No abstract

Intrathecal drug administration via implanted pump is an effective treatment for intractable pain and spasticity but can be compromised by catheter-related complications. To determine the etiology of catheter-related complications, we have conducted a multicenter, prospective study of the long-term performance of a one-piece catheter system. Data pertaining to catheter-related complications were collected at implant and at specified times during the follow-up period. Catheter implantation characteristics that might affect complications were assessed. Two hundred nine patients were studied at 22 participating centers, with 1764 cumulative patient-months of catheter experience. Forty-nine catheter system complications occurred in 37 patients (7 complications related to the catheter itself, and 42 complications related to the implantation procedure). The 9-month complication-free "survival" rate was 78.9% overall (95.5% for the catheter itself). No specific catheter implantation characteristics were associated with the occurrence of complications. These data indicate that the incidence of complications for a one-piece catheter system is similar to that of commercially available two-piece systems, and highlight the need for careful surgical technique during implantation.

No abstract

No abstract

The prevalence of peripheral arterial occlusive disease (PAOD) is high in elderly patients and its clinical manifestation is often atypical. Comorbidity and morbidity as a consequence of PAOD are significant. Therefore, standardized primary diagnostics are required among geriatric patients. Drawn from a search of the literature, evidence-based recommendations are provided. Pulse palpation and the evaluation of a patient's medical history are obligatory components of primary diagnostics, even in the absence of typical symptoms. In the case of pathological and ambiguous findings, measuring Doppler ankle pressures is suggested as the next diagnostic step. Further measures depend on the following factors: the presence of lesions on the leg with disturbed blood flow, predominantly in the foot and lower leg areas, degree of PAOD-related ailments, and, finally, intended surgery of the affected leg for other medical reasons.