[Medical-legal evaluation of peripheral chronic vascular disease].
The prevalence of chronic obstructive vascular disease of the inferior limbs has been increasing in the western countries. As a consequence, the number of patients affected by this pathology, who undergo public health or forensic medicine examination to obtain the law-established benefits, is constantly rising. This paper illustrates the pathophysiology, epidemiology, clinical and prognostic factors used to attribute the Fontaine and Rutherford class, and the instrumental evaluation parameters necessary for a medical-legal assessment. The authors describe also the variety of welfare and social actions that the social security system provides to this type of patients in Italy, with an overview of damage assessment parameters within the forensic medicine. Finally, the authors suggest medical-legal criteria for the staging of permanent damage in these patients, based on stenosis degree, on systolic pressure measured at the ankle at rest and after exercise, on ankle brachial index, on Doppler morphology and spectral analysis of the velocity peak, and on the walking distance ability.
Molisso
Ciro
C
Servizio di CardioAngiologia, Centro Polispecialistico Medico-Legale INPS per la Regione Campania, Napoli. molissociro@virgilio.it
Molisso
Valentina
V
D002908:Chronic Disease; D006801:Humans; D007558:Italy; D016491:Peripheral Vascular Diseases / Q000175:diagnosis*; D012943:Social Security / Q000331:legislation & jurisprudence