[Peripheral arterial obstruction and acute lower limb ischemia]

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Endovascular Therapy

Background:

• Lower limb ischemia presents acute and chronic forms, necessitating diverse treatment strategies.
• Endovascular techniques and open surgical vascular strategies offer varied therapeutic possibilities.
• Combined endovascular and open surgical approaches may offer synergistic benefits.

Purpose of the Study:

• To present current evidence-based treatment recommendations for acute and chronic lower limb ischemia.
• To compare endovascular and open surgical interventions, acknowledging the lack of prospective randomized controlled trials.
• To discuss therapeutic rules across different vascular segments for peripheral arterial disease.

Main Methods:

• Review of current evidence-based treatment recommendations.
• Discussion of endovascular techniques and open surgical vascular strategies.
• Analysis of therapeutic approaches for aortoiliac and infrainguinal segments in acute and chronic peripheral arterial disease.

Main Results:

• Aortoiliac revascularization for chronic obstructions increasingly utilizes endovascular or hybrid procedures.
• Acute aortoiliac occlusions are still primarily treated with open surgical techniques.
• Endovascular strategies are gaining favor in the infrainguinal region, but bypass procedures remain essential for multilevel and long-segment obstructions.

Conclusions:

• Treatment strategies for lower limb ischemia vary significantly based on vascular segment and disease chronicity.
• Endovascular interventions are increasingly preferred for chronic aortoiliac disease and acute infrainguinal ischemia.
• Open surgical techniques and bypass procedures remain vital for specific complex scenarios, including acute aortoiliac occlusions and extensive infrainguinal disease.