Disease relevance of Limb Salvage

• The ILP with TNF + melphalan can be performed safely in many centers and is an effective induction treatment with a high response rate that can achieve limb salvage in patients with locally advanced extremity soft tissue sarcoma [1].
• METHODS: Forty-seven client-owned dogs with osteosarcoma of the distal radius were treated with limb-salvage surgery and adjuvant chemotherapy--either carboplatin or carboplatin and doxorubicin [2].
• CONCLUSIONS: In this study, the heparin-bonded ePTFE graft provided promising early patency and limb salvage results, with no device-related complications, in patients with occlusive vascular disease [3].
• CONCLUSIONS: Perioperative anticoagulation therapy with heparin increases the incidence rate of wound hematomas, but long-term anticoagulation therapy with warfarin improves the patency rate of autogenous vein infrainguinal bypass grafts and the limb salvage rate for patients at high risk for graft failure [4].
• Successful limb salvage with prostaglandin infusion: a review of ergotamine toxicity [5].

Psychiatry related information on Limb Salvage

• In conclusion, limb salvage following infrainguinal bypass does not translate into improvements in measured ambulation or in measured physical activity in PAOD patients, even though the patients perceive these measures to be better [6].

High impact information on Limb Salvage

• Preoperatively, the limbs were classified by angiography into aortoiliac disease alone (AI) or AI and femoropopliteal disease (AIFP), and were further classified by PVR and DSP A/B into claudication and limb salvage groups [7].
• CONCLUSION: ILP with TNF, IFN, and melphalan is a safe and highly effective induction biochemotherapy procedure that can achieve limb salvage in patients with nonresectable extremity STS [8].
• Intraoperative use of systemic heparin or local urokinase or both was the only directly controllable factor associated with limb salvage [9].
• Appropriate surgery allowed limb salvage in 23 of 36 early failures (less than 3 months) and 12 of 14 late failures (greater than 3 months), and usually consisted of the same operation that would have been performed had PTA not been attempted [10].
• It is clear that the results of tibial PTA and femoropopliteal PTA are closely associated for most patients undergoing limb salvage procedures [11].

Chemical compound and disease context of Limb Salvage

• These findings suggest that a prior course of chemotherapy with Adriamycin may not be a contraindication to limb lengthening for limb salvage after resection of an osteosarcoma [12].
• CONCLUSIONS: Prompt management by peripheral vascular surgeons resulted in limb salvage in 10 legs and only one death from a pulmonary embolus [13].
• Clinical trial of photodynamic therapy using acridine orange with/without low dose radiation as new limb salvage modality in musculoskeletal sarcomas [14].
• To assess the potential of using distraction osteogenesis to reconstruct bone deficient limbs after limb salvage for musculoskeletal sarcomas, the authors examined the effect of methotrexate on distraction osteogenesis in a rabbit tibial lengthening model [15].
• CONCLUSIONS: In patients undergoing profundaplasty because of severe limb ischemia due to three-level occlusion, adjuvant intravenous 3-week treatment with PGE1 substantially improves not only the short-term results, but also the long-term outcome after five years in terms of patient survival and limb salvage [16].

Anatomical context of Limb Salvage

• These results indicate that thromboxane A2 is an important mediator of skeletal muscle reperfusion injury and suggest that administration of a thromboxane A2 receptor antagonist may improve limb salvage rates after surgery for acute ischaemia [17].
• The most characteristic feature of peripheral arterial occlusive disease of the lower extremity was a stagnation of arterial circulation in the foot, and the flow velocity in the foot was a sensitive predictive index of limb salvage [18].
• We demonstrated radiological evaluations after limb salvage surgery with an uncemented titanium endoprosthesis possessing a rotating hinge-type knee joint for 7 patients with malignant bone tumors at the distal femur [19].
• This report summarizes early results with saphenous vein bypass (SVB) utilizing both sequential and in-situ techniques (SIS SVB) in eight limbs requiring limb salvage [20].
• SETTING: Vascular Surgery Department of the University Hospital Henri Mondor based in a suburb of Paris, France. PATIENTS: All patients who underwent a femoral bypass ending below the popliteal artery for limb salvage from January 1984 to December 1995 [21].

Associations of Limb Salvage with chemical compounds

• CONCLUSION: Selective use of local anaesthetic techniques extends the benefits of limb salvage to patients considered unfit for conventional anaesthesia [22].
• TxA2 and PGI2 concentrations were determined in 22 patients before, during, and after arterial reconstruction for limb salvage and in 10 control subjects [23].
• Tumor necrosis factor (TNF)-alpha-based isolated limb perfusion (ILP) is an established alternative to achieve limb salvage but is assumed to require sufficient vasculature [24].
• HYPOTHESIS: Long-term patency and limb salvage rates of CSB are affected by sex, bypass configuration, and warfarin therapy [25].
• Eighteen patients were treated with intra-arterial doxorubicin hydrochloride, limb salvage surgery, and radiation (group A) [26].

Gene context of Limb Salvage

• These findings thus extend the indications of therapeutic angiogenesis using SeV-hFGF2 to include not only limb salvage but also prevention of late graft failure [27].
• Transplantation of Id1-overexpressing HUVECs accelerated recovery of blood flow as evaluated by laser-Doppler perfusion imaging, increased capillary density, and improved the rate of limb salvage compared with the transplantation of control HUVECs [28].
• In patients with AAO and in those with AVO, t-PA was equivalent to or better than urokinase with regard to percent of clot lysis, incidence of major bleeding complications, limb salvage, and mortality [29].
• If such an approach is followed, lasting limb salvage with minimal morbidity should be achieved in most patients with CSAD [30].
• Isolated limb perfusion (ILP) with TNF alpha, IFN gamma and melphalan causes impressive tumour reduction in patients with irresectable soft tissue sarcomas with a high limb salvage rate [31].

Analytical, diagnostic and therapeutic context of Limb Salvage

• Thirty days after treatment was commenced, limb salvage was achieved in 39 of 49 patients in the high-dose group compared with 37 of 44 who had a low-dose infusion of tPA [32].
• One month after treatment with t-PA or streptokinase 19 (68 per cent) patients had limb salvage, five (18 per cent) had required amputations and four (14 per cent) had died [33].
• Serial thallium scintigraphy can furthermore identify poor responses within two weeks after the initiation of treatment, or can prompt an early change in preoperative chemotherapy and facilitate limb salvage surgery [34].
• It is this change in the population that has made the Simple Fogarty Embolectomy an operation of the past--mandating angiography, Fogarty embolectomy, and complex vascular reconstruction for limb salvage [35].
• Using this canine model, we can estimate the effect of ifosfamide on bone graft incorporations and the fixation of biologic prostheses that is clinically the most important aspect of limb salvage surgery [36].

References