Protocolo diagnóstico y terapéutico de la isquemia crónica de las extremidades inferiores

  1. Brizuela, J. A.
  2. San Norberto García, Enrique
  3. Merino Díaz, Borja
  4. Vaquero Puerta, Carlos
Aldizkaria:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Argitalpen urtea: 2013

Zenbakien izenburua: Enfermedades cardiovasculares (XI): enfermedades vasculares

Saila: 11

Zenbakia: 45

Orrialdeak: 2713-2716

Mota: Artikulua

DOI: 10.1016/S0304-5412(13)70687-5 DIALNET GOOGLE SCHOLAR

Beste argitalpen batzuk: Medicine: Programa de Formación Médica Continuada Acreditado

Garapen Iraunkorreko Helburuak

Laburpena

Chronic lower limb ischemia is mainly caused by atherosclerosis of lower limbs arteries. Chronic lower limb ischemia patients have a high risk of major complications (ischemic heart disease, ischemic stroke and cardiovascular death) than general population. The diagnosis is made via patient history and physical examination (pulse palpation) and Doppler ultrasound scan (ankle-brachial index). Image tests are typically reserved when surgical intervention is being contemplated. Therapy of chronic lower limb ischemia is based on treatment of vascular risk factors including smoking cessation, and treatment of associated diseases (hypertension, diabetes and dyslipidemia). Symptomatic relief of complaints of intermittent claudication can be achieved by supervised exercise therapy, drug treatment (cilostazol) and surgical revascularization for the treatment of refractory and disabling cases. To avoid major limb amputation, surgical revascularization is always necessary in the treatment of critical limb ischemia. Anatomic location of the lesion influences on angioplasty strategy: surgical (bypass) or endovascular therapy (angioplasty and venous stent placement).

Erreferentzia bibliografikoak

  • Anderson JL, Halperin JL, Albert NM, Bozkurt B, Brindis RG, Curtis LH. Management of patients with peripheral artery disease (compilation of 2005 and 2011 ACCF/AHA guideline recommendations): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2013;127(13):1425-43.
  • Conte MS. Critical appraisal of surgical revascularization for critical limb ischemia. J Vasc Surg. 2013;57(2)Suppl:S8-13.
  • Halperin JL. Evaluation of patients with peripheral vascular disease. Thromb Res. 2002;106(6):V303-11.
  • Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG, Bell K, Caporusso J, Durand-Zaleski I, Komori K, Lammer J, Liapis C. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). Eur J Vasc Endovasc Surg. 2007;33Suppl1:S1-75.
  • Robless P, Mikhailidis DP, Stansby GP. Cilostazol for peripheral arterial disease. Cochrane Database Syst Rev. 2007;(1):CD003748.
  • Ruffolo AJ, Romano M, Ciapponi A. Prostanoids for critical limb ischaemia. Cochrane Database Syst Rev. 2010;(1):CD006544.
Datuen iturria: Dialnet