Perfusion Assessment in Critical Limb Ischemia: Principles for Understanding and the Development of Evidence and Evaluation of Devices: A Scientific Statement From the American Heart Association.

There are >12 million patients with peripheral artery disease in the United States. The most severe form of peripheral artery disease is critical limb ischemia (CLI). The diagnosis and management of CLI is often challenging.

Toe blood pressure and toe-brachial index.

TBP and TBI are considered more accurate in assessing lower extremity perfusion in those patients with a falsely elevated ABI suspected from medial arterial calcification. Like the ABI, a TBI may be obtained by the nurse through a similar procedure using a sphygmomanometer and hand-held Doppler. Knowledge by the vascular nurse of this noninvasive technique will assist in a more timely recognition of PAD and may improve long-term patient outcomes.

Iliofemoral deep vein thrombosis: Percutaneous endovascular treatment options.

Venous thromboembolism is defined as an acute venous thrombotic event that targets two disease entities: deep vein thrombosis (DVT), pulmonary embolism, or both. The most common site of DVT origin is in the lower extremities, with 50% of patients exhibiting no symptoms. Although anticoagulation is the gold standard for DVT, early clot removal, especially of proximal iliofemoral DVT, is felt to reduce the incidence of postthrombotic syndrome (PTS) by preserving valve function.

Clinical guidelines: grading the evidence behind the practice.

Clinical practice guidelines are statements to assist in healthcare decisions for patients with the same illness or procedure. Guidelines comprise elements that describe different aspects of the patient's condition and the required care. Many organizations publish guidelines, including the Society for Vascular Nursing.

The effects of leg/body position on transcutaneous oxygen measurements after lower-extremity arterial revascularization.

A postoperative nursing goal in a patient with peripheral artery disease requiring lower-extremity arterial reconstruction surgery is to maintain blood flow and tissue oxygenation to the revascularized extremity. This may be achieved through extremity positioning. Transcutaneous oxygen (TcPO(2)) measurements provide a noninvasive objective determination of oxygen at the skin surface and assessment of underlying circulation and tissue oxygenation.

Oxidation of fugitive methane in ground water linked to bacterial sulfate reduction.

When fugitive methane migrates upward along boreholes of oil and gas wells, it may migrate into shallow ground water or pass through overlying soil to the atmosphere. Prior to this study, there was little information on the fate of fugitive methane that migrates into ground water. In a field study near Lloydminster, Alberta, Canada, we found hydrogeochemical evidence that fugitive methane from an oil well migrated into a shallow aquifer but has been attenuated by dissimilatory bacterial sulfate reduction at low temperature ( approximately 5 degrees C) under anaerobic conditions.

Effects of leg and body position on transcutaneous oxygen measurements in healthy subjects and subjects with peripheral artery disease after lower-extremity arterial revascularization: a pilot study.

Transcutaneous oxygen (TcPO(2)) measurements provide a noninvasive, objective determination of the oxygen level at the skin surface. This offers a means of estimating the underlying circulation and tissue oxygenation. The purpose of the pilot study was to measure the TcPO(2) value of the lower extremity of healthy men and women and of patients with peripheral arterial disease (PAD) in 4 different body and leg positions 24 hours after peripheral vascular surgery reconstruction.