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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 Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

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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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Rethinking protocolized completion angiography following extremity vascular trauma: A prospective observational

Grace M Niziolek1, Jane Keating, Joanelle Bailey

  • 1From the Division of Trauma, Critical Care, and Emergency General Surgery, Department of Surgery (G.M.N., N.J.K., M.J.S.), University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; Department of Surgery (J.K.), Hartford Hospital, New Haven, Connecticut; Department of Surgery (J.B.), Rutgers New Jersey Medical School, Newark, New Jersey; Department of Surgery (N.J.K.), Emory University, Atlanta, Georgia; Salem Health Surgical Clinic - General Surgery (A.M.M.), Salem Hospital, Salem, Oregon; Department of Surgery (D.J.S.), University of Florida College of Medicine - Jacksonville, Jacksonville, Florida; Department of Surgery (A.L., M.A.V.), University of Rochester, Rochester, New York; Department of Surgery (Z.M.), Temple University, Philadelphia, Pennsylvania; Department of Surgery (S.A.M.), University of New Mexico, Albuquerque, New Mexico; Department of Surgery (M.C.S.), Vanderbilt University, Nashville, Tennessee; School of Medicine (A.L.), University of California - Irvine, Irvine, California; and Department of Surgery (K.M.S.), Yale University, New Haven, Connecticut.

The Journal of Trauma and Acute Care Surgery
|April 11, 2023
PubMed
Summary

Completion angiography (CA) after extremity vascular repair is often routine. However, performing CA only when inadequate repair is suspected may reduce unnecessary interventions and associated morbidity.

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Area of Science:

  • Vascular Surgery
  • Trauma Care
  • Diagnostic Imaging

Background:

  • Completion angiography (CA) is standard practice after extremity vascular repair, guided by trauma surgery guidelines.
  • Evidence supporting the benefit of CA in all cases is limited (Level III).

Purpose of the Study:

  • To determine which patients with extremity vascular injuries benefit from completion angiography.
  • To analyze the impact of CA on the need for secondary vascular intervention.

Main Methods:

  • Prospective, observational, multicenter study of patients aged 15+ with extremity vascular injuries requiring surgery.
  • Analysis of clinical variables and outcomes, focusing on the need for secondary vascular intervention.

Main Results:

  • Of 438 patients, 90 (30.4%) underwent CA after arterial repair, most due to institutional protocol (70.9%).
  • No secondary surgeries were needed if CA followed institutional protocol; however, 26.7% required re-operation if CA was prompted by concern for inadequate repair.
  • No significant differences were found in mortality, length of stay, ischemia, or amputation rates between groups with or without CA.

Conclusions:

  • Completion angiography for extremity vascular injuries should be individualized.
  • Restricting CA to cases with suspected inadequate repair may minimize unnecessary procedures and complications.