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The long-term functional outcome of the mangled upper extremity intricate management. A single center experience.
J Hand Microsurg
January 2025
Department of Orthopaedic Surgery and Musculoskeletal Trauma, University Hospital of Larissa, Larissa, Greece.
Purpose: Severe injury of multiple anatomical structures of the upper extremity can be caused by an extremely violent mechanism during labor and motor vehicle accidents, gunshots and explosions. The mangled upper extremity consists of trauma of at least 3 of 4 tissue types: connective tissue (skin, subcutaneous tissue, tendons, muscles), vessels, nerves, and bones. The purpose of this study is to evaluate the medium and long-term results of the limb salvage management of those injuries in our department.
View Article and Find Full Text PDFChronic hand ischemia in pediatric patients due to brachial artery injury after supracondylar humerus fracture.
Ann Vasc Surg
January 2025
Department of Surgery, University Hospital Centre Zagreb, Zagreb, Croatia.
Objectives: Brachial artery injury due to displaced supracondylar fracture (SC) of the humerus in children may present with pink pulseless hand (PPH), denoting a well perfused hand without radial pulse, or acute hand ischemia. Some reports state that brachial artery reconstruction is not necessary in children with persisting PPH, but the reports on long-term consequences such as intermittent claudications, growth retardation and ischemic contracture in children with pulseless hand are scarce and often misinterpreted. The objective of our analysis was to assess the long-term outcomes of children with brachial artery injury associated with SC fracture.
View Article and Find Full Text PDFDirect Axillary Artery Cannulation as Standard Perfusion Strategy in Minimally Invasive Coronary Artery Bypass Grafting.
J Cardiovasc Dev Dis
January 2025
Department of Cardiothoracic Surgery, Heart-Thorax Center, Klinikum Fulda, University Medicine Marburg, Campus Fulda, 36043 Fulda, Germany.
Objective: Cardiopulmonary bypass (CPB) via the right axillary artery (RAA) has become an alternative perfusion strategy, especially in complex aortic procedures. This study delineates our technique and outcome with direct axillary cannulation utilizing the Seldinger technique, which we adopted as the standard perfusion strategy in the sternum-sparing minimally invasive total coronary revascularization via left anterior thoracotomy (TCRAT) using CPB.
Methods: From November 2019 to December 2023, a total of 413 consecutive patients underwent nonemergent isolated coronary artery bypass grafting (CABG) via left anterior minithoracotomy on CPB with peripheral cannulation via the RAA and cardioplegic cardiac arrest, using this technique as a default strategy in the daily routine.
Post cardiac surgery acute kidney injury and the role of intravenous amino acids infusions.
Postgrad Med
January 2025
Internal Medicine Department of Conemaugh Health System, Johnstown, PA, USA.
Acute kidney injury (AKI) is a well-established and serious complication associated with cardiovascular revascularization procedures, regardless of its severity. According to the 2023 annual report of the National Institute of Diabetes and Digestive and Kidney Diseases - United States Renal Data System, the incidence of cardiovascular disease-related AKI hospitalizations has been steadily increasing over the past decade. Coronary artery bypass grafting (CABG), on the other hand, remains one of the most frequently performed major surgical procedures in the United States, with an estimated 400,000 surgeries conducted annually.
View Article and Find Full Text PDFPhysicians' preference for carotid revascularization impacts postoperative stroke and death outcomes.
J Vasc Surg
December 2024
Division of Vascular Surgery, Indiana University School of Medicine, Indianapolis, IN.
Objective: Transcarotid artery revascularization (TCAR) is a safe minimally invasive option for patients with carotid artery stenosis who are not appropriate candidates for carotid endarterectomy (CEA). Many physicians have not yet adopted this technique in the management of carotid artery stenosis. The aim of this study is to explore overall outcomes of carotid revascularization based on physicians' practices in the Vascular Quality Initiative (VQI).
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