title: Lower-limb ischemia in the young patient: management strategies in an endovascular era.
abstract: BACKGROUND
  The aim of this paper is to review the potential role of endovascular interventions for young patients with lower-limb ischaemia.
  
  
  METHODS
  A literature search was performed of PubMed and Medline databases using appropriate search terms and limits. Case reports, retrospective studies, and prospective studies evaluating treatment of lower-limb ischemia in patients aged <50 years were scrutinized. Articles published between 1966 and 2010 were included in this review.
  
  
  RESULTS
  Premature atherosclerosis is likely to represent the commonest cause of lower-limb ischemia in patients aged <50 years, although the incidence of nonatherosclerotic causes such as popliteal entrapment syndrome, cystic adventitial disease, and arteritis in these patients is greater than in older patients. As with older patients, endovascular interventions may be beneficial for patients with symptoms secondary to atherosclerosis. At present, the perceived durability of open surgery may be more preferable to patients aged <50 years, but the development of new endovascular technology is challenging this view. Endovascular interventions such as catheter-directed thrombolysis have specific roles in the treatment of lower-limb ischemia due to nonatherosclerotic causes.
  
  
  CONCLUSIONS
  The use of angioplasty and stenting procedures to treat young patients with lower-limb ischemia is increasing and has specific roles. However, many developmental causes and nonatherosclerotic conditions still require primary surgical correction.
authors: Department of Surgery and Cancer, Imperial College London, London, UK.
authors: Abigail
authors: A
authors: Morbi
authors: Manj S
authors: MS
authors: Gohel
authors: Mohamed
authors: M
authors: Hamady
authors: Nicholas J W
authors: NJ
authors: Cheshire
authors: Colin D
authors: CD
authors: Bicknell
mesh_terms: D000367:Age Factors; D019468:Disease Management; D057510:Endovascular Procedures / Q000592:standards*; D014943:Global Health; D006801:Humans; D015994:Incidence; D007511:Ischemia / Q000453:epidemiology / Q000628:therapy*; D007866:Leg / Q000098:blood supply*; D017410:Practice Guidelines as Topic; D012307:Risk Factors