RT Book, Section
A1 Scoville, Steven
A1 Sarac, Timur
A2 Nazzal, Munier
A2 Blebea, John
A2 Osman, Mohamed F.
SR Print(0)
ID 1200678123
T1 Chronic Lower Extremity Ischemia
T2 Vascular and Endovascular Surgery: Clinical Diagnosis and Management
YR 2024
FD 2024
PB McGraw Hill
PP New York, NY
SN 9781260462715
LK accesssurgery.mhmedical.com/content.aspx?aid=1200678123
RD 2024/04/19
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.