Tag: limb salvage

We Moved to the Toe to Escape Calcification — and It Followed Us There: Digital Artery Calcification, Falsely-High Toe Pressures, and a 20–30 mmHg Temporary Fix #DiabeticFoot #PAD #CLTI #ToePressure #Calcification #LimbPreservation #ActAgainstAmputation @alpslimb

We moved to the toe pressure precisely because digital arteries were supposed to be spared from calcification. A new JVS-Vascular Insights study from Welling, Bakker, Ferraresi and colleagues finds digital artery calcification in nearly 30% of limbs, shows it doubles one-year limb-event risk, and that it falsely elevates toe pressure — with a simple fix: when calcium shows on the foot film, subtract 20–30 mmHg.

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If It Doesn’t Look Like a Tree: #Fractals, #Microcirculation, and Why Small Artery Disease Is So Easy to See

A long-time friend's offhand observation in Bremen — that small artery disease is easy to see on an angiogram because it doesn't look like nature — leads to Mandelbrot, Murray's law, and a quantifiable complexity index for the diabetic foot.

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From Foot to Fatality: The #DiabeticFootAttack Is Real, and It’s Worse Than You Think @alpslimb #ActAgainstAmputation

A new single-center study from the Netherlands quantifies the devastating outcomes of the diabetic foot attack: only 48.5% wound closure, 46% major amputation by 12 months, 26% one-year mortality, and 12-month amputation-free survival of just 39.7%. Time is tissue.

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More on the Potentially Innovative Approach to Neuroischemic Diabetic Foot Ulcers: Modified Tibial Cortex Transverse Transport

Diabetic foot ulcers (DFUs) are a common and severe complication of diabetes, often leading to lower extremity amputations. Traditional treatments, while varied, do not always prevent the progression of these ulcers, particularly in more advanced stages. However, a recent study published by Liu et al. offers hope through a novel surgical technique known as modified... Continue Reading →

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Apples and oranges? A comparison of BEST-CLI to BASIL-2 #JVascSurg #UCSFVascular

Insightful, data-rich commentary as expected from our flowmigos Conte and O'Banion The Battle of the Limb Preservation Trials: BEST-CLI vs. BASIL-2 Two major randomized clinical trials comparing endovascular and open surgical approaches for patients with chronic limb-threatening ischemia (CLTI) - BEST-CLI and BASIL-2 - reported seemingly contradictory results recently. In the larger BEST-CLI trial, patients... Continue Reading →

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Outcomes of integrated surgical wound treatment mode based on tibial transverse transport for diabetic foot wound #ActAgainstAmputation @ALPSLimb #DiabeticFoot

Congratulations to Chang and coworkers on this effort. This makes us want to reach back to work from our team a dozen or so years ago, where we failed to really explore this fascinating area of creating, in essence, a distress signal in the bone leading to upregulation of factors that can potentially help toward... Continue Reading →

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Lower Extremity Venous Arterialization (LEVA): Present at the Creation @HENDOLAT #DiabeticFoot #ToeFlowandGo #LEVA

As a very interested vascular customer at the end of the vascular peninsula, I've been personally fascinated with my vascular colleagues' work in revisiting venous arterialization. To that end, about a year ago, I proposed a consortium of folks that were doing the most active thinking in the area. This included the team from Bergamo,... Continue Reading →

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