Department of Vascular Surgery, Helsinki University Central Hospital, Helsinki, Finland.
J Vasc Surg. 2012 Aug;56(2):545-54. doi: 10.1016/j.jvs.2012.06.053.
The uncertainty continues over the best approach to patients with symptomatic peripheral arterial disease. Medical therapy and risk factor modification is part of any treatment regimen; with this there is little disagreement. However, with the introduction of lesser invasive percutaneous technologies, the discussion regarding surgical and endovascular therapies has become more and more complicated. Unfortunately, there is a relative shortage of robust outcomes data to support many of our specific treatment recommendations. Younger patients are an especially troublesome patient cohort. They have consistently shown poorer outcomes after any intervention compared with older patients and may represent a subset of more aggressive atherosclerotic disease. Our debaters will discuss their preferred approaches to these difficult patients in the context of the currently available supporting literature.
对于有症状外周动脉疾病患者，最佳治疗方法仍不确定。医学治疗和危险因素修正都是任何治疗方案的一部分；这方面没有太多争议。然而，随着微创经皮技术的引入，关于手术和血管内治疗的讨论变得越来越复杂。不幸的是，支持我们许多具体治疗建议的可靠结果数据相对较少。年轻患者是一个特别麻烦的患者群体。与老年患者相比，他们在任何干预后都表现出更差的结果，并且可能代表更具侵袭性动脉粥样硬化疾病的亚组。我们的辩论者将根据现有支持文献讨论他们对这些困难患者的首选治疗方法。
