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Related Concept Videos

Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

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Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
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Peripheral Artery Disease V: Postoperative Nursing Management01:23

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During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
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Peripheral Artery Disease IV: Nursing Management01:26

Peripheral Artery Disease IV: Nursing Management

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 The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
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Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation

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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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Arteries of Lower Limbs01:20

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The external iliac artery transitions out of the body cavity, entering the femoral region of the lower leg, and is renamed the femoral artery at the point where it traverses the body wall. This artery is responsible for the distribution of blood to the thigh's deep muscles and the skin's ventral and lateral regions, achieved through several minor branches and the lateral deep femoral artery, which also spawns a lateral circumflex artery. The knee area receives blood from the genicular...
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Predicting Amputation using Local Circulating Mononuclear Progenitor Cells in Angioplasty-treated Patients with Critical Limb Ischemia
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Lower extremity arterial interventions in England.

A Staniszewska1, M Gimzewska1, S Onida1

  • 1Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London, London, UK.

Annals of the Royal College of Surgeons of England
|April 14, 2021
PubMed
Summary
This summary is machine-generated.

Lower extremity revascularization procedures increased significantly over two decades in NHS England, while major lower limb amputations decreased. These trends impact vascular surgery service provision and training.

Keywords:
AmputationEndovascular interventionLower extremityOpen surgeryRevascularisation

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Area of Science:

  • Vascular Surgery
  • Public Health
  • Epidemiology

Background:

  • Diabetes mellitus prevalence and endovascular therapy advancements influence lower extremity arterial disease management.
  • This study examines trends in lower extremity revascularization and major lower limb amputation within NHS England from 2000 to 2019.

Purpose of the Study:

  • To analyze temporal trends in lower extremity revascularization procedures.
  • To assess changes in major lower limb amputation rates.
  • To understand the impact of these trends on healthcare service provision and surgical training.

Main Methods:

  • Utilized hospital admitted patient care activity reports from NHS England (2000-2019).
  • Extracted data on lower extremity endovascular interventions, open surgical procedures, and major lower limb amputations.
  • Employed linear regression models and chi-square tests to evaluate trends.

Main Results:

  • Over 527,000 revascularizations and 92,000 amputations were performed.
  • Lower limb revascularization procedures increased significantly (402.4 units/year, p < 0.001).
  • Endovascular interventions rose by 43.5%, while open surgical procedures showed no significant change.
  • Major lower limb amputations decreased by 9.4% (p = 0.003).

Conclusions:

  • A notable increase in lower limb revascularization procedures correlates with a decrease in major lower limb amputations over the past two decades.
  • These epidemiological shifts necessitate adjustments in service provision and vascular surgery training planning.