[Treatment of critical lower limb ischemia--where are we standing at the turn of the Millennium?].
The treatment of chronic critical limb ischaemia (CLI) is a very important and constantly developing field of vascular surgery. The high incidence of CLI (50-100/100,000 inhabitants [10]) means that vascular surgeons at a district general hospital/county hospital, providing care for 250-300,000 people, see about 120-150 cases in a year, 70-75% of them needing elective or acute intervention. We have witnessed many important changes over the last 1-2 decades in the management of this substantial field of vascular surgery. The in situ technique, angioscopically assisted valvulotomy, venous cuffs and A-V fistulae at the distal anastomosis of an infrainguinal bypass, the intraluminal and subintimal angioplasty-technique in hand, graft-surveillance programmes and the more aggressive treatment of graft-infection all provide a potentially better chance for limb salvage. Do we follow the trends and seize them?
Papp
L
L
Vascular Surgery Office, Royal Infirmary of Edinburgh, Lauriston Place, Edinburgh EH3 9YW Scotland.
D000208:Acute Disease; D000714:Anastomosis, Surgical; D001807:Blood Vessel Prosthesis; D002908:Chronic Disease; D016638:Critical Illness; D006801:Humans; D007511:Ischemia / Q000150:complications / Q000601:surgery* / Q000628:therapy; D007866:Leg / Q000098:blood supply*; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000601:surgery; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000379:methods