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[PMID]:29169600
[Au] Autor:Lebowitz C; Matzon JL
[Ad] Endereço:Department of Orthopedic Surgery, Rowan University School of Osteopathic Medicine, Stratford, NJ 080084, USA.
[Ti] Título:Arterial Injury in the Upper Extremity: Evaluation, Strategies, and Anticoagulation Management.
[So] Source:Hand Clin;34(1):85-95, 2018 02.
[Is] ISSN:1558-1969
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Trauma to the upper extremity can present with an associated arterial injury. After patient stabilization, thorough assessment with physical examination and various imaging modalities allows accurate diagnosis of the specific arterial injury. After diagnosis, efficient treatment is necessary to allow limb salvage. Treatment options include ligation, primary repair, graft reconstruction, endovascular repair, and amputation. The final treatment rendered is frequently dependent on injury location and mechanism. With any of the treatment options, complications may occur, including thrombosis. Currently, no validated anticoagulation protocol has been established for managing arterial injuries in the upper extremity.
[Mh] Termos MeSH primário: Artérias/lesões
Artérias/cirurgia
Extremidade Superior/irrigação sanguínea
Extremidade Superior/cirurgia
[Mh] Termos MeSH secundário: Algoritmos
Anticoagulantes/uso terapêutico
Artérias/diagnóstico por imagem
Diagnóstico por Imagem
Seres Humanos
Salvamento de Membro
Complicações Pós-Operatórias/prevenção & controle
Trombose/prevenção & controle
Extremidade Superior/lesões
Veias/transplante
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anticoagulants)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180303
[Lr] Data última revisão:
180303
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171125
[St] Status:MEDLINE


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[PMID]:29237360
[Au] Autor:Modaghegh MS; Hafezi S
[Ad] Endereço:1 Vascular and Endovascular Surgery Research Center, Alavi Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
[Ti] Título:Endovascular Treatment of Thromboangiitis Obliterans (Buerger's Disease).
[So] Source:Vasc Endovascular Surg;52(2):124-130, 2018 Feb.
[Is] ISSN:1938-9116
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: When critical limb ischemia (CLI) occurs in patients with thromboangiitis obliterans (TAO) or Buerger's disease, smoking cessation alone may be insufficient to relieve rest pain and promote wound healing. Accordingly, adjunctive measures are warranted to restore adequate blood flow required for limb salvage. This study aimed to evaluate the feasibility and efficacy of percutaneous transluminal angioplasty (PTA) for the treatment of patients with TAO and CLI. In addition, a review of the literature on endovascular management of TAO is included. METHODS: Between April 2012 and June 2017, all patients with TAO and CLI who underwent PTA were studied retrospectively. Patient demographics, presentation, procedural details, and clinical response were recorded. Patients were monitored at 1 week, 1, 2, 3, and 6 months after revascularization and at least every 6 months thereafter. RESULTS: Thirteen patients with TAO and CLI, who presented with rest pain only (n = 1), ischemic ulcer (n = 4), or gangrene (n = 8) underwent endovascular interventions with primary and assisted primary technical success of 85% and 92%, respectively. A below-knee amputation was eventually done in the only patient with technical failure (limb salvage rate: 92%). Following the procedures, 11 patients had clinical response, one of whom also received intra-arterial vasodilator to achieve complete symptom relief. The other patient who failed PTA underwent a successful lumbar sympathectomy. In addition, all ulcers healed and eight minor amputations were performed due to already established gangrene. During follow-up (mean: 19.4 months), four patients needed reintervention. Patients who continued to smoke experienced more severe ischemia ( P = .017) and were more likely to require reintervention ( P = .009). CONCLUSION: Percutaneous transluminal angioplasty can be considered as a technically feasible and potentially effective treatment for patients with TAO and CLI, as well as a last resort for limb salvage when other options have failed. However, reintervention may be required, especially in patients who continue smoking.
[Mh] Termos MeSH primário: Angioplastia com Balão
Tromboangiite Obliterante/terapia
[Mh] Termos MeSH secundário: Adulto
Amputação
Angioplastia com Balão/efeitos adversos
Intervalo Livre de Doença
Estudos de Viabilidade
Feminino
Seres Humanos
Salvamento de Membro
Masculino
Meia-Idade
Retratamento
Estudos Retrospectivos
Fatores de Risco
Fumar/efeitos adversos
Tromboangiite Obliterante/diagnóstico por imagem
Tromboangiite Obliterante/etiologia
Tromboangiite Obliterante/fisiopatologia
Fatores de Tempo
Resultado do Tratamento
Cicatrização
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171215
[St] Status:MEDLINE
[do] DOI:10.1177/1538574417744085


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[PMID]:29202650
[Au] Autor:Wrede A; Wiberg F; Acosta S
[Ad] Endereço:These authors contributed equally to this work.
[Ti] Título:Increasing the Elective Endovascular to Open Repair Ratio of Popliteal Artery Aneurysm.
[So] Source:Vasc Endovascular Surg;52(2):115-123, 2018 Feb.
[Is] ISSN:1938-9116
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Open repair (OR) for popliteal artery aneurysm (PAA) has recently been challenged by endovascular repair (ER) as the primary choice of treatment. The aim of the present study was to evaluate time trends in treatment modality and compare outcomes between OR and ER among electively operated patients after start of screening in 2010 for abdominal aortic aneurysm (AAA), a disease highly associated with PAA. METHODS: Between January 1, 2009, and April 30, 2017, 102 procedures and 36 acute and 66 elective repairs for PAA were identified. RESULTS: Over time, a trend ( P = .089) for an increasing elective to acute repair ratio of PAA and an increase in elective ER to OR ratio ( P = .003) was found. Among electively repaired PAAs, the ER group was older ( P = .047) and had a higher ankle-brachial index (ABI; P = .044). The ER group had fewer wound infections ( P = .003), fewer major bleeding complications ( P = .046), and shorter in-hospital stay ( P < .001). After 1 year of follow-up, the ER group had a higher rate of major amputations ( P = .037). Amputation-free survival at the end of follow-up did not differ between groups ( P = .68). Among the 17 patients with PAA eligible for AAA screening, 4 (24%) were diagnosed with PAA through the screening program of AAA. CONCLUSION: The epidemiology of elective repair of PAA has changed toward increased ER, although ER showed a higher rate of major amputations at 1 year. Confounding was considerable and a randomized trial is needed for evaluation of the best therapeutic option.
[Mh] Termos MeSH primário: Aneurisma/cirurgia
Implante de Prótese Vascular
Procedimentos Endovasculares
Artéria Poplítea/cirurgia
Veia Safena/transplante
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Amputação
Aneurisma/diagnóstico por imagem
Aneurisma/epidemiologia
Implante de Prótese Vascular/efeitos adversos
Implante de Prótese Vascular/tendências
Procedimentos Cirúrgicos Eletivos
Procedimentos Endovasculares/efeitos adversos
Procedimentos Endovasculares/tendências
Feminino
Seres Humanos
Salvamento de Membro
Masculino
Meia-Idade
Artéria Poplítea/diagnóstico por imagem
Complicações Pós-Operatórias/etiologia
Estudos Retrospectivos
Fatores de Risco
Suécia/epidemiologia
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE
[do] DOI:10.1177/1538574417742762


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[PMID]:29437061
[Au] Autor:Chraim M; Krenn S; Alrabai HM; Trnka HJ; Bock P
[Ad] Endereço:Orthopaedic Hospital Speising, Speisingerstrasse 109, A-1130, Vienna, Austria.
[Ti] Título:Mid-term follow-up of patients with hindfoot arthrodesis with retrograde compression intramedullary nail in Charcot neuroarthropathy of the hindfoot.
[So] Source:Bone Joint J;100-B(2):190-196, 2018 Feb.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: Hindfoot arthrodesis with retrograde intramedullary nailing has been described as a surgical strategy to reconstruct deformities of the ankle and hindfoot in patients with Charcot arthropathy. This study presents case series of Charcot arthropathy patients treated with two different retrograde intramedullary straight compression nails in order to reconstruct the hindfoot and assess the results over a mid-term follow-up. PATIENTS AND METHODS: We performed a retrospective analysis of 18 consecutive patients and 19 operated feet with Charcot arthropathy who underwent a hindfoot arthrodesis using a retrograde intramedullary compression nail. Patients were ten men and eight women with a mean age of 63.43 years (38.5 to 79.8). We report the rate of limb salvage, complications requiring additional surgery, and fusion rate in both groups. The mean duration of follow-up was 46.36 months (37 to 70). RESULTS: The limb salvage rate was 16 of 19 limbs. Three patients had to undergo below-knee amputation due to persistent infection followed by osteomyelitis resistant to parenteral antibiotic therapy and repeated debridement. Complications including infection, hardware removal, nonunion, and persistent ulcers requiring further intervention were also observed. Postoperative functional scores revealed significant improvement compared with preoperative scores on American Orthopaedic Foot and Ankle Society (AOFAS) - Hindfoot scale, Foot Function Index (FFI), visual analogue scale (VAS), and Foot and Ankle Outcome Score (FAOS). CONCLUSION: The use of retrograde intramedullary compression nail results in good rates of limb salvage when used for hindfoot reconstruction in patients with Charcot arthropathy. Cite this article: 2018;100-B:190-6.
[Mh] Termos MeSH primário: Artrodese/métodos
Artropatia Neurogênica/cirurgia
Doenças do Pé/cirurgia
Fixação Intramedular de Fraturas
[Mh] Termos MeSH secundário: Adulto
Idoso
Amputação
Desbridamento
Feminino
Seguimentos
Seres Humanos
Salvamento de Membro
Masculino
Meia-Idade
Complicações Pós-Operatórias
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180214
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.100B2.BJJ-2017-0374.R2


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[PMID]:29391116
[Au] Autor:Badash I; Burtt KE; Leland HA; Gould DJ; Rounds AD; Azadgoli B; Patel KM; Carey JN
[Ad] Endereço:Keck School of Medicine of University of Southern California, Los Angeles, California, USA.
[Ti] Título:Outcomes of Soft Tissue Reconstruction for Traumatic Lower Extremity Fractures with Compromised Vascularity.
[So] Source:Am Surg;83(10):1161-1165, 2017 Oct 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Traumatic lower extremity fractures with compromised arterial flow are limb-threatening injuries. A retrospective review of 158 lower extremities with traumatic fractures, including 26 extremities with arterial injuries, was performed to determine the effects of vascular compromise on flap survival, successful limb salvage and complication rates. Patients with arterial injuries had a larger average flap surface area (255.1 vs 144.6 cm2, P = 0.02) and a greater number of operations (4.7 vs 3.8, P = 0.01) than patients without vascular compromise. Patients presenting with vascular injury were also more likely to require fasciotomy [odds ratio (OR): 6.5, confidence interval (CI): 2.3-18.2] and to have a nerve deficit (OR: 16.6, CI: 3.9-70.0), fracture of the distal third of the leg (OR: 2.9, CI: 1.15-7.1) and intracranial hemorrhage (OR: 3.84, CI: 1.1-12.9). After soft tissue reconstruction, patients with arterial injuries had a higher rate of amputation (OR: 8.5, CI: 1.3-53.6) and flap failure requiring a return to the operating room (OR: 4.5, CI: 1.5-13.2). Arterial injury did not correlate with infection or overall complication rate. In conclusion, arterial injuries resulted in significant complications for patients with lower extremity fractures requiring flap coverage, although limb salvage was still effective in most cases.
[Mh] Termos MeSH primário: Artérias/lesões
Fraturas Ósseas/cirurgia
Salvamento de Membro/métodos
Extremidade Inferior/lesões
Lesões dos Tecidos Moles/cirurgia
Retalhos Cirúrgicos
Lesões do Sistema Vascular/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Amputação/estatística & dados numéricos
Artérias/cirurgia
Criança
Feminino
Seguimentos
Seres Humanos
Salvamento de Membro/estatística & dados numéricos
Extremidade Inferior/irrigação sanguínea
Extremidade Inferior/cirurgia
Masculino
Meia-Idade
Complicações Pós-Operatórias/epidemiologia
Complicações Pós-Operatórias/etiologia
Estudos Retrospectivos
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE


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[PMID]:29328615
[Au] Autor:Radunovic A; Kosutic M; Vulovic M; Milev B; Janjusevic N; Ivosevic A; Krulj V
[Ti] Título:Ilizarov method as limb salvage in treatment of massive femoral defect after unsuccessful tumor arthroplasty.
[So] Source:Vojnosanit Pregl;73(8):779-82, 2016 Aug.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Introduction: Surgical management of massive bone defects is very challenging in terms of estimating possibilities of saving the extremity and adequate method that can make it possible. Selection of methods is additionally limited in the presence of infection at site of defect. Case report: The female patient, diagnosed with Ewing sarcoma was treated by segmental bone resection and implantation of Kotz modular tumor endoprosthesis. After 5 years the signs of infection occured and persisted with low grade intensity. After falling, 12 years following implantation, the patient acquired periprosthetic fracture. Then endoprosthesis was removed, all along with surgical debridement of wound and application of the Ilizarov apparatus. The apparatus was applied, osteotomy of callus and the tibia performed with transport of bone segments, untill reconstruction of defect and arthrodesis of the knee was achieved. Conclusion: The Ilizarov apparatus offered us huge possibilities for management of massive bone defects with natural bone which has superior biomechanical characteristics comparing to the implant. The most frequent complication of this method is a prolonged treatment period that demands good patient selection and preparation and wide surgical experience.
[Mh] Termos MeSH primário: Neoplasias Femorais/cirurgia
Fêmur/cirurgia
Técnica de Ilizarov
Salvamento de Membro
Sarcoma de Ewing/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Feminino
Fraturas do Fêmur/diagnóstico
Seres Humanos
Fraturas Periprotéticas/diagnóstico
Implante de Prótese
Infecções Relacionadas à Prótese/diagnóstico
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180113
[St] Status:MEDLINE
[do] DOI:10.2298/VSP150419039R


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[PMID]:28451812
[Au] Autor:Katsanos K; Spiliopoulos S; Reppas L; Karnabatidis D
[Ad] Endereço:Department of Interventional Radiology, School of Medicine, Patras University Hospital, Panepistimiou St., 26504, Rion, Greece. katsanos@med.upatras.gr.
[Ti] Título:Debulking Atherectomy in the Peripheral Arteries: Is There a Role and What is the Evidence?
[So] Source:Cardiovasc Intervent Radiol;40(7):964-977, 2017 Jul.
[Is] ISSN:1432-086X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Traditional percutaneous balloon angioplasty and stent placement is based on mechanical plaque disruption and displacement within the arterial wall. On the contrary, transcatheter atherectomy achieves atherosclerotic plaque clearance by means of directional plaque excision or rotational plaque removal or laser plaque ablation. Debulking atherectomy may allow for a more uniform angioplasty result at lower pressures with consequently less vessel barotrauma and improved luminal gain, thereby decreasing the risk of plaque recoil and dissection that may require permanent metal stenting. It has been also argued that atherectomy may disrupt the calcium barrier and optimize drug transfer and delivery in case of drug-coated balloon applications. The authors discuss the various types of atherectomy devices available in clinical practice to date and critically appraise their mode of action as well as relevant published data in each case. Overall, amassed randomized and observational evidence indicates that percutaneous atherectomy of the femoropopliteal and infrapopliteal arteries may achieve high technical success rates and seems to lessen the frequency of bailout stenting, however, at the expense of increased risk of peri-procedural distal embolization. Long-term clinical outcomes reported to date do not support the superiority of percutaneous atherectomy over traditional balloon angioplasty and stent placement in terms of vessel patency or limb salvage. The combination of debulking atherectomy and drug-coated balloons has shown promise in early studies, especially in the treatment of more complex lesions. Unanswered questions and future perspectives of this continuously evolving endovascular technology as part of a broader treatment algorithm are discussed.
[Mh] Termos MeSH primário: Aterectomia/instrumentação
Procedimentos Cirúrgicos de Citorredução/instrumentação
Procedimentos Endovasculares/instrumentação
Doenças Vasculares Periféricas/cirurgia
[Mh] Termos MeSH secundário: Algoritmos
Desenho de Equipamento
Artéria Femoral/cirurgia
Seres Humanos
Salvamento de Membro/instrumentação
Ensaios Clínicos Controlados Aleatórios como Assunto
Stents
Grau de Desobstrução Vascular
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180126
[Lr] Data última revisão:
180126
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1007/s00270-017-1649-6


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[PMID]:28466753
[Au] Autor:Singh GD; Armstrong EJ; Waldo SW; Alvandi B; Brinza E; Hildebrand J; Amsterdam EA; Humphries MD; Laird JR
[Ad] Endereço:1 Division of Cardiovascular Medicine and the Vascular Center, University of California, Davis School of Medicine, Sacramento, CA, USA.
[Ti] Título:Non-compressible ABIs are associated with an increased risk of major amputation and major adverse cardiovascular events in patients with critical limb ischemia.
[So] Source:Vasc Med;22(3):210-217, 2017 06.
[Is] ISSN:1477-0377
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Ankle-brachial indices (ABIs) are important for the assessment of disease burden among patients with peripheral artery disease. Although low values have been associated with adverse clinical outcomes, the association between non-compressible ABI (ncABI) and clinical outcome has not been evaluated among patients with critical limb ischemia (CLI). The present study sought to compare the clinical characteristics, angiographic findings and clinical outcomes of those with compressible (cABI) and ncABI among patients with CLI. Consecutive patients undergoing endovascular evaluation for CLI between 2006 and 2013 were included in a single center cohort. Major adverse cardiovascular events (MACE) were then compared between the two groups. Among 284 patients with CLI, 68 (24%) had ncABIs. These patients were more likely to have coronary artery disease ( p=0.003), diabetes ( p<0.001), end-stage renal disease ( p<0.001) and tissue loss ( p=0.01) when compared to patients with cABI. Rates of infrapopliteal disease were similar between the two groups ( p=0.10), though patients with ncABI had lower rates of iliac ( p=0.004) or femoropopliteal stenosis ( p=0.003). Infrapopliteal vessels had smaller diameters ( p=0.01) with longer lesions ( p=0.05) among patients with ncABIs. After 3 years of follow-up, ncABIs were associated with increased rates of mortality (HR 1.75, 95% CI: 1.12-2.78), MACE (HR 2.04, 95% CI: 1.35-3.03) and major amputation (HR 1.96, 95% CI: 1.11-3.45) when compared to patients with cABIs. In conclusion, ncABIs are associated with higher rates of mortality and adverse events among those undergoing endovascular therapy for CLI.
[Mh] Termos MeSH primário: Amputação
Índice Tornozelo-Braço
Procedimentos Endovasculares
Isquemia/diagnóstico
Isquemia/terapia
Doença Arterial Periférica/diagnóstico
Doença Arterial Periférica/terapia
[Mh] Termos MeSH secundário: Idoso
Amputação/efeitos adversos
Amputação/mortalidade
Angiografia
California
Comorbidade
Estado Terminal
Procedimentos Endovasculares/efeitos adversos
Procedimentos Endovasculares/mortalidade
Feminino
Seres Humanos
Isquemia/fisiopatologia
Estimativa de Kaplan-Meier
Salvamento de Membro
Masculino
Meia-Idade
Doença Arterial Periférica/fisiopatologia
Valor Preditivo dos Testes
Modelos de Riscos Proporcionais
Sistema de Registros
Estudos Retrospectivos
Medição de Risco
Fatores de Risco
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:180118
[Lr] Data última revisão:
180118
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1177/1358863X16689831


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[PMID]:29305458
[Au] Autor:Stevenson JD; Kumar VS; Cribb GL; Cool P
[Ad] Endereço:Aston University Medical School, Aston Express Way, Birmingham, B4 7ET, UK.
[Ti] Título:Hemiarthroplasty proximal femoral endoprostheses following tumour reconstruction: is acetabular replacement necessary?
[So] Source:Bone Joint J;100-B(1):101-108, 2018 Jan.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: Dislocation rates are reportedly lower in patients requiring proximal femoral hemiarthroplasty than for patients undergoing hip arthroplasty for neoplasia. Without acetabular replacement, pain due to acetabular wear necessitating revision surgery has been described. We aimed to determine whether wear of the native acetabulum following hemiarthroplasty necessitates revision surgery with secondary replacement of the acetabulum after proximal femoral replacement (PFR) for tumour reconstruction. PATIENTS AND METHODS: We reviewed 100 consecutive PFRs performed between January 2003 and January 2013 without acetabular resurfacing. The procedure was undertaken in 74 patients with metastases, for a primary bone tumour in 20 and for myeloma in six. There were 48 male and 52 female patients, with a mean age of 61.4 years (19 to 85) and median follow-up of two years (interquartile range (IQR) 0.5 to 3.7 years). In total, 52 patients presented with a pathological fracture and six presented with failed fixation of a previously instrumented pathological fracture. RESULTS: All patients underwent reconstruction with either a unipolar (n = 64) or bipolar (n = 36) articulation. There were no dislocations and no acetabular resurfacings. Articular wear was graded using the criteria of Baker et al from 0 to 3, where by 0 is normal; grade 1 represents a narrowing of articular cartilage and no bone erosion; grade 2 represents acetabular bone erosion and early migration; and grade 3 represents protrusio acetabuli. Of the 49 patients with radiological follow-up greater than one year, six demonstrated grade 1 acetabular wear and two demonstrated grade 2 acetabular wear. The remainder demonstrated no radiographic evidence of wear. Median medial migration was 0.3 mm (IQR -0.2 to 0.7) and superior migration was 0.3 mm (IQR -0.2 to 0.6). No relationship between unipolar bipolar articulations and wear was evident. CONCLUSION: Hemiarthroplasty PFRs for tumour reconstruction eliminate joint instability and, in the short to medium term, do not lead to native acetabular wear necessitating later acetabular resurfacing. Cite this article: 2018;100B:101-8.
[Mh] Termos MeSH primário: Acetábulo/cirurgia
Artroplastia de Quadril/métodos
Neoplasias Femorais/cirurgia
Hemiartroplastia/métodos
Prótese de Quadril
[Mh] Termos MeSH secundário: Acetábulo/diagnóstico por imagem
Adulto
Idoso
Idoso de 80 Anos ou mais
Artroplastia de Quadril/efeitos adversos
Feminino
Neoplasias Femorais/secundário
Seguimentos
Hemiartroplastia/efeitos adversos
Luxação do Quadril/etiologia
Seres Humanos
Salvamento de Membro/métodos
Masculino
Meia-Idade
Falha de Prótese
Radiografia
Reoperação/métodos
Reoperação/estatística & dados numéricos
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180107
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.100B1.BJJ-2017-0005.R1


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[PMID]:28458517
[Au] Autor:Kronlage M; Printz I; Vogel B; Blessing E; Müller OJ; Katus HA; Erbel C
[Ad] Endereço:Department of Cardiology, Angiology and Pneumology, University Hospital Heidelberg.
[Ti] Título:A comparative study on endovascular treatment of (sub)acute critical limb ischemia: mechanical thrombectomy vs thrombolysis.
[So] Source:Drug Des Devel Ther;11:1233-1241, 2017.
[Is] ISSN:1177-8881
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: The aim of this study was to compare different interventional methods for treatment of (sub)acute limb ischemia upon thrombotic occlusions of the lower extremity in terms of their safety and efficacy in a tertiary hospital setting. DESIGN: This is a retrospective, single-center study of non-randomized data. METHODS: A total of 202 patients, including 26 critically ill patients, underwent rotational thrombectomy (Rotarex ), local thrombolysis (recombinant tissue plasminogen activator), or combination of both at the University Hospital Heidelberg (2006-2015). The different interventional procedures were compared in terms of overall and amputation-free survival, as well as patency in a 1-year follow-up (Kaplan-Meier analysis). RESULTS: The study demonstrated a primary revascularization success of >98% in all groups. One year after revascularization, primary and secondary patency after mechanical thrombectomy alone were significantly better in comparison to local thrombolysis or a combination of Rotarex and lysis (63% and 85%, <0.05). Overall survival 12 months after intervention reached up to 96% in noncritically ill patients, and amputation-free survival was 94.3% in all three groups. Mean hospitalization duration and rate of major bleedings were significantly increased after thrombolysis compared to Rotarex ( <0.05). CONCLUSION: In patients with (sub)acute limb ischemia, Rotarex mechanical thrombectomy represents a safe and effective alternative to thrombolysis and is associated with a reduced rate of major bleedings, shorter hospitalization durations, and lower costs.
[Mh] Termos MeSH primário: Isquemia/terapia
Salvamento de Membro
Vacinas contra Rotavirus/uso terapêutico
Trombectomia
Terapia Trombolítica
Ativador de Plasminogênio Tecidual/metabolismo
[Mh] Termos MeSH secundário: Doença Aguda
Idoso
Feminino
Seres Humanos
Masculino
Meia-Idade
Estudos Retrospectivos
Vacinas contra Rotavirus/administração & dosagem
Vacinas Atenuadas/administração & dosagem
Vacinas Atenuadas/uso terapêutico
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (RIX4414 vaccine); 0 (Rotavirus Vaccines); 0 (Vaccines, Attenuated); EC 3.4.21.68 (Tissue Plasminogen Activator)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171222
[Lr] Data última revisão:
171222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170502
[St] Status:MEDLINE
[do] DOI:10.2147/DDDT.S131503



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