Endovascular therapy for critical limb ischemia

Expert Review of Cardiovascular Therapy
Arturo DominguezMitul Patel

Abstract

Critical limb ischemia (CLI) represents an advanced disease state of peripheral arterial disease. It manifests as lower extremity ischemic rest pain or ischemic skin lesions leading to ulceration or gangrene. Patients with CLI often have multiple medical comorbidities and a 1-year mortality rate of 25% and a 1-year amputation rate of 25%. Historically, bypass surgery with autogenous veins for flow restoration has been the first-line therapy for CLI. However, advances in endovascular techniques and device technology have changed the treatment paradigm. Catheter-based technologies are rapidly evolving at a rate that is outpacing large-scale studies evaluating relevant clinical outcomes. Patients with CLI require a multidisciplinary management approach centered on aggressive medical therapies, wound care and prompt revascularization, with an emphasis on limb salvage. This review summarizes the contemporary endovascular therapies including balloon angioplasty, atherectomy and bare-metal stenting. In addition, we review emerging technologies, such as drug-eluting stents, drug-coated balloons and chronic total occlusion recanalization devices.

References

Oct 6, 1997·Journal of Vascular Surgery·R B RutherfordD N Jones
Aug 7, 2001·Journal of Vascular and Interventional Radiology : JVIR·R WaksmanUNKNOWN Peripheral Artery Radiation Investigational Study (PARIS) Investigators
Jul 5, 2003·Journal of Vascular Surgery·Mark R NehlerWilliam C Krupski
Dec 6, 2003·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Thomas ZellerFranz-Josef Neumann
Dec 30, 2003·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Gary M AnselBarry S George
Jun 4, 2004·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Ramin R SaketMichael D Dake
Sep 3, 2004·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Fernando BoccalandroOscar R Rosales
Dec 16, 2004·Annals of Vascular Surgery·Jamal F RabbiAlan Dardik
Jan 18, 2005·Journal of the American College of Cardiology·Dierk ScheinertAndrej Schmidt
Mar 11, 2005·Journal of Vascular and Interventional Radiology : JVIR·Stephan H DudaJean P Bérégi
Jul 14, 2005·Journal of Vascular Surgery·Jamal BaraniAnders Gottsäter
Jul 22, 2005·Cardiovascular and Interventional Radiology·Manfred Cejna
Aug 18, 2005·Journal of Vascular and Interventional Radiology : JVIR·John LairdJames D Joye
Dec 21, 2005·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Oliver SchlagerMartin Schillinger
Feb 1, 2006·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·John R LairdUNKNOWN LACI Investigators
Feb 1, 2006·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·David E KandzariRoger S Gammon
Feb 21, 2006·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Rajeev SuriBoulos Toursarkissian
May 5, 2006·The New England Journal of Medicine·Martin SchillingerErich Minar
Jun 10, 2006·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Gloria MelziAntonio Colombo
Jul 5, 2006·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Peter J MossopRobert J Whitbourn
Oct 18, 2006·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Venkatesh RamaiahUNKNOWN TALON Registry
Oct 19, 2006·Journal of the American College of Cardiology·Thomas ZellerFranz-Josef Neumann
Dec 5, 2006·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·L NorgrenKenneth Rosenfield
Dec 13, 2006·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Stephan H DudaJean-Paul Beregi
Jan 16, 2007·Journal of Vascular Surgery·L NorgrenUNKNOWN TASC II Working Group
Aug 29, 2007·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Thomas ZellerDierk Scheinert
Oct 2, 2007·Journal of Vascular Surgery·Eric C ScottJean M Panneton
Oct 31, 2007·Circulation·Jason H Rogers, John R Laird
Dec 7, 2007·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Tony DasJohn E Aruny
Feb 15, 2008·The New England Journal of Medicine·Gunnar TepeUlrich Speck
Mar 29, 2008·Journal of Vascular Surgery·Marcello RomitiNelson De Luccia

❮ Previous
Next ❯

Citations

Jun 9, 2017·Journal of Interventional Cardiology·Shohei KataokaNobuhisa Hagiwara
Aug 11, 2017·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Ehtisham MahmudRyan R Reeves
Sep 16, 2017·Expert Review of Cardiovascular Therapy·Ali PourdjabbarEhtisham Mahmud
Jul 5, 2017·Circulation Journal : Official Journal of the Japanese Circulation Society·Kentaro JujoNobuhisa Hagiwara
Feb 27, 2021·The Journal of Cardiovascular Surgery·Nathalie Moreels, Isabelle VAN Herzeele
Sep 2, 2021·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·Taira KobayashiShinya Takahashi

❮ Previous
Next ❯

Related Concepts

Related Feeds

Brain Ischemia

Brain ischemia is a condition in which there is insufficient blood flow to the brain to meet metabolic demand. Discover the latest research on brain ischemia here.

Related Papers

Current Treatment Options in Cardiovascular Medicine
Warren J GasperChristopher D Owens
The Journal of Cardiovascular Surgery
A GulatiL A Garcia
Progress in Cardiovascular Diseases
Philip B Dattilo, Ivan P Casserly
© 2022 Meta ULC. All rights reserved