Hypothesis: Patency after primary percutaneous transluminal angioplasty (PTA) and stenting of superficial femoral artery (SFA) occlusions is better than historical experience with PTA alone. Design: Consecutive case series of primary PTA with stenting, and follow-up with duplex imaging every 6 months (mean± SD follow-up, 32 ± 15 months). Setting: Veterans Affairs medical center. Patients and Methods: Patients were 57 previously untreated men with 71 limbs having chronic atherosclerotic SFA occlusion with suprageniculate reconstitution and patent tibial runoff. Critical ischemia (Society for Vascular Surgery [SVS] category, 4-6) was present in 7 (10%), the remainder had intermittent claudication only (SVS, 1-3). Interventions: Guidewire recanalization followed by PTA, Wallstent deployment, and adjunctive thrombolysis as necessary; 19 limbs (27%) required thrombolysis to manage periprocedural thrombosis. Main Outcome Measures: Cumulative patency, limb salvage, and complications. Results: Length (mean±SD) of occlusion was 14.4±9.9 cm. Length of stented artery was 24.3 ± 11.1 cm. Ankle brachial index increased from 0.59 ± 0.14 to 0.86±0.16
Verrucous carcinoma is a rare variant of well-differentiated squamous cell carcinoma. It usually occurs in the oral cavity, genital area, and sole. Verrucous carcinoma of the sole, also called epithelioma cuniculatum, often presents a diagnostic challenge both clinically and histopathologically. The authors report such a case that mimics infected epidermal cyst and gout clinically.
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