The etiologies of lower limb amputations in minority communities and novel surgical techniques for no-option patients
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Abstract
Lower limb amputation is on the rise in the United States, and unfortunately, due to provider implicit racial bias, predisposed health conditions, lower socioeconomic status, and limited access to quality healthcare minority populations have an increased risk of developing diabetes and vascular diseases that cause increased rates of lower limb amputations and thereby reducing their overall health outcomes. Minority populations include African Americans/Blacks, Hispanics/Latinos, Indigenous Americans, Pacific Islanders, Native Hawaiians, and Asian Americans, however for this thesis the two populations of focus will be the African American/Black and Hispanic/Latino populations due to the vastly available data compared to other minority groups. This literature thesis titled Etiologies of Lower Limb Amputations in Minority Communities and Novel Surgical Techniques for No-Option Patients will dive into the primary causes of lower limb amputations in minority populations, discuss ways to prevent lower limb amputations in the African American/Black and Hispanic/Latino populations, provide insight on ways to improve health outcomes to prevent lower limb amputations & increase health outcomes after vascular reconstruction. This thesis will also discuss the newer option of the LimFlow pDVA system for candidates whose only option is amputation after exhausting all conventional options such as healthy eating and exercise. Moreover, this thesis will analyze whether this innovative LimFlow pDVA system is different from other already utilized vascular reconstructive surgical methods, like bypass and angioplasty, for improved blood flow and amputation prevention. These patients are also known as “no-option.” The term “no-option” is defined as being ineligible for surgical or endovascular arterial revascularization” to regain at minimum partial blood flow. Furthermore, patients where amputation is deemed to be the only available intervention are also known as “no-option. Additionally, this thesis will dissect the connection between primary chronic and predisposed health conditions of the African American/Black and Hispanic/Latino population such as diabetes, cardiovascular disease, Peripheral Arterial Disease (PAD), and Chronic Limb Threatening Ischemia (CLTI) and an individual’s increased risk of undergoing a single or double amputation. Provider implicit racial bias, lower socioeconomic status, and limited access to quality healthcare in minority populations will also be explored as contributing factors to the increased risk of lower limb amputations seen in these communities. Although research has shown that the LimFlow pDVA system seems to be a better alternative for “no-option” patients, there are some limitations that were mentioned. Literary findings that supported and opposed the two-part hypothesis were found to have several limitations which included gaps in the centers of revascularization, underrepresentation of minority groups in research trials, the discrepancy in the term minority, lack of recommended tests to the general population, use of small sample size, and minimal diversity in the LimFlow clinical trials noting the importance of improving these limitations to help decrease the rates of lower limb amputations and improve health outcomes in African American/Black and Hispanic/Latino communities.
Description
2024