TY - CHAP M1 - Book, Section TI - Chronic Lower Extremity Ischemia A1 - Scoville, Steven A1 - Sarac, Timur A2 - Nazzal, Munier A2 - Blebea, John A2 - Osman, Mohamed F. Y1 - 2024 N1 - T2 - Vascular and Endovascular Surgery: Clinical Diagnosis and Management AB - Worldwide, more than 200 million people are affected by peripheral artery disease (PAD). The definition of PAD is variable, but in general consists of a disease state characterized by compromised arterial perfusion to meet the oxygen and metabolic needs of organs. PAD overwhelmingly involves the lower extremities and to a much less extent upper extremities. Approximately 5% to 10% of patients with PAD of the lower extremities will progress to develop critical limb ischemia (CLI) over a 5-year period characterized by rest pain and/or the presence of nonhealing wounds or gangrene.1 If left untreated, rates of limb loss are nearly 40% over the first year.2 Despite a variety of available limb sparing open and minimally invasive surgical options, amputation rates among patients who are not candidates for treatment are as high as approximately 70%.3 Furthermore, it is reported that patients presenting with CLI have as high as 20% mortality rate in the first year after presentation.4 Risk factors for progression to CLI include advanced age, smoking, diabetes, hypertension, age, renal disease, and hypercholesterolemia.4 Due to increased prevalence of uncontrolled tobacco use and diabetes, the number of people affected is only expected to increase. In addition, nearly 90% of patients with CLI also have concomitant coronary artery disease of which two-thirds require treatment.5 Therefore, the clinical knowledge required for appropriate prevention, diagnosis, and treatment are critical to allow for concise evaluation, workup, and treatment. SN - PB - McGraw Hill CY - New York, NY Y2 - 2024/04/18 UR - accesssurgery.mhmedical.com/content.aspx?aid=1200678123 ER -