Basic data related to endovascular management of peripheral arterial disease in critical limb ischemia.
Chronic critical limb ischemia occurs in the setting of severe peripheral arterial disease that is often characterized by advanced atherosclerosis at multiple levels in the lower extremity. Despite the challenges posed by the complexity of arterial disease in such patients, endovascular intervention is a less invasive alternative to infrainguinal bypass graft surgery in most patients, with low procedural morbidity and mortality. Continual advances in percutaneous techniques have made it possible to revascularize lesions considered nonamenable for endovascular intervention. For example, the development of dedicated peripheral wires, balloons, stents, and catheters allows the recanalization and revascularization of almost any anatomy. Pharmaceutical advances in risk factor modification for recurrent stenosis impact results. Such evolution makes data comparison difficult. This review aims to present the available data on endovascular therapy in critical limb ischemia patients reported over the past 2 decades.
Department of Medicine, Cleveland Clinic, Cleveland, OH, USA.
Sridhar
S
Venkatachalam
Mehdi H
MH
Shishehbor
Bruce H
BH
Gray
D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation; D057785:Catheters; D003251:Constriction, Pathologic; D016638:Critical Illness; D004867:Equipment Design; D019317:Evidence-Based Medicine; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000628:therapy*; D035002:Lower Extremity / Q000098:blood supply*; D018579:Patient Selection; D058729:Peripheral Arterial Disease / Q000150:complications / Q000628:therapy*; D011474:Prosthesis Design; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome