Abstract：
PURPOSE:We sought to analyze the results of lower limb arterial injury (LLAI) management in a busy metropolitan vascular unit and to identify risk factors associated with limb loss. PATIENTS AND METHODS:Between 1987 and 1997, prospectively collected data on 550 patients with 641 lower limb arterial injuries were analyzed. RESULTS:The mechanism of LLAI was gunshot wounds in 46.1%, blunt in 19%, stabbing in 11.8%, and shotgun in 9.1%. The most frequently injured vessel was the superficial femoral artery (37.2%), followed by the popliteal (30.7%), crural (11%), common femoral (8.7%), and deep femoral (5.3%) arteries. In 3.4% of cases, there was a combined injury on either side of the knee (ipsilaterally). Associated injuries included bony injury in 35.1% of cases, nerve injury in 7.6%, and remote affecting the head, chest, or abdomen in 3.6%. Surgery was carried out on 96.2% of cases with a limb salvage rate of 83.8% and a survival of 98.5%. In spite of a rising trend in LLAI, our total and delayed amputation rates remained stable. On stepwise logistic regression analysis, significant (P <.01) independent risk factors for amputation were occluded graft (odds ratio [OR] 16.7), combined above- and below-knee injury (OR 4.4), tense compartment (OR 4.2), arterial transsection (OR 2.8), and associated compound fracture (OR 2.7). CONCLUSION:LLAI carries a high amputation rate. Stab injuries are the least likely to lead to amputations, whereas high-velocity firearm injuries are the most likely to do so. The most significant independent risk factor for limb loss was failed revascularization.
journal_name
J Vasc Surgjournal_title
Journal of vascular surgeryauthors
Hafez HM,Woolgar J,Robbs JVdoi
10.1067/mva.2001.113982subject
Has Abstractpub_date
2001-06-01 00:00:00pages
1212-9issue
6eissn
0741-5214issn
1097-6809pii
S0741521401700912journal_volume
33pub_type
杂志文章,评审abstract：PURPOSE:The purpose of this study was to investigate the blood flow changes and venous wall movements that occur in the perivalvular area during venous flow, to learn how these physiologic events influence the movements of the valve cusps, and to learn how the movements of the valve cusps influence the venous flow. MA...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/s0741-5214(03)00711-0
更新日期：2003-11-01 00:00:00
abstract：OBJECTIVE:This study determined the incidence, the surgical details, and the outcome of late open conversion after failed endovascular aneurysm repair (EVAR) for abdominal aortic aneurysm. METHODS:A review of English-language medical literature from 1991 to 2014 was conducted using the PubMed and EMBASE databases to f...
journal_title：Journal of vascular surgery
pub_type： 杂志文章,评审
doi：10.1016/j.jvs.2015.02.019
更新日期：2015-05-01 00:00:00
abstract：PURPOSE:This study was performed to determine intra-aneurysm sac pressure of abdominal aortic aneurysm after endovascular aneurysm repair in patients considered successfully treated with aneurysm shrinkage and absence of endovascular leakage. METHODS:In 10 patients with median aneurysm shrinkage of 12 mm (range, 7 to ...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1067/mva.2003.138
更新日期：2003-04-01 00:00:00
abstract：:Paper-based information systems are cumbersome and inefficient. The microcomputer is an attractive, affordable, and powerful alternative to traditional paper-based record keeping. This article reviews fundamentals of data base management and microcomputer technology for the surgeon interested in microcomputer-based in...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1067/mva.1984.avs0010585
更新日期：1984-07-01 00:00:00
abstract：:The lack of a rapid, noninvasive, and accurate method to confirm or rule out prosthetic graft infection continues to constitute a compelling and vexing clinical problem. A host of adjunctive diagnostic techniques has been used in the past, but early promising results subsequently have usually not yielded acceptable se...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1067/mva.1986.avs0030042
更新日期：1986-01-01 00:00:00
abstract：OBJECTIVE:Prosthetic femoral-popliteal bypasses are performed by using an end-to-side anastomosis, and disease can develop at the distal end; this can lead to poor long-term patency rates. Disturbed flow characteristics are hypothesized as being a major factor in promoting disease development. The objective of this stu...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2005.08.016
更新日期：2005-12-01 00:00:00
abstract：INTRODUCTION:Thoracoabdominal aortic replacement requires visceral vessel revascularization and is usually performed with Crawford's inclusion technique or a large Carrel patch. This segment of retained native aorta may be prone to recurrent aneurysmal disease. We reviewed our experience with patients in whom aneurysma...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1067/mva.2001.117149
更新日期：2001-09-01 00:00:00
abstract：OBJECTIVES:Carotid artery stenting (CAS) has been recommended as an alternative to carotid endarterectomy (CEA) by some clinicians. However, recently published clinical trials have reported 30-day stroke and death rates of 10% to 12%. This prompted review of our experience with CAS in patients at high risk, to document...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/s0741-5214(02)75448-7
更新日期：2003-06-01 00:00:00
abstract：PURPOSE:Differences in the reporting methods of results for arteriovenous (AV) access can dramatically affect apparent outcome. To enable meaningful comparisons in the literature, the Society for Vascular Surgery and the American Association for Vascular Surgery (SVS/AAVS) recently published reporting standards for dia...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/s0741-5214(03)00720-1
更新日期：2004-02-01 00:00:00
abstract：PURPOSE:The purpose of this study was to determine whether the combined insults of hemorrhagic shock and aortic clamping simulating ruptured abdominal aortic aneurysm repair had a synergistic effect on the production of pulmonary injury, indicating remote organ injury. METHODS:Animals were randomized to one of three g...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/s0741-5214(95)70081-1
更新日期：1995-07-01 00:00:00
abstract：BACKGROUND:Induction of collateral development to improve tissue perfusion is a promising approach for the treatment of arterial occlusive diseases. Several growth factors and cells have been reported to increase collateral circulation; however, the appropriate site for the delivery of these factors and cells is unclea...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2014.02.004
更新日期：2015-07-01 00:00:00
abstract：BACKGROUND:Renal artery stent placement is a recognized treatment for patients with hemodynamically significant renal artery stenosis when medical therapy fails. Duplex ultrasound (DUS) is the primary method used for noninvasive assessment of renal artery patency. Arterial stents alter the compliance of the artery, whi...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2008.12.066
更新日期：2009-07-01 00:00:00
abstract：BACKGROUND:Surgical skills and simulation courses are emerging to meet the demand for vascular simulation training for vascular surgical skills, but their educational effect has not yet been described. We sought to determine the effect of an intensive vascular surgical skills and simulation course on the procedural kno...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2016.12.065
更新日期：2017-03-01 00:00:00
abstract：PURPOSE:The aim of this study was to seek a relationship between the morphologic features of abdominal aortic aneurysms and the feasibility of endoaortic grafting. METHODS:Between June 1995 and January 1996, 86 patients were prospectively studied with contrast-enhanced spiral computed tomographic scans, which provided...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/s0741-5214(97)70184-8
更新日期：1997-08-01 00:00:00
abstract：OBJECTIVE:Totally percutaneous aortic aneurysm repair has been shown to be technically feasible, with low morbidity. Complications from percutaneous arterial closure are not insignificant, however, and can be fatal. We sought to evaluate our experience with this technique, compare it with the published literature, and ...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2005.11.004
更新日期：2006-02-01 00:00:00
abstract：OBJECTIVE:This study aimed to address the shortcomings of previous clinical trials that were inadequate to prove the superiority of thoracic endovascular aortic repair (TEVAR) in managing type B aortic dissection (TBAD) over open surgery (OS) or best medical treatment (BMT). The comparative effectiveness of these three...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2019.02.062
更新日期：2019-12-01 00:00:00
abstract：:Late presentation of aortic injuries secondary to internal fixation hardware is uncommon and generally associated with pseudoaneurysm formation. We herein present a case of transmural migration of a pedicle screw into the descending thoracic aorta, which was revealed incidentally by computed tomography scan after almo...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2011.12.084
更新日期：2012-07-01 00:00:00
abstract：:Dilatation of the common iliac arteries is one of the most frequent causes for exclusion of patients in a series of endovascular correction of abdominal aortic aneurysms (AAAs). In this article we describe the banding technique we use to constrict the large iliac arteries. Four patients underwent endovascular treatmen...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1067/mva.2000.109771
更新日期：2000-12-01 00:00:00
abstract：OBJECTIVE:The clinical decision-making utility of scoring algorithms for predicting mortality after ruptured abdominal aortic aneurysms (rAAAs) remains unknown. We sought to determine the clinical utility of the algorithms compared with our clinical decision making and outcomes for management of rAAA during a 10-year p...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2016.07.121
更新日期：2016-12-01 00:00:00
abstract：BACKGROUND:Approximately 20% of strokes are attributable to carotid stenosis. However, the number of asymptomatic patients needed to prevent one stroke or death with endarterectomy is high at 17 to 32. There is a clear need to identify asymptomatic individuals at high risk of developing future ischemic events to improv...
journal_title：Journal of vascular surgery
pub_type： 杂志文章,评审
doi：10.1016/j.jvs.2011.01.037
更新日期：2011-07-01 00:00:00
abstract：OBJECTIVE:Various animal models of critical limb ischemia have been developed in the past. However, there is no animal model that can undergo endovascular treatment, while providing reproducible true critical limb ischemia with arterial ulcers and rest pain. We evaluated the efficacy of a new model of rabbit hindlimb i...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2017.07.140
更新日期：2018-09-01 00:00:00
abstract：PURPOSE:Neointimal hyperplasia frequently develops after placement of prosthetic vascular grafts and is a major cause of graft failure. This study was an attempt to prevent vascular lesion formation by coating the graft luminal surface with a thin layer of nonporous silicone polymer, and subsequently with an ultrathin ...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/s0741-5214(96)70019-8
更新日期：1996-11-01 00:00:00
abstract：BACKGROUND:The hemodynamic effects of carotid angioplasty with stent placement (CAS) on the collateral blood supply and on the regional cerebral blood flow (rCBF) have not been established. Recently, arterial spin-labeling (ASL) magnetic resonance imaging (MRI) has been introduced as the first method to quantify the ac...
journal_title：Journal of vascular surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jvs.2006.11.067
更新日期：2007-06-01 00:00:00
abstract：:Renal cell carcinoma extends into the lumen of the inferior vena cava in approximately 4% of patients at the time of diagnosis. Surgical removal of the intracaval tumor thrombus with radical nephrectomy is the preferred treatment for this malignancy. From January 1977 to June 1990, 31 such patients were examined for c...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1067/mva.1991.29912
更新日期：1991-09-01 00:00:00
abstract：OBJECTIVE:Transcatheter embolization with coils and other agents has been described as a treatment method for type II endoleak after endovascular aortic aneurysm repair (EVAR). Type I endoleak has not been treated commonly with such therapies, although most investigators believe they warrant definitive intervention. Th...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/s0741-5214(03)00729-8
更新日期：2003-10-01 00:00:00
abstract：OBJECTIVE:The aim of this study was to evaluate outcomes of fenestrated-branched endovascular aortic repair (F-BEVAR) of pararenal abdominal aortic aneurysms or thoracoabdominal aortic aneurysms (TAAAs) in patients with a solitary functional kidney (SFK). METHODS:We analyzed the outcomes of 287 consecutive patients (2...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2019.10.062
更新日期：2020-08-01 00:00:00
abstract：PURPOSE:This study was done to evaluate the use of published standardized risk factors for venous thromboembolism (VTE) in patients admitted to a trauma intensive care unit (ICU) and to derive guidelines for the use of low molecular weight heparin (LMWH) and surveillance venous Doppler ultrasound scanning (VDUS). METH...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/s0741-5214(98)70161-2
更新日期：1998-08-01 00:00:00
abstract：OBJECTIVE:The objective of this study was to evaluate the remodeling of abdominal aortic aneurysms after endovascular aortic aneurysm repair (EVAR) with the Zenith (Cook Medical, Bloomington, Ind) device. METHODS:This was a retrospective study of anatomic data related to characteristics of the aortic neck diameter, il...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2014.06.104
更新日期：2015-01-01 00:00:00
abstract：BACKGROUND:Existing risk prediction models for contrast-induced nephropathy (CIN) are based on studies for percutaneous coronary interventions, with none validated for use in vascular procedures. We aim to validate existing CIN prediction models in patients who underwent aortic endovascular aneurysm repair (EVAR). MET...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2019.07.093
更新日期：2020-05-01 00:00:00
abstract：:Vascular surgeons are often called emergently to help treat bleeding patients. These cases may involve unexpected intraoperative bleeding, bleeding in the pregnant patient, or bleeding in patients in the emergency room. In many instances, the vascular surgeon is not "on call" and therefore has no legal duty to assist ...
journal_title：Journal of vascular surgery
pub_type： 杂志文章
doi：10.1016/j.jvs.2010.02.028
更新日期：2010-06-01 00:00:00
