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Pharmacotherapy of critical limb ischaemia

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Abstract

Peripheral arterial disease is a frequent cause of morbidity. Five percent of men in the United Kingdom over the age of 50 years suffer from its most common symptom, intermittent claudication [54]. Critical ischaemia which threatens limb survival develops in approximately 12% [58]. The second European Consensus Document on critical limb ischaemia (CLI) [37] describes clinical CLI as patients who have persistent recurring rest pain requiring regular analgesia for greater than 2 weeks and/or ulceration or gangrene of the foot or toes. An ankle systolic pressure of > 50 mmHg is a further, though debated, requirement. A fundamental process in the pathogenesis of CLI is the development of atherosclerosis causing narrowing or occlusion of proximal blood vessels which reduces blood flow and perfusion pressure to the distal circulation. This is the primary problem in CLI which leads to the changes in the microcirculation described below.

Keywords

  • Peripheral Arterial Disease
  • Critical Limb Ischaemia
  • Intermittent Claudication
  • Anti Platelet Therapy
  • Lower Limb Ischaemia

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Belch, J.F., McCollum, P. (1994). Pharmacotherapy of critical limb ischaemia. In: Horsch, S., Claeys, L. (eds) Spinal Cord Stimulation. Steinkopff. https://doi.org/10.1007/978-3-642-48441-4_9

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