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[Progress and prospect of the treatment of lower extremity arteriosclerosis obliterans]

Y H Zheng1, X T Song1

  • 1Department of Vascular Surgery,Peking Union Medical College Hospital,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100730,China.

Zhonghua Wai Ke Za Zhi [Chinese Journal of Surgery]
|December 6, 2021
PubMed

Insights

Recent advancements in treating lower extremity arteriosclerosis obliterans show promise. Drug-coated balloons and inframalleolar bypass are effective for limb salvage in critical limb threatening ischemia (CLTI).

Area of Science:

  • Vascular Surgery
  • Endovascular Therapy
  • Peripheral Artery Disease

Background:

  • Treatment for lower extremity arteriosclerosis obliterans has seen advancements and emerging challenges in the last five years.
  • The 2019 Global Vascular Guidelines offer comprehensive suggestions for critical limb threatening ischemia (CLTI), yet require broader application of grading and treatment recommendations.

Purpose of the Study:

  • To review current treatment strategies for lower extremity arteriosclerosis obliterans.
  • To highlight recent advancements and persistent challenges in managing this condition.
  • To inform peripheral vascular practitioners on the present situation and future trends.

Main Methods:

  • Review of latest literature on lower extremity arteriosclerosis obliterans.
  • Inclusion of institutional experience in treatment outcomes.
  • Analysis of endovascular and surgical revascularization techniques.

Main Results:

  • Drug-coated balloons demonstrate efficacy in limb salvage and graft patency for femoropopliteal and infrapopliteal artery diseases.
  • Inframalleolar bypass offers good graft patency and limb salvage rates in CLTI patients.
  • Regional anesthesia presents a lower risk profile compared to general anesthesia for lower extremity revascularization.
  • Percutaneous deep vein arterialization shows potential for limb salvage in CLTI patients without other treatment options.

Conclusions:

  • Continuous education and surveillance are crucial for maintaining surgical revascularization quality.
  • Emerging techniques like drug-coated balloons and percutaneous deep vein arterialization offer new hope for limb salvage.
  • A comprehensive understanding of current treatments and trends is vital for effective management of lower extremity arteriosclerosis obliterans.

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