[Critical chronic ischemia of the limbs: organization of the management of a malignant disease].
Chronic critical ischemia of the limbs (CCIL) typically raises the problem of early diagnosis and specialized treatment. The challenge is considerable since the incidence of CCIL is in the range of 500 to 1,000 patients/million inhabitants/year, with an incidence of major amputations from 100 to 300/million inhabitants/year. Mortality of these patients reaches 20% at 6 months and more than 80% at 10 years, which places the CCIL in the group of highly malignant oncological diseases. Despite therapeutic advances, the rate of amputations continues to progress especially in diabetics whose life expectancy is increasing due the excellent contribution of coronaropathy. Prequisites are summarized in the TASC consensus and in the discussions conducted during the creation of vascular centres: multidisciplinary teams, arteriopathy register (including CCIL and center audits), development of protocols (evaluation cost - efficiency of revascularization and medical treatments, evaluation of angiogenesis projects), collaboration between vascular centers and networks. CCIL is a malignant disease with an increasing incidence implying early and specialized care; means exist but efforts have to be made regarding their evaluation and coordination.
Boccalon
H
H
Service de MédecineVasculaire, Pôle cardiovasculaire et métabolique, CHU, TSA 50032, 31059 Toulouse Cedex 9. boccalon.h@chu-toulouse.fr
D000671:Amputation, Surgical; D002908:Chronic Disease; D005121:Extremities / Q000098:blood supply*; D006801:Humans; D007511:Ischemia / Q000401:mortality / Q000628:therapy*; D014652:Vascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality / Q000628:therapy*