+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Comprehensive approach to management of critical limb ischemia



Comprehensive approach to management of critical limb ischemia



Current Treatment Options in Cardiovascular Medicine 16(9): 332



Fighting major amputation has been one out of the four priorities of the World Health Organization (WHO) for a decade. If we consider that according to all epidemiological studies, the number of diabetic people is expected to double by 2030, the worse complication of this disease could represent a big sanitary, social, and economic problem in the near future. In developed countries, the cost of treatment for diabetic disease-related foot problems represents 15 - 25 % of available resources for the treatment of diabetes in general, but in some developing countries, the same cost may reach up to 40 % of available resources for diabetic disease. On the positive side, currently over 90 % of all diabetes-related amputations may be prevented thanks to the education of diabetic patients as primary prevention, and mainly to the new non-surgical revascularization techniques, which effectively fight the consequences of diabetic arteriopathy as a secondary prevention. The virtual pathway in reducing lower limb amputations starts with a better comprehension of critical limb ischemia (CLI), particularly its diagnostic aspects and consequent revascularization treatment. For 15 years we have assisted in a spectacular improvement of revascularization modalities and particularly of endovascular interventions. As a consequence, a large series of treated patients have shown the possibility to reduce the risk of limb loss in subjects at a higher risk to a rate of 1.7 - 2.4 %. Management of CLI requires integrating clinical, interventional, and surgical competencies together to a significant cultural advancement of every single physician involved in reducing the risk of limb loss. Consensus documents and international guidelines are, in general, precious opportunities to promote cultural and scientific upgrading of the involved specialist, but their results sometimes do not meet the physician's expectations. A close look into the available scientific literature adopted for scientific statements reveals an urgent need for standardized reporting of demographic data, severity of disease, and outcome of the studied population.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 052269988

Download citation: RISBibTeXText

PMID: 25080031

DOI: 10.1007/s11936-014-0332-3


Related references

Incidence of critical limb ischemia and amputation outcome in contralateral limb in diabetic patients hospitalized for unilateral critical limb ischemia during 1999-2003 and followed-up until 2005. Diabetes Research and Clinical Practice 77(3): 445-450, 2007

An Endovascular-First Approach to the Treatment of Critical Limb Ischemia Results in Superior Limb Salvage Rates. Journal of Endovascular Therapy 22(4): 473-481, 2016

Salvage of critical limb ischemia with the "trellis reserve'' of subintimal superficial femoral-popliteal artery occlusion: a new modality in managing critical limb ischemia--a case report. Vascular and Endovascular Surgery 39(6): 531-535, 2005

Endovascular therapy as the primary approach for limb salvage in patients with critical limb ischemia: experience with 443 infrapopliteal procedures. Vascular 14(2): 63-69, 2006

Stem cells of the lower limb: their role and potential in management of critical limb ischemia. Experimental Biology and Medicine 238(10): 1118-1126, 2013

Retrograde Approach Using Surgical Cutdown Technique for Limb Salvage in a Case of Critical Limb Ischemia With Severely Calcified Tibial Occlusive Disease. Vascular and Endovascular Surgery 50(4): 295-298, 2017

Nonoperative active management of critical limb ischemia: initial experience using a sequential compression biomechanical device for limb salvage. Vascular 16(3): 130-139, 2008

Evolving european consensus on critical limb ischemia meeting of the european working group on critical limb ischemia berlin west germany march 9 11 1989. Acta Cardiologica 44(5): 361-366, 1989

Comparative effectiveness of endovascular and surgical revascularization for patients with peripheral artery disease and critical limb ischemia: systematic review of revascularization in critical limb ischemia. American Heart Journal 167(4): 489-498.E7, 2014

Graz Critical Limb Ischemia Score: A Risk Score for Critical Limb Ischemia in Peripheral Arterial Occlusive Disease. Medicine 94(27): E1054, 2015

Long-term limb salvage and survival after endovascular and open revascularization for critical limb ischemia after adoption of endovascular-first approach by vascular surgeons. Journal of Vascular Surgery 56(2): 361-371, 2012

Personalized approach to revascularization of critical limb ischemia. Circulation. Cardiovascular Interventions 7(5): 642-644, 2015

Introduction. Multidisciplinary approach to critical limb ischemia. Seminars in Vascular Surgery 27(1): 1-2, 2015

Management of Critical Limb Ischemia. Circulation. Cardiovascular Interventions 9(2): E001946, 2016

Design and rationale of a randomized, double-blind, placebo-controlled phase III study for autologous bone marrow cell transplantation in critical limb ischemia: the BONe Marrow Outcomes Trial in Critical Limb Ischemia (BONMOT-CLI). Vasa. Zeitschrift für Gefasskrankheiten 37(4): 319-325, 2008