This case series shows that the clinical neurological course of Takayasu arteritis on treatment is benign in most cases despite the severe vascular involvement.

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Primary self-expanding nitinol stenting did not show statistically different clinical outcomes compared to angioplasty with bailout stenting for infrapopliteal lesions.

SummaryBackground: Patients with neuroischemic diabetic foot syndrome (DFS) may need arterial revascularization, minor amputations, débridements as well as meticulous wound care. Unfortunately, postoperative outpatient care is frequently inadequate. Th is is especially true for Germany, where the in-and outpatient sectors are funded and managed separately, with poor communication between the two. Th us, many patients may be readmitted to the hospital following successful treatment and discharge. In an attempt to overcome these problems, we looked at whether an integrated case management (CM) system for outpatient care according to in-hospital standards might improve patients care and avoid readmissions. In addition we analyzed the length of hospital stay (LOS) as well as hospital costs. Patients and methods: In this retrospective cohort study patients with DFS, bypass surgery and foot surgery aft er implementation of the CM (study group; n = 376) were compared with a matched historic control group (HCG; n = 190) including the fl at rate revenues (G-DRG K01B). Following a standardized assessment, integrated trans-sectoral CM care was off ered to 116 patients (CMP). Results: Th e proportion of patients who were readmitted to hospital was reduced in CMP compared to HCG (8.8 vs. 16.4 %; p < 0.01), with consequent reduction of case consolidations (9.7 % versus 17.8 %, p < 0.001). Although initially, the mean LOS was higher in the CMP patients, the reduction in readmissions meant that this integrated CM program improved the hospital's economic situation. Conclusions: A hospital-based integrated CM system signifi cantly reduces the hospital readmissions in patients with neuroischemic DFS following bypass surgery, with lower hospital costs.

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