الفهرس | Only 14 pages are availabe for public view |
Abstract Critical limb ischemia (CLI) is a manifestation of peripheral arterial disease (PAD) that describes patients with typical chronic ischemic rest pain or patients with ischemic skin lesions either ulcers or gangrene. The management of CLI requires a multidisciplinary team of experts in different areas of vascular disease from atherosclerotic risk factor management to imaging and from intervention to wound care and physical therapy. The evaluating physician should be fully aware of all revascularization options in order to select the most appropriate intervention or combination of interventions, while taking into consideration the goals of therapy, risk-benefit ratios, patient co morbidities and life expectancy. The primary goals of intervention for CLI include the restoration of pulsatile, inline flow to the foot to assist wound healing, the relief of rest pain, the avoidance of major amputation, preservation of mobility and the primary outcome would be amputation free survival and improvement of patient function and quality of life The low morbidity of percutaneous procedures compared with surgical revascularization has expanded the spectrum of patients with CLI who are deemed candidates for revascularization. The Peroneal Artery is relatively spared from the terminal stages of atherosclerosis and is often the last tibial vessel to become occluded in diabetes or end-stage vascular disease. |