| Chronic critical limb ischemia: diagnosis, treatment and prognosis. | |
| | |
MedLine Citation:
|
PMID: 10208708 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Chronic critical limb ischemia is manifested by pain at rest, nonhealing wounds and gangrene. Ischemic rest pain is typically described as a burning pain in the arch or distal foot that occurs while the patient is recumbent but is relieved when the patient returns to a position in which the feet are dependent. Objective hemodynamic parameters that support the diagnosis of critical limb ischemia include an ankle-brachial index of 0.4 or less, an ankle systolic pressure of 50 mm Hg or less, or a toe systolic pressure of 30 mm Hg or less. Intervention may include conservative therapy, revascularization or amputation. Progressive gangrene, rapidly enlarging wounds or continuous ischemic rest pain can signify a threat to the limb and suggest the need for revascularization in patients without prohibitive operative risks. Bypass grafts are usually required because of the multilevel and distal nature of the arterial narrowing in critical limb ischemia. Patients with diabetes are more likely than other patients to have distal disease that is less amenable to bypass grafting. Compared with amputation, revascularization is more cost-effective and is associated with better perioperative morbidity and mortality. Limb preservation should be the goal in most patients with critical limb ischemia. |
| | |
Authors:
|
J D Santilli; S M Santilli |
Related Documents
:
|
15229738 - Vascular complications associated with the use of intraaortic balloon pumping. 11054228 - The value of air plethysmography in predicting clinical outcome after surgical treatmen... 17309918 - Use of a constitutively active hypoxia-inducible factor-1alpha transgene as a therapeut... 10757378 - Roux-en-y limb motility after total or distal gastrectomy in symptomatic and asymptomat... 21616558 - Narrowband ultraviolet b phototherapy for the treatment of steroid-refractory and stero... 17570788 - The deflux procedure reduces the incidence of urinary tract infections in patients with... |
Publication Detail:
|
Type: Journal Article; Review |
Journal Detail:
|
Title: American family physician Volume: 59 ISSN: 0002-838X ISO Abbreviation: Am Fam Physician Publication Date: 1999 Apr |
Date Detail:
|
Created Date: 1999-04-23 Completed Date: 1999-04-23 Revised Date: 2005-11-16 |
Medline Journal Info:
|
Nlm Unique ID: 1272646 Medline TA: Am Fam Physician Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 1899-908 Citation Subset: AIM; IM |
Affiliation:
|
Department of Family Practice and Community Health, University of Minnesota School of Medicine, Minneapolis, USA. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Amputation Chronic Disease Critical Illness Diagnosis, Differential Humans Ischemia / diagnosis*, etiology, physiopathology, therapy* Leg / blood supply* Pulse Risk Factors Wound Healing |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Multiple myeloma: recognition and management.
Next Document: Insomnia.