title: [The role of drug therapy in the treatment of critical ischemia of the lower limbs].
abstract: A SERIOUS CONDITION: Critical ischemia results when severe chronic ischemia worsens, creating a threatening situation for tissue survival in the lower limbs. The degree of ischemia is related to the extent of impairment in microcirculation, adding further deleterious effects to stenoses and/or obstructions of the large vessels. MANAGEMENT DIFFICULTIES: Surgery is the mainstay therapy for critical ischemia of the lower limbs. Medical therapy is indicated as first intention treatment in only 10 to 15% of the patients and in a small proportion after partial or total surgical failure when immediate secondary amputation appears to be avoidable. TREATMENTS USED: Antithrombosis agents and drugs with a hemorrheologic effect are used in case of surgical failure or non-indication for surgery. Iloprost is one of the most extensively studied hemorrheology agents. Its use improves the chances of avoiding amputation within a mid-term delay. BUERGER DISEASE: Buerger disease is a specific condition different from the two other major causes (artherothrombosis and diabetes mellitus). The therapeutic management and functional prognosis are much different.
authors.affiliation: Médecine interne B, CHU Bretonneau, Tours.
authors.forename: J L
authors.initials: JL
authors.lastname: Guilmot
authors.forename: E
authors.initials: E
authors.lastname: Diot
mesh_terms: D002908:Chronic Disease; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D007511:Ischemia / Q000188:drug therapy* / Q000503:physiopathology; D007866:Leg / Q000098:blood supply*; D013919:Thromboangiitis Obliterans / Q000188:drug therapy
chemical_list: D005343:Fibrinolytic Agents