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Short and long-term outcomes of peripheral arterial indirect bypass surgery in Diabetic patients with critical limb ischemia
Iraq-Kurdistan (IFMSA-Kurdistan) - Hawler Medical University/College of Medicine, Erbil
Cardiothoracic and vascular surgery/Department of Surgery. Kurdistan Board of Medical Specialities (KBMS). Runaki, Erbil, Iraq.
Zana Tharwat Mohammed
Zana Tharwat Mohammed
Required: English Accepted: Kurdish, Arabic
Type of Research Project
- Clinical Project with Laboratory work
What is the background of the project?
Critical limb ischemia (CLI) is a severe blockage in the arteries of the lower extremities, which markedly reduces blood-flow, and is characterized by rest pain and tissue loss in the form of ulceration and/or gangrene. Patients with CLI have a considerably bad prognosis and is associated with increased risk of limb amputation and cardiovascular-related mortality. In order for patients with CLI to have salvaged limbs they have to undergo revascularization, either by endovascular means or through bypass surgery with vein or prosthetic conduits. The choice of either endovascular revascularization, bypass surgery, or both together depends on the patient’s risk estimation, limb staging, and anatomic pattern of the disease. The primary goals of the treatment are to prevent amputation, relieve ischemic pain, allow wound healing, and improve the patient's ability to ambulate. Discussing the results of lower extremity vein bypasses requires an examination of some hard objective endpoints including patency, limb salvage, and patient survival and examination of other endpoints such as functional outcome, quality of life, and cost-benefit analysis.
What is the aim of the project?
1.To evaluate the outcomes of indirect bypass grafting surgery for diabetic patients with critical limb ischemia. 2. Evaluation of limb salvage surgery in diabetic patients
What techniques and methods are used?
This will be a prospective observational study of approximately 175 patients that were selected through simple random sampling that followed the inclusion criteria of the following: diabetic patients who have CLI in Rutherford clinical categories 3 through 6. With angiographic finding compatible with indirect non-angiosom bypass operation No supra-inguinal significant arterial lesions. No endovascular revascularization procedures indicated Data entry into the SPSS system, results of statistical analysis of data using statistical methods like descriptive statistics in the form of (frequencies, cross tabs) and correlate methods from SPSS and Excel will be performed with interpretation and conclusion of results in the form of tables and graphs, and comparison with other regional and international studies will be made.
What is the role of the student?
- The student will mainly observe
- The student will observe the practical experiments but will be highly involved in the analysis of the results
- If the project is clinical
- the student will take active part in the clinical examination
- The tasks will be done under supervision
What are the tasks expected to be accomplished by the student?
The student will not be involved in data collection since data will already be collected by the time, instead he will be able to interrogate and do rounds on patients with the help of a supervisor, thereby improving their communication skills regarding patients from different backgrounds and acquire preoperative and postoperative examinational skills. Later encoding the data into SPSS system and will be highly involved in the data analysis, quantification and obtaining results using both SPSS and Excel (software systems), and lastly, he will be able participate in the writing process of the paper and improve their article reviewing/writing skills.
Will there be any theoretical teaching provided (preliminary readings, lectures, courses, seminars etc)
There will be theoretical teaching in the form of practical lectures once or twice per week by someone assigned by the tutor. The lecture will be about cardiothoracic and vascular surgery in general, focusing mainly on peripheral arterial diseases.
What is expected from the student at the end of the research exchange? What will be the general outcome of the student?
- The student will prepare a scientific report - The student will prepare an abstract - The student will have the opportunity to present the results together with the supervisor at a conference
What skills are required of the student? Is there any special knowledge or a certain level of studies needed?
Student in clinical years knowing the definition and stages of the arterial occlusive disease of lower limbs. And have a basic knowledge regarding use of SPSS and Excel software.
Are there any legal limitations in the student’s involvement
Type of students accepted
This project accepts: - Medical students
- Kota SK; Kota SK; Meher LK; Sahoo S; Mohapatra S; Modi KD. Surgical revascularization techniques for diabetic foot. Journal of cardiovascular disease research. 2013 Jun 1;4(2):79-83.
- Del Conde I; Erwin PA. Evaluation of the patient who presents with critical limb ischemia: diagnosis; prognosis; and medical management. Techniques in vascular and interventional radiology. 2014 Sep 1;17(3):140-6.
- Dalal PK; Prasad A. Contemporary Outcomes of Endovascular Intervention for Critical Limb Ischemia. Interventional cardiology clinics. 2017 Apr;6(2):251-9.
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