Peripheral Vascular Disease in Spinal Cord Injury Patients: A Difficult Diagnosis

Yokoo, Karen M.; Kronon, Michael; Lewis, Victor L.; McCarthy, Walter J.; McMillan, William D.; Meyer, Paul R.

doi:10.1097/00000637-199611000-00007

Cited by 6 publications

(4 citation statements)

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“…Instead, the health care practitioner must rely on physical signs, such as necrosis. 22 Of note given the undetermined utility of diagnosing PAD in patients with SCI, early endovascular interventions are not typically performed. We could not find literature regarding when intervention for PAD in patients with SCI should be performed or how frequently those with SCI should be assessed for PAD.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Predictors of Lower Limb Amputation in the Spinal Cord Injury Population

Yu¹

2022

Federal Practitioner

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Background: Despite limited data demonstrating altered hemodynamics in the lower extremities (LEs) among the population with spinal cord injury (SCI) and increased frequency of peripheral arterial disease (PAD), epidemiologic data are limited for amputations, a potential consequence. This study investigates the association of amputation due to vascular complications as a secondary outcome measure within the SCI population.Methods: A retrospective cohort study was performed within a veteran population with SCI at a US Department of Veteran Affairs hospital to determine the prevalence of limb loss. We hypothesized that premorbid SCI increased the likelihood of LE amputation.Results: Of 1055 charts reviewed, 91 (8.7%) patients had an amputation, 70 (76.1%) had a dysvascular etiology. Transfemoral amputations were the most common level (n = 53) of amputation. Our results showed a positive correlation between the completeness of injury and the prevalence of amputation. Conclusion:There is an increased frequency of amputation among the veteran population with SCI compared with that of the general US population. Amputations frequently occur at more proximal levels with motor complete injuries. Studies using a larger population and multiple centers are needed to confirm this alarming trend.

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Section: Discussionmentioning

confidence: 99%

Prevalence and Predictors of Lower Limb Amputation in the Spinal Cord Injury Population

Yu¹

2022

Federal Practitioner

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“…They often have problems healing their amputation stumps and develop severe pressure sores refractory to reconstructive surgery; these sores often require multiple revascularization along with the amputation surgery. Indigent patients with spinal cord injuries in nursing homes, without family involvement, may be less likely to receive optimal health care screening (including noninvasive vascular studies of peripheral pulses) 35 and therefore may be more vulnerable to feelings of abandonment and anger. These patients may be less prepared to undergo postamputation training and strengthening of the remaining extremities.…”

Section: What Conditions Lead To Amputation?mentioning

confidence: 99%

Reactions to Amputation: Recognition and Treatment

Bhuvaneswar¹,

Epstein²,

Stern³

2007

Prim. Care Companion J. Clin. Psychiatry

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“…Often, the initial manifestation of PVD in these patients is advanced gangrene, and this renders subsequent healing difficult or even impossible. 4,5,22 The presence of pressure wounds over the sacrum or ischium may be exacerbated, and their reconstruction is complicated by the presence of PVD. The timely diagnosis of PVD involving the iliac segment in the SCI patients may be overlooked and is often necessary to optimize the treatment of LE ulcers and pressure sores.…”

Section: Vasculogenic Conditionsmentioning

confidence: 99%

“…The timely diagnosis of PVD involving the iliac segment in the SCI patients may be overlooked and is often necessary to optimize the treatment of LE ulcers and pressure sores. 22 SCI may modify vascular reactivity in the denervated region. Walden et al 23 reported an original observation of altered vascular response in SCI patients.…”

Section: Vasculogenic Conditionsmentioning

confidence: 99%

Some Problems of the Lower Extremity in Patients with Spinal Cord Injuries

Heruti

Ohry

2003

The International Journal of Lower Extremity Wounds

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Spinal cord injury (SCI) is devastating, leaving patients wholly or partly paralyzed. Health care providers who care for SCI patients during the acute or chronic phases are faced with different phenomena in the lower extremities of these subjects. In this article, the authors review the relevant changes associated with SCI. Preventive measures of these medical complications are directed according to the specific cause. Early comprehensive rehabilitation carried out by a specialized team prevents complications while enhancing functional gains.

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Peripheral Vascular Disease in Spinal Cord Injury Patients: A Difficult Diagnosis

Cited by 6 publications

References 0 publications

Prevalence and Predictors of Lower Limb Amputation in the Spinal Cord Injury Population

Prevalence and Predictors of Lower Limb Amputation in the Spinal Cord Injury Population

Reactions to Amputation: Recognition and Treatment

Some Problems of the Lower Extremity in Patients with Spinal Cord Injuries

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