Seminars in Vascular Surgery最新文献_第2页

Diabetes-Related Extremity Amputation Depression and Distress (DREADD): A Multimethod Study

IF 3.3 3区医学

Seminars in Vascular Surgery Pub Date : 2025-03-01 DOI: 10.1053/j.semvascsurg.2025.01.002

Levi M. Brooks , Bradley M. Brooks , Allison S. Arp , Cyaandi R. Dove , Lee C. Rogers , Rosemay Michel , Valentina Clinton , Jonathan Labovitz , Brandon M. Brooks , David G. Armstrong

{"title":"Diabetes-Related Extremity Amputation Depression and Distress (DREADD): A Multimethod Study","authors":"Levi M. Brooks , Bradley M. Brooks , Allison S. Arp , Cyaandi R. Dove , Lee C. Rogers , Rosemay Michel , Valentina Clinton , Jonathan Labovitz , Brandon M. Brooks , David G. Armstrong","doi":"10.1053/j.semvascsurg.2025.01.002","DOIUrl":"10.1053/j.semvascsurg.2025.01.002","url":null,"abstract":"<div><div>Of the roughly 38 million people diagnosed with type 2 diabetes mellitus in the United States, up to 34% will develop a diabetic foot ulcer at some point, up to 75% of those who develop an ulcer will experience recurrent ulcers, and approximately 18% of patients with a diabetic foot ulcer will undergo lower-limb amputation. The aim of this study was to determine whether depressive symptoms change after a minor, nontraumatic amputation. We conducted a multimethod study consisting of semi-structured interviews (n = 12) and a retrospective cohort (n = 20) of patients with type 2 diabetes mellitus who underwent a nontraumatic, minor amputation of a single toe (partial or total) or partial ray resection. Patient Health Questionnaire-9 (PHQ-9) scores were noted before and after surgery within 30 days of each other. The Wilcoxon matched pairs signed rank test was used to determine differences in the PHQ-9 scores before amputation and after amputation. Of the 20 patients in the retrospective cohort, 90% (18 of 20) had higher PHQ-9 scores within 30 days of amputation. Mean PHQ-9 scores were 3.65 and 12.35 before and after amputation, respectively (a difference of 8.7; <em>P</em> = .0001). Diabetes-related extremity amputation depression and distress is a potentially dangerous complication of diabetes mellitus. Nontraumatic amputations can be a traumatic experience for patients. Surgeons should screen their patients with type 2 diabetes mellitus before and after any (minor or major) nontraumatic amputation and make the appropriate referral, if necessary. Sufficient evidence exists in the literature to warrant the inclusion of psychiatrists and other mental health clinicians in multidisciplinary limb preservation teams.</div></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"38 1","pages":"Pages 94-100"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Percutaneous approach to deep vein arterialization for the “no-option” chronic limb-threatening ischemia patient

IF 3.3 3区医学

Seminars in Vascular Surgery Pub Date : 2025-03-01 DOI: 10.1053/j.semvascsurg.2025.01.005

Jayne R. Rice, Brett C. Chatman, Elizabeth A. Genovese

{"title":"Percutaneous approach to deep vein arterialization for the “no-option” chronic limb-threatening ischemia patient","authors":"Jayne R. Rice, Brett C. Chatman, Elizabeth A. Genovese","doi":"10.1053/j.semvascsurg.2025.01.005","DOIUrl":"10.1053/j.semvascsurg.2025.01.005","url":null,"abstract":"<div><div>Chronic limb-threatening ischemia is an advanced stage of peripheral artery disease characterized by rest pain or tissue loss. Treatment of patients classified as ``no-option'' CLTI remains particularly challenging, as historically their primary treatment has been limited to major amputation. Venous arterialization has emerged as a promising alternative in this difficult-to-treat population. Advances in optimized technology and endovascular techniques, particularly deep venous arterialization, have had encouraging outcomes for long-term limb salvage. Successful limb preservation relies on proper patient selection, a compliant patient, and a robust multidisciplinary clinical team to support the complex processes of deep venous arterialization maturation and wound healing. This review will discuss the historical background of venous arterialization, patient selection criteria, and surgical techniques for percutaneous deep venous arterialization, and postoperative management after the index procedure, including wound care, surveillance, and reintervention strategies for successful limb salvage.</div></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"38 1","pages":"Pages 41-53"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Institutional toe & flow programs: How and why the teams work

IF 3.3 3区医学

Seminars in Vascular Surgery Pub Date : 2025-03-01 DOI: 10.1053/j.semvascsurg.2025.01.008

Ahmed A. Naiem, Ryan T. Callahan, Alexander M. Reyzelman, Michael S. Conte

{"title":"Institutional toe & flow programs: How and why the teams work","authors":"Ahmed A. Naiem, Ryan T. Callahan, Alexander M. Reyzelman, Michael S. Conte","doi":"10.1053/j.semvascsurg.2025.01.008","DOIUrl":"10.1053/j.semvascsurg.2025.01.008","url":null,"abstract":"<div><div>Diabetic foot ulcers with or without concomitant chronic limb-threatening ischemia put patients at exceedingly high risk of limb loss and death. The toe & flow model is a multidisciplinary team-based model captained by a podiatrist or orthopedic foot and ankle specialist and a vascular specialist, which streamlines treatment for patients with diabetic foot ulcer and chronic limb-threatening ischemia. This model creates a functional ecosystem around it by integrating other medical professionals and community partners. It provides a high standard of care first via community education and engagement. It eliminates barriers to access between it and the community by establishing clear referral pathways. This model uses the best available evidence to create treatment pathways governing the patient trajectory through different stage of disease. Once acute treatment is provided, it aims to consolidate success and disease remission through aggressive surveillance and collaboration with the community. An important aspect of this model is that it collects and reports its outcomes and serves as an educational hub within its region. It ultimately aims to develop national policies and allocate resources to continue to improve. This review sheds light on successes associated with institutional toe & flow programs.</div></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"38 1","pages":"Pages 3-10"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143600754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Choice of dialysis access: Catheter, peritoneal, or hemodialysis 透析途径的选择：导管、腹膜或血液透析。

IF 3.3 3区医学

Seminars in Vascular Surgery Pub Date : 2024-12-01 DOI: 10.1053/j.semvascsurg.2024.09.003

Andrea Lubitz , Karen Woo

{"title":"Choice of dialysis access: Catheter, peritoneal, or hemodialysis","authors":"Andrea Lubitz , Karen Woo","doi":"10.1053/j.semvascsurg.2024.09.003","DOIUrl":"10.1053/j.semvascsurg.2024.09.003","url":null,"abstract":"<div><div>The most recent National Kidney Foundation Kidney Disease Outcomes Quality Initiative guidelines shifted emphasis to kidney replacement modality selection and vascular access planning and creation of the Endstage Kidney Disease Life-Plan, which promotes a patient-centered approach. The Life-Plan is intended to be created through discussions between the patient and their multidisciplinary care team to ultimately develop a lifelong kidney replacement therapy strategy. The focus of the Life-Plan is to engage the patient in a multidisciplinary patient-centered approach. The Life-Plan includes selection of the most suitable treatment modality (eg, hemodialysis, peritoneal dialysis, or transplantation), setting (home or center), and type of vascular access. Ultimately, this approach considers overall patient health, preferences, and anatomic factors. Patients choose between hemodialysis, which can be performed either in center or at home, and peritoneal dialysis. When considering vascular access, options consist of tunneled dialysis catheter, arteriovenous fistula, and arteriovenous graft. Each modality and vascular access type has benefits and disadvantages that should be weighed carefully with the patient and their supportive team to arrive at a decision that aligns as closely as possible with each individual patient's circumstances.</div></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"37 4","pages":"Pages 369-374"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The effects of hemodialysis on the cardiovascular system 血液透析对心血管系统的影响。

IF 3.3 3区医学

Seminars in Vascular Surgery Pub Date : 2024-12-01 DOI: 10.1053/j.semvascsurg.2024.10.001

Zachary S. Pallister, Jayer Chung

引用次数: 0

Tunneled dialysis catheter: Simple, re-do, complicated 隧道式透析导管：简单、重做、复杂

IF 3.3 3区医学

Seminars in Vascular Surgery Pub Date : 2024-12-01 DOI: 10.1053/j.semvascsurg.2024.10.009

Ehab Sorial , Mrinal Shukla

引用次数: 0

Management of carotid disease in the end-stage renal disease patient 终末期肾病患者的颈动脉疾病管理。

IF 3.3 3区医学

Seminars in Vascular Surgery Pub Date : 2024-12-01 DOI: 10.1053/j.semvascsurg.2024.09.002

Ali AbuRahma, Zachary AbuRahma

{"title":"Management of carotid disease in the end-stage renal disease patient","authors":"Ali AbuRahma, Zachary AbuRahma","doi":"10.1053/j.semvascsurg.2024.09.002","DOIUrl":"10.1053/j.semvascsurg.2024.09.002","url":null,"abstract":"<div><div>Chronic kidney disease (CKD) has been increasing in incidence as a result of the growing prevalence of diabetes and other risk factors for cardiovascular disease. This study highlights reports related to management of carotid disease in patients with CKD, with a special emphasis on end-stage renal disease (ESRD). Several earlier studies found that patients with CKD are more likely to die from cardiovascular causes than progress to ESRD requiring dialysis. Data derived from the US Renal Data System showed that the 30-day stroke/death rate was 10% after carotid endarterectomy and 11% after carotid artery stenting in patients on dialysis, with a median postoperative survival of 2.5 years. However, these data were representative of a patient cohort from 2005 to 2008. In the past 2 decades, significant life expectancy gains have been noted for patients with ESRD. Recent studies reported adjusted mortality has decreased by 20% in patients on hemodialysis and 29% in patients who underwent transplantation. In addition, recent studies have found that among patients with CKD, carotid endarterectomy and transcarotid artery revascularization had stroke/death rates of <2% for asymptomatic patients and <3% for symptomatic patients. Based on studies published to date, the risk of carotid intervention, whether carotid endarterectomy or stenting, specifically transcarotid artery revascularization, can be justified for carefully selected symptomatic patients with severe CKD with acceptable operative risk and good long-term life expectancy. However, patients with asymptomatic carotid disease and severe CKD, specifically ESRD, should be offered best optimal medical therapy unless life expectancy exceeds what has been recommended by recent Society for Vascular Surgery carotid guidelines.</div></div>","PeriodicalId":51153,"journal":{"name":"Seminars in Vascular Surgery","volume":"37 4","pages":"Pages 427-432"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Management of thrombosed or failed dialysis access 处理血栓形成或失效的透析通路。

IF 3.3 3区医学

Seminars in Vascular Surgery Pub Date : 2024-12-01 DOI: 10.1053/j.semvascsurg.2024.10.006

Stephen N. Dalton-Petillo, Jeffrey J. Siracuse

引用次数: 0

Review of maintenance and surveillance of dialysis access 透析途径维持和监测的审查。

IF 3.3 3区医学

Seminars in Vascular Surgery Pub Date : 2024-12-01 DOI: 10.1053/j.semvascsurg.2024.10.008

Shayna Brathwaite , Amber B. Kernodle , Nader N. Massarweh , Olamide Alabi

引用次数: 0

Effects of dialysis on peripheral arterial disease 透析对外周动脉疾病的影响。