The role of hemodynamic measurements in the management of venous and ischemic ulcers
Datum
2007Schlagwort
Zusammenfassung
There is a need for quantitative investigations in the vascular laboratory to manage lower extremity ulcers. The majority of leg ulcers are of venous (45%-60%) or arterial origin (10%-20%). Despite the increasing complexity of new devices used in vascular surgical practice, the anklebrachial pressure index (ABPI) remains the cornerstone for the differential diagnosis of ischemic ulcers. The toe-brachial pressure index and the pole test represent attractive alternative tests especially in patients with diabetes. Color flow Doppler imaging (CFDI) is advantageous over ABPI in cases in which wounds and ulcers prevent the use of a cuff by virtue of their size or location; additionally CFDI technology can detect nonflow limiting lesions, lesions to nonaxial arteries such as the deep femoral artery, or lesions limited to a single tibial artery. Continued improvements in the accuracy of CFDI have prompted some vascular surgeons to replace contrast arteriography in distal bypass procedures. Transcutaneous partial oxygen tension measurement (TcPO2) is another noninvasive method that is reliable to select the level of amputation and recommended to determine tissue viability in critically ischemic limbs and in the management of the diabetic foot. CFDI has revolutionized the diagnostic approach to venous disorders and it is considered the gold standard for the assessment of the venous system of the lower limb, causes minimal inconvenience to patients, and is easily repeatable, but it is considered highly operator dependent. Various plethysmography techniques are of limited application in ulcer investigations, because of their difficulty to calibrate signal, unless time measurements such as the postexercise refilling time are used. © 2007 Sage Publications.
Collections
Verwandte Dokumente
Anzeige der Dokumente mit ähnlichem Titel, Autor, Urheber und Thema.
-
High-dose pantoprazole continuous infusion is superior to somatostatin after endoscopic hemostasis in patients with peptic ulcer bleeding
Tsibouris, P.; Zintzaras, E.; Lappas, C.; Moussia, M.; Tsianos, G.; Galeas, T.; Potamianos, S. (2007)BACKGROUND: The best antisecretory treatment after endoscopic hemostasis in patients with ulcer bleeding is still in quest. OBJECTIVES: To compare pantoprazole and somatostatin continuous infusion after endoscopic hemostasis ... -
A kidney transplant recipient with a perforated cheek: Oral epstein-barr virus-positive mucocutaneous ulcer complicated with an opportunistic bacterial infection
Eleftheriadis T., Rountas C., Golfinopoulos S., Liakopoulos V., Stefanidis I. (2021)A 69-year-old female living donor kidney transplant recipient presented with right facial painful edema. The patient’s body mass index was 14 (kilograms per meter squared), and her creatinine clearance was 15 mL/min. A ... -
Severe unilateral corneal melting after uneventful phacoemulsification cataract surgery
Praidou, A.; Brazitikos, P.; Dastiridou, A.; Androudi, S. (2013)We present a rare case of severe unilateral corneal melt after uneventful phacoemulsification. A 38-year-old woman presented one week after uneventful phacoemulsification cataract surgery complaining of pain and blurred ...