Evidence map›Paper›PMID 34429609›Full record

ArticleVascular health and risk management2021

Acute Upper Limb Ischemia: Prompt Surgery and Long-Term Anticoagulation Prevent Limb Loss and Debilitation.

Patrick Harnarayan, Shariful Islam, Dave Harnanan, Vinoo Bheem, Steve Budhooram

Open access · goldAbstract read
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Article in Vascular health and risk management, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.3field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 14 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Patrick HarnarayanDepartment of Clinical Surgical Sciences, University of The West Indies, St. Augustine, Trinidad &Tobago.
Shariful IslamDepartment of Surgery, San Fernando General & Teaching Hospitals, San Fernando, Trinidad &Tobago.
Dave HarnananDepartment of Clinical Surgical Sciences, University of The West Indies, St. Augustine, Trinidad &Tobago.
Vinoo BheemDepartment of Surgery, San Fernando General & Teaching Hospitals, San Fernando, Trinidad &Tobago.
Steve BudhooramThe Surgi-Med Clinic, San Fernando, Trinidad & Tobago.
San Fernando General Hospital · TT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute upper limb ischemia is an uncommon clinical manifestation of thromboembolism seen predominantly in patients with atrial fibrillation. Treatment can be by conservative or surgical means but the consensus is that after conservative treatment, symptoms still persist. In this series, an attempt was made at limb preservation and return to functional capacity by early surgery in all patients diagnosed with acute limb ischemia.

methodsPatients referred with upper limb ischemia (22) were stratified into non-acute (6) treated with anticoagulation alone and those with acute ischemia. Sixteen (16) patients, age range 30-92 years (median 62.4 years) comprising mainly females (13), had clinical evidence of severe ischemia and underwent immediate brachial embolectomy with postoperative anticoagulation.

resultsSixteen patients underwent 20 embolectomies with immediate reperfusion of limbs and relief of symptoms. Two patients had two re-operations each due to recurrent symptoms but both recovered with good outcome, one going on to have an axillary-radial bypass. There was no limb disability nor limb loss, but one postoperative mortality. All other patients were seen at their 1-year review and at 5 years, eleven out of 15 patients were still alive with most resuming an active lifestyle and some returning to work.

conclusionGood outcomes were obtained in this series in both the short and long term. Despite one mortality, there was no limb loss nor disability in a mainly elderly population. Prompt surgery and meticulous long-term anticoagulation reduced complications and improved limb salvage rates ensuring that patients had a good quality of life after surgery.

Indexed as

AdultAgedAged, 80 and overAnticoagulantsEmbolectomyFemaleHumansIschemiaLimb SalvageMaleMiddle AgedQuality of LifeRetrospective StudiesTime FactorsTreatment OutcomeUpper ExtremityAnticoagulantsWarfarinacute-ischemiaanticoagulationlimb-salvageprompt-surgery

Identifiers

PMID34429609
PMCPMC8379708
OpenAlexW3193573484

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.