Treitl M, Ruppert V, Mayer A K, Degenhart C, Reiser M, Rieger J
Institut für Klinische Radiologie, Innenstadt-Klinikum der Ludwig-Maximilians-Universität, Pettenkoferstrasse 8a, 80336 Munich, Germany.
Radiologe. 2006 Nov;46(11):962-72. doi: 10.1007/s00117-006-1423-2.
Each year 1-2% of patients with peripheral arterial occlusive disease (pAOD) develop critical limb ischemia (CLI), characterized by rest pain and peripheral ulcer or gangrene. This aggravation of the disease is accompanied by an increase of the 1-year mortality rate up to 25% and a similarly increased frequency of major amputation. We can choose between conservative, endovascular, and surgical procedures for an adequate therapy of the underlying vascular stenoses or occlusions. Yet, clear therapeutic recommendations only exist for suprapopliteal lesions. However, in a number of cases, especially in diabetics, target lesions have an infrapopliteal location. Since endovascular procedures have undergone significant improvement in the last few years, the following review discusses methods for infrapopliteal revascularization taking into consideration the newest publications on this topic.
每年,1%-2%的外周动脉闭塞性疾病(pAOD)患者会发展为严重肢体缺血(CLI),其特征为静息痛以及外周溃疡或坏疽。疾病的这种加重伴随着1年死亡率增至25%以及大截肢频率的类似增加。对于潜在的血管狭窄或闭塞的充分治疗,我们可以在保守治疗、血管内治疗和外科手术之间进行选择。然而,仅存在针对腘动脉上方病变的明确治疗建议。然而,在许多病例中,尤其是糖尿病患者,目标病变位于腘动脉下方。由于血管内治疗在过去几年中取得了显著进展,以下综述考虑到关于该主题的最新出版物,讨论了腘动脉下方血管重建的方法。