Faculty Opinions recommendation of Pathology of peripheral artery disease in patients with critical limb ischemia.

2018 ◽  
Author(s):  
Joseph Emmerich
Keyword(s):  
Peripheral Artery Disease ◽  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Peripheral Artery ◽  
Artery Disease

Multi-Level Lower Extremity Arterial Revascularization Via Retrograde Pedal Access Under Local Anesthesia in a Patient With Severe Cardiopulmonary Comorbidities: A Case Report

2021 ◽  
pp. 153857442110264
Author(s):  
Hee Korleski ◽  
Laura DiChiacchio ◽  
Luiz Araujo ◽  
Michael R. Hall
Keyword(s):  
Case Report ◽  
General Anesthesia ◽  
Peripheral Artery Disease ◽  
Critical Limb Ischemia ◽  
Treatment Modality ◽  
Conventional Treatment ◽  
Limb Ischemia ◽  
Peripheral Artery ◽  
Endovascular Revascularization ◽  
Artery Disease

Background: Chronic limb-threatening ischemia is a severe form of peripheral artery disease that leads to high rates of amputation and mortality if left untreated. Bypass surgery and antegrade endovascular revascularization through femoral artery access from either side are accepted as conventional treatment modalities for critical limb ischemia. The retrograde pedal access revascularization is an alternative treatment modality useful in specific clinical scenarios; however, these indications have not been well described in literature. This case report highlights the use of retrograde pedal access approach as primary treatment modality in a patient with an extensive comorbidities precluding general anesthesia nor supine positioning. Case Presentation: The patient is a 60-year-old female with multiple severe cardiopulmonary comorbidities presenting with dry gangrene of the right great toe. Her comorbidities and inability to tolerate supine positioning precluded her from receiving open surgery, general anesthesia or monitored sedation, or percutaneous femoral access. Rather, the patient underwent ankle block and retrograde endovascular revascularization via dorsalis pedis artery access without post-operative complications. Discussion: The prevalence of comorbidities related to peripheral artery disease is increasing and with it the number of patients who are not optimal candidates for conventional treatment methods for critical limb ischemia. The retrograde pedal access revascularization as initial treatment modality offers these patients an alternative limb salvaging treatment option.

scholarly journals Awareness of Scleroderma Peripheral Artery Disease Presenting With Critical Limb Ischemia in Elderly Patients

2019 ◽  
Vol 83 (5) ◽  
pp. 1081
Author(s):  
Sayaka Funabashi ◽  
Osami Kawarada ◽  
Toru Hirano ◽  
Shinobu Ayabe ◽  
Takeshi Yagyu ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Peripheral Artery Disease ◽  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Peripheral Artery ◽  
Artery Disease

scholarly journals CKD and Acute and Long-Term Outcome of Patients with Peripheral Artery Disease and Critical Limb Ischemia

2015 ◽  
Vol 11 (2) ◽  
pp. 216-222 ◽  
Author(s):  
Florian Lüders ◽  
Holger Bunzemeier ◽  
Christiane Engelbertz ◽  
Nasser M. Malyar ◽  
Matthias Meyborg ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Peripheral Artery ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Artery Disease

Differences Between Patients With Intermittent Claudication and Critical Limb Ischemia Undergoing Endovascular Intervention: Insights From the Excellence in Peripheral Artery Disease Registry

2021 ◽  
Author(s):  
Kunal Patel ◽  
Yulun Liu ◽  
Farshid Etaee ◽  
Chirag Patel ◽  
Peter Monteleone ◽  
...  
Keyword(s):  
Intermittent Claudication ◽  
Peripheral Artery Disease ◽  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Endovascular Intervention ◽  
Baseline Risk ◽  
Peripheral Artery ◽  
Disease Registry ◽  
Endovascular Revascularization ◽  
Artery Disease

Background: There are limited data on differences in angiographic distribution of peripheral artery disease and endovascular revascularization strategies in patients presenting with intermittent claudication (IC) and critical limb ischemia (CLI). We aimed to compare anatomic features, treatment strategies, and clinical outcomes between patients with IC and CLI undergoing endovascular revascularization. Methods: We examined 3326 patients enrolled in the Excellence in Peripheral Artery Disease registry from 2006 to 2019 who were referred for endovascular intervention for IC (n=1983) or CLI (n=1343). The primary outcome was 1-year major adverse limb events, which included death, repeat target limb revascularization, or target limb amputation. Results: Patients with CLI were older and more likely to have diabetes and chronic kidney disease and less likely to receive optimal medical therapy compared with IC. Patients with IC had higher femoropopliteal artery interventions (IC 87% versus CLI 65%; P <0.001), while below the knee interventions were more frequent in CLI (CLI 47% versus IC 12%; P <0.001). Patients with CLI were more likely to have multilevel peripheral artery disease (CLI 32% versus IC 15%, P <0.001). Patients with IC were predominantly revascularized with stents (IC 48% versus CLI 37%; P <0.001) while balloon angioplasty was more frequent in CLI (CLI 37% versus IC 25%; P <0.001). All-cause mortality was higher in patients with CLI (CLI 4% versus IC 2%; P =0.014). Major adverse limb event rates for patients with IC and CLI were 16% and 26%, respectively ( P <0.001) and remained higher in CLI after multivariable adjustment of baseline risk factors. Conclusions: Patients with IC and CLI have significant anatomic, lesion, and treatment differences with significantly higher mortality and adverse limb outcomes in CLI. REGISTRATION: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01904851.

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