Annals of vascular surgery
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Case Reports
Limitation of imaging in identifying iatrogenic aortic coarctation following thoracic endovascular aortic repair.
A 21-year-old male suffered blunt trauma from a motor vehicle accident causing thoracic aorta tear. The smallest available stent graft was deployed. Definitive repair was later performed using a 22 × 22 × 116 mm Talent Thoracic Stent Graft. ⋯ This case report demonstrates a need for wider availability and selecting appropriate stent graft in treating traumatic aortic injuries in young patients. It is the first case report of the inability of current imaging modalities in confirming stent collapse. Pressure gradient is a useful tool in confirming stent collapse when clinical scenario does not match CT findings.
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Multidisciplinary amputation prevention teams decrease the frequency of major amputations by increasing the use of revascularization procedures and minor amputations. The outcomes of wound healing, wound recurrence, and ambulatory status are assumed to be improved but are not routinely reported. This study investigates the midterm outcomes of neuroischemic wounds treated by our multidisciplinary team. ⋯ Multidisciplinary limb salvage teams effectively heal wounds and maintain ambulatory status in patients with limb-threatening neuroischemic wounds. Patient specific factors, such as hindfoot or ankle wounds, can adversely influence the outcome. Even with aggressive care, healing can be prolonged and a substantial proportion of patients can be expected to have a recurrence, making subsequent surveillance mandatory. Our data also suggest that a coordinated amputation prevention program may help to minimize hospital readmissions in this high-risk population.
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The measurement of psoas muscle area is a new and potentially useful tool for assessing the frailty of patients in the context of various disease states ranging from cancer to abdominal aortic aneurysms (AAAs). Considering the similarity of risk factors for frailty and atherosclerosis, we sought to investigate whether patients with peripheral artery disease (PAD) have smaller psoas muscle areas in general. Furthermore, we investigated whether PAD symptom severity correlates with psoas muscle size. ⋯ Using psoas muscle area as a measure of frailty, patients with PAD may be frail as a group. However, the severity of each patient's symptoms does not appear to correlate with the patient's degree of frailty. Prospective studies with larger populations are needed to clarify whether the psoas muscle area has any prognostic value in PAD.