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Critical Limb Ischemia pp 71–77Cite as

Overlap of Atherosclerotic Disease

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Abstract

The importance of identifying overlap disease aids not only in perioperative management but may explain the long-term success or failure of operative interventions. Arterial disease represents a systemic process; thus, isolated interventions may benefit regional symptoms but do not change the overall prognosis for patients. Mitigating these systemic risk factors would logically not only improve perioperative morbidity and mortality but also long-term survival.

Follow-up data from the REACH registry at 3 years demonstrated, similar to the 1-year follow-up, that patients with multivessel disease had nearly double the event rates (MI, vascular death, rehospitalization) compared to those with single disease (40.5 % vs 25.5 %) (Alberts et al., Eur Heart J 30:2318–2326, 2009; Steg et al., JAMA 297:1197–1206, 2007). Progression from uni- to poly-vascular disease varies based upon the initial location of disease. Not only progression to poly-vascular disease but event rates also vary based upon the primary vascular bed with PAD carrying the worst prognosis for both progression to multivessel disease and event rate (Alberts et al., Eur Heart J 30:2318–2326, 2009).

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Authors and Affiliations

  1. General Surgery, University of Chicago, Chicago, IL, USA

    Natalie Gwilliam MD

  2. Vascular Surgery, Center for Aortic Diseases, University of Chicago, 5841 S. Maryland Ave., MC5028, Chicago, IL, 60637, USA

    Ross Milner MD

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  1. Natalie Gwilliam MD
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  1. Loyola University Medical Center, Maywood, Illinois, USA

    Robert S. Dieter

  2. Northwestern Medicine Central DuPage Hospital, Glen Ellyn, Illinois, USA

    Raymond A. Dieter, Jr

  3. The University of Tennessee Medical Center, Knoxville, Tennessee, USA

    Raymond A. Dieter, III

  4. West Virginia University, Charleston, West Virginia, USA

    Aravinda Nanjundappa

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Gwilliam, N., Milner, R. (2017). Overlap of Atherosclerotic Disease. In: Dieter, R., Dieter, Jr, R., Dieter, III, R., Nanjundappa, A. (eds) Critical Limb Ischemia. Springer, Cham. https://doi.org/10.1007/978-3-319-31991-9_9

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