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Current State of Diagnosis and Management of Critical Limb Ischemia

  • Peripheral Vascular Disease (M Shishehbor, Section Editor)
  • Published:
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Abstract

Critical limb ischemia represents the most severe form of peripheral arterial disease and carries with it severe morbidity and mortality risks. Because of comorbidity risks, early diagnosis and aggressive medical management make up an important part of the treatment paradigm for these individuals. However, in addition to managing these comorbid conditions, the physician caring for these individuals must be able to provide revascularization options that will improve arterial flow to the threatened extremity and assure healing of complicated wounds. Both open surgical and endovascular therapies have proven beneficial in restoring flow to severely ischemic limbs in these patients. Additionally, combinations of the above therapeutic methods have offered more available options for these patients. This article reviews care of patients with critical limb ischemia with critical assessment of options for medical and revascularization options.

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Abbreviations

ABSOLUTE:

Balloon Angioplasty Versus Stenting with Nitinol Stents in the Superficial Femoral Artery

BASIL:

Bypass Versus Angioplasty in Severe Ischemia of the Leg

CAPRIE:

Clopidogrel Versus Aspirin in Patients at Risk of Ischemic Events

CASPAR:

Clopidogrel and Acetylsalicylic Acid in Bypass Surgery for Peripheral Arterial Disease

CHARISMA:

Clopidogrel for High Atherothrombotic Risk and Ischemia Stabilization, Management, and Avoidance

EUROPA:

European Trial on Reduction of Cardiac Events with Perindopril in Stable Coronary Artery Disease

FemPac:

Femoral Paclitaxel

HOPE:

Heart Outcomes Prevention Evaluation

PREVENT III:

Project of Ex-Vivo Vein Graft Engineering Via Transfection III

RESILIENT:

Edwards Lifesciences Self-Expanding Stent Peripheral Vascular Disease Study

SIROCCO:

Sirolimus-Coated Cordis Self-Expandable Stent

STRIDES:

SFA Treatment with Drug-Eluting Stents Study

THUNDER:

Local Taxan with Short Time Exposure for Reduction of Restenosis in Distal Arteries

UKPDS:

United Kingdom Prospective Diabetes Study

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Disclosure

Conflicts of interest: D.Clair: has been a consultant for GORE, Endologix, Boston Scientific, Vessix Vascular, and Medtronic; S. Shah: none; J. Weber: none.

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Authors and Affiliations

  1. Department of Vascular Surgery, Cleveland Clinic Lerner College of Medicine, 9500 Euclid Avenue—H32, Cleveland, OH, 44195, USA

    Dan Clair, Samir Shah & John Weber

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  1. Dan Clair
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  2. Samir Shah
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Correspondence to Dan Clair.

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Clair, D., Shah, S. & Weber, J. Current State of Diagnosis and Management of Critical Limb Ischemia. Curr Cardiol Rep 14, 160–170 (2012). https://doi.org/10.1007/s11886-012-0251-4

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