persons with Diabetes and Ischaemic Foot Ulcers.

J Clin Med 2021 Sep 2;10(17). Epub 2021 Sep 2.

Department of Systems Medicine, University of Rome "Tor Vergata", 00133 Rome, Italy.

The study aims to evaluate the effectiveness of foot revascularization in persons with diabetic foot ulcers (DFUs) and below-the-ankle (BTA) arterial disease. Consecutive patients referred for a new active ischaemic DFU requiring lower limb revascularization were considered. Among those, only patients with a BTA arterial disease were included. Read More

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September 2021

Outcomes and Role of Peripheral Revascularization in Type A Aortic Dissection (TAAD) Presenting with Acute Lower Extremity Ischemia.

J Vasc Surg 2021 Sep 6. Epub 2021 Sep 6.

Division of Vascular & Endovascular Surgery, University of Virginia, Charlottesville, VA 22908; Aortic Center, University of Virginia Medical Center, Charlottesville, VA 22908. Electronic address:

Objective: Limited data exists on management and outcomes of patients presenting with TAAD and acute lower extremity ischemia (ALI). The role of limb-related revascularization and optimal treatment strategy remains undefined. The objective of this study was to analyze dissection characteristics, treatment modalities, and outcomes of patients undergoing proximal aortic repair for TAAD with ALI. Read More

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September 2021

Risk factors and incidence over time for lower extremity amputations in people with type 1 diabetes: an observational cohort study of 46,088 patients from the Swedish National Diabetes Registry.

Diabetologia 2021 Sep 8. Epub 2021 Sep 8.

Department of Molecular and Clinical Medicine, University of Gothenburg, Gothenburg, Sweden.

Aims/hypothesis: The aim of this work was to study the incidence over time of lower extremity amputations and determine variables associated with increased risk of amputations in people with type 1 diabetes.

Methods: Individuals with type 1 diabetes registered in the Swedish National Diabetes Registry with no previous amputation from 1 January 1998 and followed to 2 October 2019 were included. Time-updated Cox regression and gradient of risk per SD were used to evaluate the impact of risk factors on the incidence of amputation. Read More

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September 2021

Split Anterior Tibial Tendon Transfer to Dorsal Lateral Foot for Cavovarus Deformities With Neuropathic Ulcerations: A Case Series.

J Foot Ankle Surg 2021 Aug 15. Epub 2021 Aug 15.

Assistant Professor Fellowship Program Director, Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD.

Cavovarus deformity leads to increased peak pressure on the plantar lateral foot, which can lead to ulceration, and can potentially progress to amputation. Techniques have been suggested in the treatment of cavovarus deformity, such as peroneus brevis or longus tendon transfer, anterior tibial tendon lengthening, posterior tibial tendon transfer, or boney resection. This case series shows split anterior tibial tendon transfer as a surgical reconstruction of cavovarus pedal deformity. Read More

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Aortic thrombosis in a neonate with COVID-19-related fetal inflammatory response syndrome requiring amputation of the leg: a case report.

Paediatr Int Child Health 2021 Sep 7:1-6. Epub 2021 Sep 7.

Department of Pediatrics, MGM Medical College and Hospital, Navi Mumbai, India.

Neonatal infection with SARS-CoV-2 is considered to have no major complications. A neonate with lower limb gangrene owing to spontaneous aortic thrombosis in the setting of a fetal inflammatory response syndrome (FIRS) post-intrauterine COVID-19 infection is presented. A healthy full-term newborn discharged from hospital on Day 3 developed irritability and progressive blackish discoloration of the toes of the right lower limb on Day 6 of life. Read More

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September 2021

Necrotizing Fasciitis and Diabetic Foot: Results of a Prompt Identification, Surgery and Antibiotic Therapy (P.I.S.A.) Protocol.

Int J Low Extrem Wounds 2021 Sep 7:15347346211041452. Epub 2021 Sep 7.

Diabetic Foot Section, Pisa, Italy.

Necrotizing fasciitis (NF) is a rapidly progressive, life-threatening infection, involving the skin, soft tissue and fascia. We evaluated outcomes of its surgical management in diabetic foot (DF) patients in a tertiary referral centre. We retrospectively searched for NF in the database of our DF Section from 2016 to 2018. Read More

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September 2021

Under-Prescription of Medical Treatment for Peripheral Artery Disease in the Under 50s: A Retrospective Study.

Angiology 2021 Sep 5:33197211042155. Epub 2021 Sep 5.

Department of Vascular Medicine, 36673Amiens-Picardie University Hospital, Amiens, France.

Peripheral artery disease (PAD) is a common cause of morbidity and mortality; however, data on its etiology and evolution in patients under 50 years old are scarce. Therefore, we performed a retrospective analysis of data from medical records, including cardiovascular risk factors, etiology, medical and surgical treatment, and follow-up. We included all patients with PAD aged between 18 and 50 years attending our university hospital between 2005 and 2015. Read More

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September 2021

Pedal arterial calcification score is associated with risk of major amputation in chronic limb-threatening ischemia.

J Vasc Surg 2021 Sep 2. Epub 2021 Sep 2.

University of California, San Francisco Department of Surgery, Division of Vascular and Endovascular Surgery, San Francisco, California. Electronic address:

Objective: The medial arterial calcification (MAC) score is a simple metric that describes the burden of inframalleolar calcification based on plain foot x-ray. We hypothesize that higher MAC score is independently associated with risk of major amputation in patients with chronic limb threatening ischemia (CLTI).

Methods: This is a single-institution retrospective study of 250 patients who underwent infrainguinal revascularization for CLTI between 1/2011 and 7/2019 and had foot x-rays available for MAC score calculation. Read More

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September 2021

Procedural and 12 month in-hospital costs of primary infra-popliteal bypass surgery, infra-popliteal best endovascular treatment, and major lower limb amputation for Chronic Limb Threatening Ischaemia.

J Vasc Surg 2021 Sep 2. Epub 2021 Sep 2.

University of Birmingham Department of Vascular Surgery, Netherwood House, Solihull Hospital, University Hospitals Birmingham NHS Foundation Trust, B91 2JL, UK.

Background: Chronic limb threatening ischaemia (CLTI) is a growing global problem due to the widespread use of tobacco and increasing prevalence of diabetes. Although the financial consequences are considerable, few studies have compared the relative cost-effectiveness of different CLTI management strategies. The Bypass versus Angioplasty in Severe Ischaemia of the Leg (BASIL)-2 trial is randomising CLTI patients to primary infra-popliteal (IP) vein bypass surgery (BS) or best endovascular treatment (BET) and includes a comprehensive within-trial cost-utility analysis. Read More

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September 2021

Changing patterns in Australian and New Zealand: Vascular surgery during COVID-19.

ANZ J Surg 2021 Sep 4. Epub 2021 Sep 4.

Department of Vascular Surgery, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.

Background: Early government-mandated restrictions in Australia and New Zealand contributed to a successful public health outcome during the COVID-19 pandemic, including an unprecedented temporary cancellation of all non-urgent elective surgical procedures. This study describes the change in vascular surgery services across Australia and New Zealand before and during the COVID-19 restrictions.

Methods: De-identified data from the Australia and New Zealand Society for Vascular Surgery Australasian Vascular Audit from January 2015 to September 2020 was obtained. Read More

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September 2021

The Timing of Limb Amputation in Nontraumatic Patients: Impact on Mortality and Postoperative Complication Rates.

J Foot Ankle Surg 2021 Aug 12. Epub 2021 Aug 12.

Consultant, Infectious Disease Unit, Shaare Zedek Medical Center, Affiliated with the Hebrew University-Hadassah Medical School, Jerusalem, Israel. Electronic address:

Diabetes and peripheral vascular diseases are accompanied frequently by lower limb ischemia and in minority, need for amputation, as a treatment of last resort. Even after a decision has been made regarding amputation, the procedures are often repeatedly postponed due to more urgent surgeries and lack of operating room availability. This study assessed the possible relationship between the duration of time inpatients wait for semiurgent amputations and the incidence of postamputation complications. Read More

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Amputation versus Primary Nonoperative Management of Chronic Osteomyelitis Involving a Pedal Digit in Diabetic Patients.

J Am Podiatr Med Assoc 2021 Jul;111(4)

Background: The preferred primary treatment of toe osteomyelitis in diabetic patients is controversial. We compared the outcome of primary nonoperative antibiotic treatment versus digital amputation in patients with diabetes-related chronic digital osteomyelitis.

Methods: We conducted a retrospective medical record review of patients treated for digital osteomyelitis at a single center. Read More

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Protocol for a prospective observational study: the Australia and New Zealand Diabetic and Ischaemic Foot Outcomes Study (ANZ-DIFOS).

BMJ Open 2021 09 2;11(9):e050833. Epub 2021 Sep 2.

Department of Surgery, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.

Introduction: Diabetic foot disease is a common condition globally and is over-represented in indigenous populations. The propensity for patients with diabetic foot disease to undergo minor or major limb amputation is a concern. Diabetic foot disease and lower limb amputation are debilitating for patients and have a substantial financial impact on health services. Read More

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September 2021

The Needle and the Damage Done: A retrospective review of the health impact of recreational intravenous drug use and the collateral consequences for Vascular Surgery.

Ann Vasc Surg 2021 Aug 30. Epub 2021 Aug 30.

East of Scotland Vascular Network, Department of Vascular Surgery, Ninewells Hospital, Dundee, Scotland, UK.

Background: The UK has one of the highest rates of recreational drug use and consequent deaths in Europe. Scotland is the "Drugs death capital of Europe." Intravenous drug use can result in limb- and life-threatening pathology. Read More

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