Annals of vascular surgery
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Popliteal vessel injuries are associated with traumatic knee injury often requiring emergency revascularization. Medial and posterior approaches to the popliteal space have been proposed. This study evaluates the outcome of patients treated for traumatic popliteal vessel injuries via a posterior approach. ⋯ After traumatic knee injury, posterior approach to the popliteal vessels is feasible and effective. It allows revascularization by direct repair or a short segment interposition graft avoiding long distance bypass. A high limb salvage rate can be achieved with excellent long-term outcomes.
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Comparative Study
Perioperative Outcomes after Regional Versus General Anesthesia for Above the Knee Amputations.
Nontraumatic lower extremity amputation (LEA) remains a common procedure among patients who frequently have significant comorbidities. Patients undergoing above knee amputation (AKA) have the highest rates of mortality in this cohort, yet there is little evidence to support selection between peripheral nerve block or neuraxial regional anesthesia (RA) versus general anesthesia (GA) techniques. The objective of this study was to determine whether RA (neuraxial or peripheral nerve block) techniques were associated with more favorable outcomes versus general anesthesia among patients undergoing AKA. ⋯ The present investigation did not detect any difference between regional and general anesthetic with respect to morbidity or mortality among patients undergoing AKA. This data set did not allow us to address other relevant markers including pain control or phantom limb syndrome.
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Temporary hepatic ischemia is inevitable during open aortic surgery when supraceliac clamping is necessary, as in thoracoabdominal or pararenal aneurysms. Remote ischemic preconditioning (RIPC) has been described as a potential protective means against ischemia-reperfusion injury (IRI) in various tissues including the liver. The aim of this experimental study was to detect the effect of RIPC on liver IRI in a model of supraceliac aortic cross-clamping. ⋯ Remote ischemic preconditioning produced with short bouts of ischemia of the lower body by temporary clamping of the infrarenal aorta might be used as a means of decreasing the detrimental effects of hepatic ischemia-reperfusion injury after supraceliac aortic cross-clamping. This was found in a swine model of suprarenal AAA open repair by studying the variance of certain biological biomarkers in selective blood samples retrieved from the hepatic vein.