title: Treatment of infrapopliteal critical limb ischemia in 2013: the wound perfusion approach.
abstract: The primary goals of treatment for critical limb ischemia (CLI) are alleviation of ischemic rest pain, healing of arterial insufficiency ulcers, and improving quality of life. These goals are directed toward preventing limb loss and CLI-related mortality. Arterial revascularization serves as the foundation of a contemporary approach to promote amputation-free survival. Mounting evidence supports a wound-directed angiosome revascularization approach, increasingly achieved with endovascular techniques. Innovations in technology and wound-perfusion strategy have advanced patient care and are accelerating the pace of CLI treatment. The evolving angiosome revascularization approach has been augmented with a multidisciplinary wound care strategy that deserves particular emphasis. These state-of-the-art advances in CLI management are reported herein with considerations for the future treatment of CLI.
authors.affiliation: Robert & Suzanne Tomsich Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic, Mail code J3-5, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Bunte
authors.forename: Mehdi H
authors.initials: MH
authors.lastname: Shishehbor
mesh_terms: D000671:Amputation, Surgical; D017130:Angioplasty / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000473:pathology / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007511:Ischemia / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D023821:Limb Salvage / Q000379:methods*; D035002:Lower Extremity / Q000473:pathology*; D008297:Male; D010477:Perfusion / Q000379:methods*; D011150:Popliteal Artery / Q000473:pathology*; D012307:Risk Factors; D016896:Treatment Outcome; D014945:Wound Healing