Severe Ischemia of Lower Extremity Due to Arteriosclerosis Obliterans

Humphries, Alfred W.; Young, Jess R.; deWolfe, Victor G.; LeFevre, Fay A.; Beven, Edwin G.

doi:10.1001/archsurg.1963.01310130177022

Cited by 12 publications

(7 citation statements)

References 2 publications

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“…The problem is that there is a paucity of adequate studies delineating the natural history of PVD and its naturally occurring amputation rate. Humphries, in 1963, presented historical data showing foot salvage at one year to be approximately 34% in patients with severe PVD( 52). In patients with foot ischemia at rest (Fontaine Class III) the limb salvage, at one year, was 51%, but for patients with ischemic pain at rest plus tissue loss with ulcers or gangrene (Fontaine Class IV) their foot salvage at one year was only 17%.…”

Section: Discussionmentioning

confidence: 99%

Spinal Cord Stimulation in Severe, Inoperable Peripheral Vascular Disease

Huber¹,

Vaglienti²,

Huber³

2000

Neuromodulation: Technology at the Neural Interface

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Section: Discussionmentioning

confidence: 99%

Spinal Cord Stimulation in Severe, Inoperable Peripheral Vascular Disease

Huber¹,

Vaglienti²,

Huber³

2000

Neuromodulation: Technology at the Neural Interface

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“…Erythema of the skin of the leg in connection with arterial ischaemia has been described (40), but information as to the possible concomitant presence of diabetes is lacking. Ischaemic ulcers of the legs (17,18,30) and so-called hypertensive ulcers of the legs (47) have also been described without mention of whether diabetes was present or not. Skeletal destruction in association with distal diabetic gangrene with ulceration has been described (40).…”

Section: 64)mentioning

confidence: 99%

Cutaneous Erythema, With or Without Necrosis, Localized to the Legs and Feet—a Lesion in Elderly Diabetics

Lithner

1974

Journal of Internal Medicine

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The paper describes cutaneous lesions of the leg and/or foot in elderly diabetics, consisting of areas of erythema the size of a child's palm or larger, and in the same group of patients areas of necrosis from the size of confetti up to the size of a child's palm, surrounded by erythema. The necrosis involves all layers of the skin. Similar skin lesions are seen in elderly persons without recognized diabetes. When a group of patients of the latter type was compared with a control group, it appeared that their glucose tolerance was altered in a diabetic direction. The skin lesions usually follow cardiac decompensation, with or without oedema of the legs, or unilateral oedema of the leg due, for example, to venous thrombosis. The author suggests that the lesions are due to a qualitatively or quantitatively altered reaction in diabetics. The patients may also have skeletal destruction in the feet. The initial lesions in dermopathia diabetica (Melin) are also described. They consist of superficial ulcerations the size of confetti or somewhat larger, surrounded by a narrow zone of erythema. Acta med. scand. 1%

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“…Historical data show that the natural course of patients with severe limb ischemia is often amputation. In patients with pain at rest and nonhealing ischemic ulcers amputation is needed in 65–70% within a year if no effective treatment in initiated (20). More recently the control group of a randomized study that had standard medical therapy (analgesics, anticoagulants, vasoactive agents, local wound care, and antibiotics) showed a cumulative limb survival of 68%, 46%, and 46% after 6, 12, and 24 months, respectively (21).…”

Section: Scs Outcomes In Pad Patientsmentioning

confidence: 99%

“…As mentioned earlier the age‐adjusted prevalence of PAD in the US is 12%, and patients with nonhealing ischemic ulcers have only a 30–35% chance of limb salvage at one year (6,20). Such abysmal data have led to numerous different treatment modalities in patients who are not surgical candidates.…”

Section: Alternativesmentioning

confidence: 99%