Vaskulárna medicína 3/2011

Endovascular treatment options in patients with critical limb ischemia

Critical limb ischemia (CLI) is the end stage of peripheral arterial disease resulting in ischemic rest pain and/or skin ulcers. Optimal treatment strategy is endovascular or angiosurgical ischemic limb revascularisation. Without revascularisation, patients with CLI are at high risk for amputation or limb loss, what is associated with high morbidity and mortality. The goal of endovascular therapy is the restoration of pulsatile flow to the affected extremity and thus the relief of rest pain, promotion of ulcer healing and prevention of limb amputation. This article reviews the current radiologic modalities in diagnostic algorithm of CLI and techniques and accesses in endovascular treatment of CLI from percutaneous transluminal angioplasty, stents implantation to special techniques such as endovascular atherectomy, cutting-balloon angioplasty or cryoplasty.

Keywords: critical limb ischemia, endovascular treatment, revascularisation