Review of the Current Basic Science Strategies to Treat Critical Limb Ischemia

2019 ◽  
Vol 53 (4) ◽  
pp. 316-324 ◽  
Author(s):  
Leila Haghighat ◽  
Costin N. Ionescu ◽  
Christopher J. Regan ◽  
Sophia Elissa Altin ◽  
Robert R. Attaran ◽  
...  

Critical limb ischemia (CLI) is a highly morbid disease with many patients considered poor surgical candidates. The lack of treatment options for CLI has driven interest in developing molecular therapies within recent years. Through these translational medicine studies in CLI, much has been learned about the pathophysiology of the disease. Here, we present an overview of the macrovascular and microvascular changes that lead to the development of CLI, including impairment of angiogenesis, vasculogenesis, and arteriogenesis. We summarize the randomized clinical controlled trials that have used molecular therapies in CLI, and discuss the novel imaging modalities being developed to assess the efficacy of these therapies.

VASA ◽  
2012 ◽  
Vol 41 (2) ◽  
pp. 78-88 ◽  
Author(s):  
Lawall ◽  
Zemmrich ◽  
Bramlage ◽  
Amann

Critical limb ischemia (CLI) is the terminal stage of peripheral artery disease. Research in recent years has been largely focussed on treatment options such as bypass surgery / endovascular treatment, surgery / primary amputation and additional benefits of supportive pharmacotherapy. Despite this plethora of treatment options, however, patients continue to have a reduced health related quality of life (HRQoL). Aim of the present work was to review the available evidence of improvement of HRQoL with regard to different treatment options. We found that a number of clinical studies have been conducted using HRQoL measures mostly as secondary outcomes in patients with CLI and other less severe forms of peripheral arterial disease. The studies demonstrate a consistent improvement of HRQoL over baseline within the first few months after the intervention. Prostaglandins, but no other pharmacotherapies, appear to be effective in patients without an option for revascularization. Due to a largely differing patient population under investigation and the different degrees of disease progression it appears difficult however to compare different treatment options with respect to their impact on HRQoL. HRQoL improvement as a predefined endpoint of novel therapeutic approach studies should be considered more consequently.


Diabetes Care ◽  
2016 ◽  
Vol 39 (11) ◽  
pp. 2058-2064 ◽  
Author(s):  
Marlon I. Spreen ◽  
Hendrik Gremmels ◽  
Martin Teraa ◽  
Ralf W. Sprengers ◽  
Marianne C. Verhaar ◽  
...  

2021 ◽  
pp. 153857442198986
Author(s):  
Tammam Harfouch ◽  
Andrei Tarus ◽  
Elena-Teodora Agafitei ◽  
Raluca Ozana Chistol ◽  
Grigore Tinica

The management of peripheral artery disease with no revascularization options can be challenging due to the very limited treatment options available and the high rate of major amputation which is linked to increased mortality and poor quality of life. Using a distal venous bed as an alternative bypass runoff seems to be a viable option when arterial reconstruction is not feasible. We report our experience with distal venous arterialization for limb salvage in non-reconstructable critical limb ischemia and describe the configuration used to achieve venosome directed revascularization in a patient with concomitant varicose veins.


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