OBJECTIVE: To determine the clinical course of Buerger's disease as observed in two vascular surgery centers located in the capital of Iran. STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: Sina and Imam Hospitals, Tehran, Iran, during the years 1997 to 2002. METHODOLOGY: The records of all the patients ...

Peripheral arterial disease is more aggressive in concomitant diabetes posing an increased risk for critical limb ischemia and subsequent limb loss. The majority of therapies available are not effective to prevent amputation in patients with severe disease. The current observational study reports the effect of the heparin-induced extracorporal LDL-precipitation (H.E.L.P.) ...

OBJECTIVES: This study aimed to evaluate the efficacy and safety of argatroban during percutaneous interventions for peripheral arterial disease (PAD). BACKGROUND: Endovascular interventions are commonly used in patients with peripheral arterial disease. Heparin is routinely administered during these procedures, but cannot be used in patients with a history of heparin-induced ...

The aim of our study was to demonstrate the role of certain risk factors in reconstructive head and neck surgery with free flaps. The data taken from the charts of all patients who received free flap for head and neck reconstruction in our department between January 2001 and December 2004 ...

OBJECTIVE: To examine the overall magnitude of change in self-reported physical function over a 10-year period in patients with rheumatoid arthritis (RA), and to compare changes in physical function between the lower and upper limbs. METHODS: Self-reported data on physical function were collected from the patients in the Oslo RA ...

BACKGROUND: Ischaemia is a common phenomenon in the pathogenesis of a wide range of medical and surgical conditions, including myocardial infarction, mesenteric vascular occlusion and compartment syndrome. Ischaemia modified albumin has been suggested as an aid to clinical decision making in various clinical settings. This study examines the usefulness of ...

Lower extremity revascularization is often described as excessively lesion-centric, with insufficient focus on the patient. We investigated patients' perspectives of multiple procedures for limb salvage that culminated in major lower extremity amputation. A prospective vascular surgery database was queried from January 2000 to December 2005 for patients who had undergone ...

The loss of elbow extension power is particularly disabling for the nonambulatory patient. Reconstruction of elbow extension can be performed by a deltoid to triceps transfer or by a biceps to triceps transfer provides the most satisfying reconstruction for patients. Although the overall time for rehabilitation can be lengthy, the ...

BACKGROUND: Percutaneous peripheral intervention (PPI) for superficial femoral artery (SFA) stenosis is associated with a high restenosis rate. Whether PPI improves the long-term outcome of patients with SFA occlusive disease remains to be determined. METHODS AND RESULTS: A review was done of 107 patients with SFA occlusive disease. Fifty-five patients ...

BACKGROUND: Diabetic patients with end-stage renal disease (ESRD) are at high risk for developing foot complications and few have studied this complication in the diabetic patients treated with peritoneal dialysis (PD). The purpose of this study was to examine peripheral vascular disease (PVD) in diabetic patients with ESRD, who are ...

The use of endovascular therapy (EVT) for lower extremity atherosclerosis is markedly increasing while open surgical bypass is in decline. The results of EVT for critical limb ischaemia (CLI) are difficult to evaluate, especially for patients with diabetes. To date, only one randomized, prospective trial has been published comparing EVT ...

The purpose of this investigation was to determine size differences between affected and unaffected upper extremities in patients with brachial plexus birth palsy (BPBP). Forty-eight patients with BPBP underwent measurements of the bilateral upper extremities. Average age at the time of evaluation was 47 months. In addition, patients or families ...

Patients with diabetes mellitus (DM) are at increased risk of developing lower extremity peripheral arterial disease (PAD). The effect of DM on restenosis and patency rates in patients with PAD undergoing surgical revascularization or percutaneous interventions has not been fully clarified. We therefore critically reviewed the role of DM in ...

BACKGROUND AND OBJECTIVES: The use of IABP is helpful for haemodynamic stability of patients with low cardiac output and compromised left ventricular function in patients who undergo coronary artery bypass grafting. This procedure is also associated with some vascular complications due to the insertion of IABP. The objective of this ...

BACKGROUND: Raynaud's syndrome is a known complication of cold injuries. Stress, smoking and metabolic diseases may further aggravate the disease course. The purpose of this study was to determine the efficacy of Cervico-thoracic sympathectomy as compared to conservative management in severe Raynaud's syndrome after frostbite. METHODS: This non-randomized controlled trial ...

We describe a novel treatment of secondary osteonecrosis (ON) of the femoral condyles that is relatively simple, has low morbidity, and does not preclude the patient from other more extensive treatments in the event of failure. Three patients with extensive secondary ON of the femoral condyles were treated with decompression ...

BACKGROUND: Erysipelas is a common skin infection that is usually caused by beta-haemolytic group A streptococci. After having had erysipelas in an extremity, a significant percentage of patients develops persistent swelling or suffers from recurrent erysipelas. We hypothesize that in cases of erysipelas without a clear precipitating agent, subclinical pre-existing ...

Diabetic nephropathy is a major cause of lower-limb amputation. We enrolled 250 type 2 diabetic patients without apparent occlusive peripheral arterial disease (ankle-brachial indices >0.9) and 40 age-matched nondiabetic subjects consecutively admitted to our hospital. Flow volume and resistive index (RI), an index of vascular resistance, at the popliteal artery ...

This study retrospectively evaluated the efficacy and safety of the 6F Angio-Seal (St. Jude Medical, St. Paul, Minn) as a closure device for transbrachial artery access for endovascular procedures in diabetic patients with critical limb ischemia. From January 2005 and September 2007, 1887 diabetic patients underwent interventional procedures in the ...

The objective of this study was to evaluate the patency rate as well as complications of polytetrafluoroethylene vascular grafts (ePTFE) in patients on hemodialysis (HD). In a prospective study, 84 patients who underwent implantation of vascular grafts for HD at the Sina Hospital, Tehran, Iran, between April 2001 and April ...

Shoe modification and foot orthoses can play an important role in the nonsurgical management of foot and ankle pathology. Therapeutic footwear may be used to treat patients with diabetes, arthritis, neurologic conditions, traumatic injuries, congenital deformities, and sports-related injuries. These modalities may improve patient gait and increase the level of ...

This study presents an unusual case of primary lymphedema of the upper extremity in a healthy 28-year-old woman. The onset of swelling of the left upper extremity was observed at birth, but was not accurately diagnosed until the patient visited our department. Diagnostic assessment included evaluating the patient's history and ...

OBJECTIVES: The aim of this study was to evaluate the epidemiology of diabetic foot problems (DFP) and predictive factors for major amputations (below- and above-knee). METHODS: This is a prospective study of 202 patients treated in National University Hospital (NUH) during the period of January 2005 to May 2006. A ...

OBJECTIVE: To describe the characteristics of patients with peripheral vascular disease leading to amputation of digits or limbs encountered in patients with the antiphospholipid syndrome (APS). METHODS: Twenty-one cases derived from several geographical centers (Brazil, Serbia, Italy, Israel, United Kingdom, and South Africa) are presented. The major clinical, serological, and ...

BACKGROUND: Complete decongestive therapy (CDT), including manual lymphatic drainage (MLD) is a manipulative intervention of documented benefit to patients with lymphedema (LE). Although the role of CDT for LE is well described, to the authors' knowledge there are no data regarding its efficacy for patients with LE due to tumor ...

The American Society of Anesthesiology (ASA) classification remains the most widely used risk-stratification system in the world. However, it is not practical in patients undergoing revascularization procedures because most are classified as ASA III. We hypothesized that ASA III patients can be subdivided into two subgroups, ASA IIIA and ASA ...

A flow-mediated endothelium-dependent vasodilation and endothelium-independent nitroglycerin-induced vasodilation were carried out in 70 patients and 15 age-matched adults without any atherosclerotic risk factors to clarify vascular responsiveness in patients with atherosclerotic peripheral vascular disease. The percent change in flow-mediated vasodilation was significantly lower in patients than in controls (5.4 +/- ...

BACKGROUND: Autologous transplantation of bone marrow mononuclear cells (ATBMMNC) has been used successfully in critical limb ischemia. All reported patients were of Asian descent, however, and several studies included only young patients with thromboangiitis obliterans. Whether the beneficial results can be extrapolated to older Caucasian patients with atherosclerosis obliterans and ...

The clinical spectrum of Buerger's disease (TAO; thromboangiitis obliterans) seems to be changing. Considering the lack of any formal studies on the epidemiology of this disease in Iran, we evaluated the data of 198 confirmed cases of TAO during the period 1996-2006. Diagnosis was based on Papa's scoring system. All ...

Using the experience gained from taking care of World War II veterans with amputations, Ernest Burgess taught that amputation surgery is reconstructive surgery. It is the first step in the rehabilitation process for patients with an amputation and should be thought of in this way. An amputation is often a ...

With the variety of bariatric procedures available today, there is a steadily growing stream of massive weight loss patients. Although there have been major advances in upper extremity and upper and lower truncal contouring, the lower extremity often remains the most difficult to treat. Historically, thigh reductions were designed to ...

Purpose. Rotationplasty has proven its efficacy in the treatment of malignant bone tumors of the lower extremity in predominantly young patients. To our knowledge this procedure has not been reported in patients over 60 years before. Materials and Methods. 3 patients over 60 years with an A1-rotationplasty because of a ...

Osteoarticular allograft reconstruction is an option in patients with massive periarticular elbow bone loss secondary to tumor surgery or trauma. Our consecutive series consisted of 18 patients with tumors and one patient with trauma. Reconstruction consisted of 16 hemiarticular allografts and three total elbow osteoarticular allografts; patients had a minimum ...

The purpose of this study was to determine diagnostic reference levels (DRLs) for common angiographic and interventional procedures in Belgium. Dose Area Product (DAP) measurements were performed on 21 systems, (13 angiography and 4 vascular surgery centres). Type of procedure, total DAP, patient weight and height were collected on a ...

The fibrous process of chronic ulcerated lesions of lower limbs can impair the mobility of the affected limb. The aim of this work was to assess the benefits of lymph drainage in patients who suffer from this disease. Twenty female and five male patients with ages ranging from 53 to ...

During the past three decades, internal fixation has become increasingly popular for fracture management and limb reconstruction. As a result, during their training, orthopaedic surgeons receive less formal instruction in the art of extremity immobilization and cast application and removal. Casting is not without risks and complications (eg, stiffness, pressure ...

OBJECTIVES: Idiopathic cyclic oedema syndrome is a group of clinical conditions that exhibit a vascular capillary hyperpermeability accompanied by oedema caused by the interstitial retention of fluid. The objective of the current study was to evaluate the efficacy of aminaphtone in the treatment of idiopathic cyclic oedema. METHODS: A total ...

Post surgical patients need to resume a correct load distribution over both legs in order to facilitate bone osteogenesis. We propose a device for continuously monitoring lower limbs loads. It can be used by the patient to be aware of his loading conditions, by the physician or physical therapist to ...

Epidemiology of peripheral arterial disease is currently unknown in French West Indies (Antilles). The aim of this study is to present peripheral arterial disease (PAD) occurring in the French West Indian subjects through the analysis of our database of vascular surgery. The study population included 754 patients (mean age 73 ...

BACKGROUND AND PURPOSE: Hemiparetic stroke patients with disturbed awareness for their motor weakness (anosognosia for hemiparesis/-plegia [AHP]) may exhibit further abnormal attitudes toward or perceptions of the affected limb(s). The present study investigated the clinical relationship and the anatomy of such abnormal attitudes and AHP. METHODS: In a new series ...

AIM: To evaluate the relationship between vascular invasion and microvessel density (MVD) of tissue and micrometastasis in blood. METHODS: Vascular invasion was detected by both hematoxylin and eosin staining and immunohistochemiscal staining. Blood samples were collected from 17 patients with vascular invasion and 29 patients without vascular invasion and examined ...

We investigated whether baseline lymphscintigraphic findings can predict long-term response to complex physical therapy (CPT) in patients with early stage extremity lymphedema. Twenty patients with unilateral extremity lymphedema of clinical stage I or II underwent CPT after baseline lymphscintigraphy. Therapeutic responses (good vs. poor) were evaluated at 1 year post-CPT ...

Worldwide, there is a growing number of patients with myocardial ischemia and limb ischemia associated with the aging population and an increased prevalence of atherosclerotic diseases. Medical therapy, percutaneous angioplasty and surgical revascularization are the present treatments of choice, but such treatments are not feasible for some patients with severe ...

BACKGROUND: Coldness, numbness, or causalgia usually affects the lower limbs in patients after back surgeries. The treatment of causalgia is still the source of continuing debate. We treated patients presenting with causalgia secondary to LD with CT-guided CLS and determined the therapeutic outcome at long-term follow-up. METHODS: From January 2002 ...

AIM: This observational study (Survey of Peripheral Arterial Disease Epidemiology, SPADE) evaluated the prevalence of asymptomatic peripheral arterial disease (PAD) in general practice. METHODS: PAD was determined as an ankle-brachial pressure index (ABI) <0.9 measured with Doppler ultrasound. Included patients had a history of ischemic events and/or risk factors for ...

PURPOSE: Ulna longitudinal dysplasia is an uncommon congenital anomaly that demonstrates a wide variety of clinical manifestations. The clinical manifestations and function of patients with Bayne type IV ulna longitudinal dysplasia have not been well characterized. The purpose of this study was to report the clinical features of type IV ...

Patients with limb-threatening ischemia and a paucity of ipsilateral greater saphenous vein for conduit represent a challenge for lower extremity revascularization. We present four patients with limited autogenous conduit who underwent hybrid revascularization using the Silverhawk atherectomy device and infrapopliteal artery bypass for limb-threatening ischemia. All patients experienced complete wound ...

BACKGROUND: Dermatologists may be called to assist in the diagnosis and management of purpura fulminans. METHODS: This retrospective case series details the clinical presentation and outcomes of patients presenting with purpura fulminans associated with peripheral gangrene between 1989 and 2004. RESULTS: All 12 patients presented with sudden onset of purpuric ...

BACKGROUND: Traumatic popliteal artery injury carries heavy morbidity. Ischaemic time is an important factor affecting limb survival. In developing countries most patients present late for repair and there are no distinct guidelines in deciding for revascularisation. PATIENTS AND METHODS: Patients with popliteal artery trauma who had presented at least 24h ...

BACKGROUND: Pyogenic flexor tenosynovitis is a closed space infection involving the digital flexor tendon sheaths of the upper extremity that can cause considerable morbidity. The purpose of the present report is to describe the various risk factors leading to poor outcomes and to recommend a clinical classification system for this ...