A case for an aggressive reconstruction policy for CLI.
Chronic critical leg ischaemia (CLI) occurs with increasing frequency in the population. A main reason for this is the increasing proportion of elderly persons in the population. CLI mostly affects persons over the age of 65 and a substantial proportion of the patients are more than 80 years old. Most patients have multiple risk factors, the most frequent being diabetes and various manifestations of cardiovascular disease. The main arterial changes are found in infrainguinal arteries in three-quarters of the patients and in 25-50% of the patients CLI will also affect the other leg at some time. Long infrainguinal bypasses are necessary for a successful treatment in most cases. Despite problems, reconstructive arterial surgery can be performed with acceptable morbidity and mortality. Re-interventions are necessary for many patients and regular follow-up should be a part of the treatment. The clinical results can ensure that most patients will have a reasonable quality of life. For society, reconstructive surgery is cost-effective as it reduces costs for long term care that otherwise would have been necessary after amputations.
Luther
M
M
Surgical Department, Vaasa Central Hospital, Finland. michael.luther@pp.inet.fi
D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D000800:Angioplasty, Balloon; D001158:Arteries / Q000601:surgery; D002908:Chronic Disease; D016638:Critical Illness; D005260:Female; D006801:Humans; D007511:Ischemia / Q000601:surgery*; D007866:Leg / Q000098:blood supply*; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D011788:Quality of Life; D014656:Vascular Surgical Procedures