Document Detail

Endovascular therapy for critical limb ischemia.
MedLine Citation:
PMID:  18687765     Owner:  NLM     Status:  MEDLINE    
Chronic critical limb ischemia (CLI) occurs when arterial perfusion is reduced below a threshold level that results in rest pain and/or tissue breakdown in the lower extremities. Importantly, it is associated with high cardiovascular morbidity and mortality. Without prompt revascularization, CLI may result in loss of a limb (i.e. amputation) and/or life. The goal of endovascular therapy is the re-establishment of pulsatile, straight-line flow to the distal extremity. Percutaneous transluminal angioplasty (PTA) has been shown to be effective and safe in the setting of CLI, with limb salvage rates that compare favorably with surgical procedures. Stents are indicated for failed PTA, while adjunctive therapies such as lasers, thermal angioplasty and atherectomy devices lack data demonstrating improved efficacy compared with conventional lower extremity interventions. In addition to successful revascularization, the institution of lifestyle changes, atherosclerotic risk factor modification, and pharmacologic therapies are indicated to reduce cardiovascular morbidity and mortality.
Salman A Arain; Christopher J White
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Vascular medicine (London, England)     Volume:  13     ISSN:  1358-863X     ISO Abbreviation:  Vasc Med     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-08     Completed Date:  2009-01-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9610930     Medline TA:  Vasc Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  267-79     Citation Subset:  IM    
Department of Cardiology, Ochnser Clinic Foundation, New Orleans, LA 70121, USA.
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MeSH Terms
Angioplasty, Balloon*
Arterial Occlusive Diseases / epidemiology,  therapy*
Drug-Eluting Stents
Ischemia / epidemiology,  therapy*
Leg / blood supply*
Limb Salvage / methods*
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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