Median arcuate ligament syndrome is rare, and as a diagnosis of exclusion, diagnosis and treatment paradigms can be unclear. Based on previously published studies, symptom relief can be achieved with a variety of interventions including celiac ganglionectomy as well as open, laparoscopic, or robotic intervention.
On the basis of this study, a cardiac rehabilitation program tailored to the needs of women appears to be feasible and acceptable. The efficacy of this intervention to improve health-related outcomes needs to be tested in a randomized, controlled trial.
Limb ischemia complications from ECMO may be decreased by prophylactic placement of an antegrade DPC. Without DPC, continuous monitoring using NIRS may identify limb ischemia, which can be treated subsequently with DPC and or fasciotomy.
The development or worsening of DM after pancreatic resection is extremely common, with different types of resections conveying different risks for disease progression. DP places patients at a greater risk for the development of new-onset postoperative diabetes when compared to PD. In contrast, patients with preoperative diabetes are more likely to experience worsening of their disease after PD as compared to DP. Patients should be screened prospectively, particularly those at highest risk, and informed of and educated about the potential for post-resection DM.
Background
The most frequent limb complications from peripheral veno‐arterial extracorporeal membrane oxygenation (VA‐ECMO) are limb ischemia and localized bleeding. To minimize these risks, perfusion of the distal limb with peripheral percutaneous cannulation was done.
Technique
Percutaneous cannulation with a distal perfusion port was performed in all patients. During the VA‐ECMO, distal limb perfusion was monitored using near‐infrared spectroscopy to assess tissue oxygenation. At the decannulation, patch angioplasty was performed to prevent the development of narrowing of the artery at the cannulation site.
Conclusions
Using our standard technique, we have not experienced any limb loss related to ischemia or bleeding. doi: 10.1111/jocs.12058 (J Card Surg 2013;28:190–192)
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