[Critical ischemia of the lower limbs: pathogenesis, clinical course and therapy. Results of authors' experience in 337 cases].
The definition of an ischaemic condition at lower limb level, may imply any different degree of the pathology, starting from a simple chronic slight claudication up to a severe ischaemia. Critical Limb Ischaemia is the term defined to identify an ischaemic condition, which endangers the limb or part of a limb and requires a prompt and appropriate treatment. However the pathophysiology of this condition remains to be well established and depends on various vascular factors. For the European Working Group on Critical Limb Ischaemia (Berlin 1989, Rudesheim 1991) the definition is strictly restricted to Fontaine's stage III B and IV, while in our opinion the definition could be very simple in all the patients with a prognostic limb-threatening condition (for localization and wide extension of the lesions) independent of the Fontaine's stage, which are going towards a future amputation if radical improvement of blood flow cannot be achieved with an adequate revascularization. In our five year late experience, we observed and surgically treated 337 patients with CLI (74% males and 80% atherosclerotic lesions). We discuss the preoperative findings, diagnostic procedures, surgical techniques and relate results.
Giuffrida
G F
GF
Istituto di Chirurgia Generale e Cardiovascolare, Università degli Studi di Milano.
Longhi
F
F
De Monti
M
M
Boneschi
M
M
Miani
S
S
Giordanengo
F
F
D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D001161:Arteriosclerosis / Q000150:complications; D003327:Coronary Disease / Q000150:complications; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000209:etiology; D007511:Ischemia / Q000145:classification / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D007558:Italy / Q000453:epidemiology; D007866:Leg / Q000098:blood supply / Q000601:surgery; D008297:Male; D008833:Microcirculation; D008875:Middle Aged
Ischemia critica agli arti inferiori: patogenesi, clinica e terapia. Risultati della nostra esperienza su 337 casi.