title: [Clinical pathways -- intervention or surgery for acute ischemia of the extremities].
abstract: There is still controversial discussion concerning the therapy of limb-threatening ischaemia. In a retrospective study, we investigated and compared surgical and percutaneous interventional methods in the treatment of both embolic and thrombotic vascular occlusions in patients with pre-existing arteriosclerotic disease and attempted to propose therapy guidelines for these methods in the therapy of acute limb ischaemia. Percutaneous mechanical thrombectomy represents a viable therapeutic alternative to surgical or surgical-interventional modalities, particularly in patients with occlusions consisting of soft, embolic material or located in infrapopliteal vessels. The indication for each respective method should be interdisciplinary and must be based on the individual patients' clinical and angiographic findings. Additional intraoperative endovascular procedures increase the range of therapeutic options and permit optimal revascularisation of vessels both proximal and distal to the site of occlusion.
authors.affiliation: Abteilung für Thorax- und Gefässchirurgie, Universitätsklinikum Ulm. gisela.halter@medizin.uni-ulm.de
authors.forename: G
authors.initials: G
authors.lastname: Halter
authors.forename: K-H
authors.initials: KH
authors.lastname: Orend
authors.forename: L
authors.initials: L
authors.lastname: Sunder-Plassmann
mesh_terms: D000208:Acute Disease; D000368:Aged; D000465:Algorithms; D000792:Angiography; D001157:Arterial Occlusive Diseases / Q000601:surgery / Q000628:therapy; D001807:Blood Vessel Prosthesis; D002404:Catheterization; D005121:Extremities / Q000098:blood supply*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D008297:Male; D018579:Patient Selection; D010960:Plasminogen Activators / Q000008:administration & dosage / Q000627:therapeutic use; D012189:Retrospective Studies; D015607:Stents; D017131:Thrombectomy / Q000379:methods; D015912:Thrombolytic Therapy; D013997:Time Factors; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D005343:Fibrinolytic Agents; D010960:Plasminogen Activators; D014568:Urokinase-Type Plasminogen Activator