Vaskulárna medicína 3/2010

Surgical approach to the chronic lower limb ischaemia

Chronic lower extremity ischaemia belongs to the most serious clinical entities in vascular medicine. Critical limb ischaemia (CLI) as the terminal stage of the disease has been considered to be one of the most serious medical, social and economical problems not only because of threatening of the limb, but also because of high long-term cardiovascular mortality. The results of management up to the date are not sufficient but, however, its possibilities have increased during recent years as a consequence of a concentrated effort of vascular specialists. Before any revascularization there is necessary to evaluate the severity of ischaemia, comorbidities and morphology of the arterial lesion. Exact knowing of the treatment indications is a condition of the optimal treatment method selection. This paper discusses main problems of surgical revascularization in several arterial segments, type of lesion and comorbidities with emphasis on the infrainguinal reconstructions.

Keywords: ischaemia, CLI, patient evaluation, revascularization