The Value of Using a Dedicated Vascular Lab in Managing and Treating Diabetic Critical Limb Ischemia Patients

2020 ◽  
Vol 44 (2) ◽  
pp. 79-82
Author(s):  
Evan Poppe ◽  
Richard Trogden ◽  
Leslie Wormely
Keyword(s):  
Critical Limb Ischemia ◽  
Wound Care ◽  
Limb Ischemia ◽  
Interventional Cardiology ◽  
Limb Loss ◽  
Advanced Level ◽  
Number Of Patients ◽  
End Stage ◽  
Experienced Team

Critical limb ischemia (CLI) is a debilitating end stage of advanced peripheral vascular disease. Treating CLI, particularly in the diabetic patient, is a multifaceted process that requires an experienced team of providers. The CLI model employs practitioners from interventional cardiology, vascular surgery, wound care, endocrinology, nephrology, internal medicine, and podiatry. The main treatment goal is to improve quality of life and reduce the number of limb amputations and the subsequent complications. Often, multiple endovascular procedures are needed to restore perfusion to the lower leg and foot to prevent limb loss. The overall health care savings are significant if limb loss is avoided despite requiring multiple procedures. The number of patients, particularly diabetics, who will need this advanced level of care is only expected to rise.

scholarly journals Critical Limb Ischemia and Its Impact on Patient Health Preferences and Quality of Life—An International Study

2012 ◽  
Vol 21 (03) ◽  
pp. 139-146 ◽  
Author(s):  
Giovanni Pisa ◽  
Thomas Reinhold ◽  
Eliot Obi-Tabot ◽  
Maria Bodoria ◽  
Bernd Brüggenjürgen
Keyword(s):  
Quality Of Life ◽  
Critical Limb Ischemia ◽  
International Study ◽  
Limb Ischemia ◽  
Patient Health

scholarly journals Quality of life in patients with no-option critical limb ischemia underlines the need for new effective treatment

2010 ◽  
Vol 52 (4) ◽  
pp. 843-849.e1 ◽  
Author(s):  
Ralf W. Sprengers ◽  
Martin Teraa ◽  
Frans L. Moll ◽  
G. Ardine de Wit ◽  
Yolanda van der Graaf ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Effective Treatment ◽  
Critical Limb Ischemia ◽  
Limb Ischemia

scholarly journals Cell Therapy in Patients with Critical Limb Ischemia

2015 ◽  
Vol 2015 ◽  
pp. 1-13 ◽  
Author(s):  
Rita Compagna ◽  
Bruno Amato ◽  
Salvatore Massa ◽  
Maurizio Amato ◽  
Raffaele Grande ◽  
...  
Keyword(s):  
Cell Therapy ◽  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Tissue Loss ◽  
Systematic Analysis ◽  
Peripheral Arterial Obstructive Disease ◽  
Peripheral Arterial ◽  
Cellular Components

Critical limb ischemia (CLI) represents the most advanced stage of peripheral arterial obstructive disease (PAOD) with a severe obstruction of the arteries which markedly reduces blood flow to the extremities and has progressed to the point of severe rest pain and/or even tissue loss. Recent therapeutic strategies have focused on restoring this balance in favor of tissue survival using exogenous molecular and cellular agents to promote regeneration of the vasculature. These are based on stimulation of angiogenesis by extracellular and cellular components. This review article carries out a systematic analysis of the most recent scientific literature on the application of stem cells in patients with CLI. The results obtained from the detailed analysis of the recent literature data have confirmed the beneficial role of cell therapy in reducing the rate of major amputations in patients with CLI and improving their quality of life.

Cumulative Number of Treatment Interventions Predicts Health-Related Quality of Life In Patients With Critical Limb Ischemia

2016 ◽  
Vol 34 ◽  
pp. 14
Author(s):  
Matthew P. Goldman ◽  
Ryan Barnard ◽  
Santiago Saldana ◽  
Jeanette M. Stafford ◽  
Douglas Easterling ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Cumulative Number ◽  
Health Related Quality ◽  
Treatment Interventions ◽  
Related Quality ◽  
Health Related ◽  
Number Of Treatment

Multidisciplinary Care for Critical Limb Ischemia: Current Gaps and Opportunities for Improvement

2019 ◽  
Vol 26 (2) ◽  
pp. 199-212 ◽  
Author(s):  
Ehrin J. Armstrong ◽  
Syed Alam ◽  
Steve Henao ◽  
Arthur C. Lee ◽  
Brian G. DeRubertis ◽  
...  
Keyword(s):  
Critical Limb Ischemia ◽  
Patient Population ◽  
Wound Care ◽  
Multidisciplinary Care ◽  
Limb Ischemia ◽  
Medical Specialty ◽  
Complex Patient ◽  
Arterial Insufficiency ◽  
Artery Disease ◽  
Improve Patient

Critical limb ischemia (CLI), defined as ischemic rest pain or nonhealing ulceration due to arterial insufficiency, represents the most severe and limb-threatening manifestation of peripheral artery disease. A major challenge in the optimal treatment of CLI is that multiple specialties participate in the care of this complex patient population. As a result, the care of patients with CLI is often fragmented, and multidisciplinary societal guidelines have not focused specifically on the care of patients with CLI. Furthermore, multidisciplinary care has the potential to improve patient outcomes, as no single medical specialty addresses all the facets of care necessary to reduce cardiovascular and limb-related morbidity in this complex patient population. This review identifies current gaps in the multidisciplinary care of patients with CLI, with a goal toward increasing disease recognition and timely referral, defining important components of CLI treatment teams, establishing options for revascularization strategies, and identifying best practices for wound care post-revascularization.

scholarly journals In-hospital outcomes in patients with critical limb ischemia and end-stage renal disease after revascularization

2016 ◽  
Vol 63 (4) ◽  
pp. 966-973 ◽  
Author(s):  
Alexander Meyer ◽  
Werner Lang ◽  
Matthias Borowski ◽  
Giovanni Torsello ◽  
Theodosios Bisdas ◽  
...  
Keyword(s):  
Renal Disease ◽  
Critical Limb Ischemia ◽  
End Stage Renal Disease ◽  
Limb Ischemia ◽  
Hospital Outcomes ◽  
Stage Renal Disease ◽  
End Stage

scholarly journals Endovascular invasions for femoral-popliteal segment disorders of C andD-type according to TASC-II classification

2018 ◽  
Vol 24 (2) ◽  
pp. 69-76
Author(s):  
O.L. Nikishin ◽  
M.I. Muz ◽  
A.I. Gavretskiy ◽  
I.V. Altman ◽  
S.I. Savoluk
Keyword(s):  
Peripheral Arterial Disease ◽  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Vascular Bed ◽  
Number Of Patients ◽  
Surgical Methods ◽  
Peripheral Arterial ◽  
Surgical Treatments ◽  
Medical Recommendations

Currently, direct re-vascularization for the management of critical limb ischemia (CLI) is effectuated through open and hybrid surgical treatments. At the same time, therapeutic recommendations for one of the methods appear as a subject of lasting discussions. Today TASC II (TransAtlantic Inter-Society Consensus for the Management of Peripheral Arterial Disease) adopted in 2007 is the most popular document that provides justifications for endovascular and surgical treatment of peripheral arterial disease. Clinical practice provides evidence that there is a significant number of patients having critical limb ischemia who suffer from vascular bed disorders and are classified as C or D-type according to TASC classification. Meanwhile, there also are cases when these patients have no other alternative than re-vascularization by means of open surgery, which is why endovascular invasion appears as the only method of re-vascularization for them. The article presents some results of comparative studies within endovascular and surgical tools aimed at revascularization in the area of femoral-popliteal segment, including cases where patients are classified as C and D-type. The results of shunting operations are compared to angioplasty and remote endarterectomy, whereas technical methods for re-entry during subintimal angioplasty are regarded apart. Despite the fact that there are medical recommendations for the use of endovascular and surgical methods depending on TASC II classification, today there is no evidence that these tools can be efficient in revascularization of femoral-popliteal segment. In order to identify the efficiency of distinct methods in revascularization of femoral-popliteal segment there a need in a number of extended randomized studies designed to evaluate the role of such factors, as anatomic location of the vascular bed disorder, the extent of a disease, the location of purolo-necrotic areas as well as other pathologies on the results of the study.

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