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Critical appraisal of surgical revascularization for critical limb ischemia.

Abstract：

:Peripheral artery disease is growing in global prevalence and is estimated to afflict between 8 and 12 million Americans. Its most severe form, critical limb ischemia (CLI), is associated with high rates of limb loss, morbidity, and mortality. Revascularization is the cornerstone of limb preservation in CLI, and has traditionally been accomplished with open surgical bypass. Advances in catheter-based technologies, coupled with their broad dissemination among specialists, have led to major shifts in practice patterns in CLI. There is scant high-quality evidence to guide surgical decision making in this arena, and market forces have exerted profound influences. Despite this, available data suggest that the expected outcomes for both endovascular and open surgery in CLI are strongly dependent on definable patient factors such as anatomic distribution of disease, vein quality, and comorbidities. Optimal patient selection is paramount for maximizing benefit with each technique. This review summarizes some of the existing data and suggests a selective approach to revascularization in CLI, which continues to rely on vein bypass surgery as a primary option in appropriately selected patients.

journal_name

J Vasc Surg

journal_title

Journal of vascular surgery

authors

Conte MS

doi

10.1016/j.jvs.2012.05.114

subject

Has Abstract

pub_date

2013-02-01 00:00:00

pages

8S-13S

issue

2 Suppl

eissn

0741-5214

issn

1097-6809

pii

S0741-5214(12)02312-9

journal_volume

57

pub_type

杂志文章,评审

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