Validity of the Diabetic Wound Assessment Learning Tool.

Purpose: The development of the Diabetic Wound Assessment Learning Tool (DiWALT) has previously been described. However, an examination of its application to a larger, more heterogeneous group of participants is lacking. In order to allow for a more robust assessment of the psychometric properties of the DiWALT, we applied it to a broader group of participants.

The role of sealants for achieving anastomotic hemostasis in vascular surgery.

Background: During vascular interventions, connections that link arteries, veins, or synthetic grafts, which are known as an 'anastomosis', may be necessary. Vascular anastomoses can bleed from the needle holes that result from the creation of the anastomoses. Various surgical options are available for achieving hemostasis, or the stopping of bleeding, including the application of sealants directly onto the bleeding vessels or tissues.

General versus loco-regional anesthesia for endovascular aortic aneurysm repair.

Background: Aortic aneurysms occur when the aorta, the body's largest artery, grows in size, and can occur in the thoracic or abdominal aorta. The approaches to repair aortic aneurysms include directly exposing the aorta and replacing the diseased segment via open repair, or endovascular repair. Endovascular repair uses fluoroscopic-guidance to access the aorta and deliver a device to exclude the aneurysmal aortic segment without requiring a large surgical incision.

Experimental Protocol and Phantom Design and Development for Performance Characterization of Conventional Devices for Peripheral Vascular Interventions.

Conventional catheter-based interventions for treating peripheral artery disease suffer high failure and complication rates. The mechanical interactions with the anatomy constrain catheter controllability, while their length and flexibility limit their pushability. Also, the 2D X-ray fluoroscopy guiding these procedures fails to provide sufficient feedback about the device location relative to the anatomy.

A multicenter retrospective cohort study of blunt traumatic injury to the common or internal carotid arteries.

Objective: Current EAST guidelines recommend against routine carotid intervention for patients with blunt carotid artery injury (BCI), but offer limited information on its role for BCI patients presenting with neurological deficit. Our goal was to describe the contemporary management and outcomes of patients presenting with BCI and neurological deficit unrelated to head injury.

Methods: We identified all adults who sustained a BCI between 2010 and 2017 in the American College of Surgeons Trauma Quality Improvement Program.

Drug-eluting balloon angioplasty versus uncoated balloon angioplasty for the treatment of in-stent restenosis of the femoropopliteal arteries.

Background: Stents are placed in the femoropopliteal arteries for numerous reasons, such as atherosclerotic disease, the need for dissection, and perforation of the arteries, and can become stenosed with the passage of time. When a stent develops a flow-limiting stenosis, this process is known as "in-stent stenosis." It is thought that in-stent restenosis is caused by a process known as "intimal hyperplasia" rather than by the progression of atherosclerotic disease.

MRI for peripheral artery disease: Introductory physics for vascular physicians.

Magnetic resonance imaging (MRI) has advanced significantly in the past decade and provides a safe and non-invasive method of evaluating peripheral artery disease (PAD), with and without using exogenous contrast agents. MRI offers a promising alternative for imaging patients but the complexity of MRI can make it less accessible for physicians to understand or use. This article provides a brief introduction to the technical principles of MRI for physicians who manage PAD patients.

Magnetic resonance imaging characteristics of lesions relate to the difficulty of peripheral arterial endovascular procedures.

Objective: Limitations with current peripheral arterial imaging modalities make selection of patients for percutaneous vascular interventions difficult. The purpose of this study was to determine whether a novel preprocedural magnetic resonance imaging (MRI) method can identify lesions that would be more challenging to cross during percutaneous vascular intervention.

Methods: Fourteen patients with peripheral arterial disease underwent MRI before their intervention.

Public health campaigns and their effect on stroke knowledge in a high-risk urban population: A five-year study.

Background The level of knowledge of stroke risk factors and stroke symptoms within a population may determine their ability to recognize and ultimately react to a stroke. Independent agencies have addressed this through extensive awareness campaigns. The aim of this study was to determine the change in baseline knowledge of stroke risk factors, symptoms, and source of stroke knowledge in a high-risk Toronto population between 2010 and 2015.

Puncturing Plaques.

Purpose: To test and validate magnetic resonance imaging (MRI) sequences for peripheral artery lesion characterization and relate the MRI characteristics to the amount of force required for a guidewire to puncture peripheral chronic total occlusions (CTOs) as a surrogate for immediate failure of endovascular therapy.

Methods: Diseased superficial femoral, popliteal, and tibial artery segments containing 55 atherosclerotic lesions were excised from the amputated limbs of 7 patients with critical limb ischemia. The lesions were imaged at high resolution (75 μm voxels) with T2-weighted (T2W) and ultrashort echo time (UTE) sequences on a 7-T MR scanner.

Critical Evaluation of Delayed Healing of Venous Leg Ulcers: A Retrospective Analysis in Canadian Patients.

Background: Venous leg ulcers (VLUs) are common but challenging health problems. Better understanding of the risk factors involved in delayed healing of VLUs may therefore guide individualized treatment plans to improve patient outcomes.

Objective: We sought to identify the risk factors associated with delayed healing of VLUs in patients seen at a tertiary academic wound care clinic.

Postoperative electrolyte management: Current practice patterns of surgeons and residents.

Background: Managing postoperative electrolyte imbalances often is driven by dogma. To identify areas of improvement, we assessed the practice pattern of postoperative electrolyte management among surgeons and residents.

Study Design: An online survey was distributed among attending surgeons and surgical residents at the University of Toronto.

Associated injuries, management, and outcomes of blunt abdominal aortic injury.

Objective: Blunt abdominal aortic injury (BAAI) is very rare, and current literature is limited to case series of single-center experience. Through an analysis of the National Trauma Data Bank, the largest aggregation of United States trauma registry data, our aim was to characterize the associated injury pattern, contemporary management, and in-hospital outcomes of patients with BAAI.

Methods: We used a nested case-control design.

Abdominal aortic aneurysm repair with a functional autotransplanted kidney.

During the course of their practice, most urologists will encounter only a few patients with renal autotransplants. Even fewer will encounter those with renal autotransplants requiring abdominal aortic aneurysm (AAA) surgery. Although there is some literature describing AAA surgery in renal allotransplant patients, there is little such literature regarding AAA surgery in patients with autotransplanted kidneys.

Long-term survival and temporal trends in patient and surgeon factors after elective and ruptured abdominal aortic aneurysm surgery.

Objective: Records for all patients in Ontario who underwent elective repair of abdominal aortic aneurysms (AAAs) or repair of ruptured AAAs between 1993 and 1999 were studied to determine whether the profile of surgeons or patients changed and to determine whether postoperative mortality changed over time. The secondary objective was to describe long-term survival after AAA surgery.

Methods: A population-based retrospective cohort was assembled from administrative data.

Survival after ruptured abdominal aortic aneurysm: effect of patient, surgeon, and hospital factors.

Objective: The purpose of this study was to determine the effects of patient, surgeon, and hospital factors on survival after repair of ruptured abdominal aortic aneurysm (AAA) and to compare them with risk factors for survival after elective AAA repair. It was hypothesized that patients operated on by high-volume surgeons with subspecialty training would have better outcomes, which might argue for regionalization of AAA surgery.

Methods: In this population-based retrospective cohort study, surgeon billing and administrative data were used to identify all patients who had undergone AAA repair between April 1, 1992, and March 31, 2001, in Ontario, Canada.

Predictors of repair and effect of gender on treatment of ruptured abdominal aortic aneurysm.

Objective: The purpose of this study was to determine factors associated with increased likelihood of patients undergoing surgery to repair ruptured abdominal aortic aneurysms (AAAs). Specifically, we investigated whether men were more likely than women to be selected for surgery after rupture of AAAs.

Methods: All patients with a ruptured AAA who came to a hospital in Ontario between April 1, 1992, and March 31, 2001, were included in this population-based retrospective study.