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Limb Salvage Using High-Pressure Intermittent Compression Arterial Assist Device in Cases Unsuitable for Surgical Revascularization—Invited Critique

Limb Salvage Using High-Pressure Intermittent Compression Arterial Assist Device in Cases... Invited Critique his manuscript bravely describes an innovative treatment of 13 patients with 14 critically ischemic limbs who by their T criteria were not candidates for routine arterial revascularization. Two thirds of these patients were diabetic and had either poor run-off, no suitable vein conduit, or were in generally poor medical condition that obviated a major operation. Surprisingly, 9 of these limbs demonstrated a significant increase in pulse volume amplitude after 3 months, giving some proof of numbers to this voodoo-type therapy. All of these limbs were salvaged. The other 4 limbs did not have such an increase in their pulse volume amplitude, and their limbs were not salvaged. Three of the 4 patients who had a flat-line pulse volume recording noted at the ankle prior to treatment unfortunately went on to undergo amputation. An element of patient compliance was noted as well. Those patients using their device for a mean of 2.38 hours a day—almost the recommended time of 4 hours per day—had their limbs salvaged, whereas those only using their device for a mean of 1.14 hours per day required an amputation. The follow-up was short—8.7 ± 6.9 months as 2 patients died during the study period. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Surgery American Medical Association

Limb Salvage Using High-Pressure Intermittent Compression Arterial Assist Device in Cases Unsuitable for Surgical Revascularization—Invited Critique

Freischlag, Julie Ann
JAMA Surgery , Volume 136 (11) – Nov 1, 2001
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Limb Salvage Using High-Pressure Intermittent Compression Arterial Assist Device in Cases Unsuitable for Surgical Revascularization—Invited Critique

Abstract

Invited Critique his manuscript bravely describes an innovative treatment of 13 patients with 14 critically ischemic limbs who by their T criteria were not candidates for routine arterial revascularization. Two thirds of these patients were diabetic and had either poor run-off, no suitable vein conduit, or were in generally poor medical condition that obviated a major operation. Surprisingly, 9 of these limbs demonstrated a significant increase in pulse volume amplitude after 3 months, giving...
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Publisher
American Medical Association
Copyright
Copyright 2001 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6254
eISSN
2168-6262
DOI
10.1001/archsurg.136.11.1286
Publisher site
See Article on Publisher Site

Abstract

Invited Critique his manuscript bravely describes an innovative treatment of 13 patients with 14 critically ischemic limbs who by their T criteria were not candidates for routine arterial revascularization. Two thirds of these patients were diabetic and had either poor run-off, no suitable vein conduit, or were in generally poor medical condition that obviated a major operation. Surprisingly, 9 of these limbs demonstrated a significant increase in pulse volume amplitude after 3 months, giving some proof of numbers to this voodoo-type therapy. All of these limbs were salvaged. The other 4 limbs did not have such an increase in their pulse volume amplitude, and their limbs were not salvaged. Three of the 4 patients who had a flat-line pulse volume recording noted at the ankle prior to treatment unfortunately went on to undergo amputation. An element of patient compliance was noted as well. Those patients using their device for a mean of 2.38 hours a day—almost the recommended time of 4 hours per day—had their limbs salvaged, whereas those only using their device for a mean of 1.14 hours per day required an amputation. The follow-up was short—8.7 ± 6.9 months as 2 patients died during the study period.

Journal

JAMA Surgery – American Medical Association

Published: Nov 1, 2001

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