Department of Medicine, Cardiovascular Division, Vascular Medicine Section, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
Angiology. 2013 Aug;64(6):466-80. doi: 10.1177/0003319712464514. Epub 2012 Nov 4.
Critical limb ischemia (CLI) is a severe form of peripheral artery disease associated with high morbidity and mortality. The primary therapeutic goals in treating CLI are to reduce the risk of adverse cardiovascular events, relieve ischemic pain, heal ulcers, prevent major amputation, and improve quality of life (QoL) and survival. These goals may be achieved by medical therapy, endovascular intervention, open surgery, or amputation and require a multidisciplinary approach including pain management, wound care, risk factors reduction, and treatment of comorbidities. No-option patients are potential candidates for the novel angiogenic therapies. The application of genetic, molecular, and cellular-based modalities, the so-called therapeutic angiogenesis, in the treatment of arterial obstructive diseases has not shown consistent efficacy. This article summarizes the current status related to the management of patients with CLI and discusses the current findings of the emerging modalities for therapeutic angiogenesis.
严重肢体缺血（CLI）是一种与高发病率和死亡率相关的外周动脉疾病的严重形式。治疗 CLI 的主要治疗目标是降低不良心血管事件的风险、缓解缺血性疼痛、愈合溃疡、预防大截肢以及改善生活质量（QoL）和生存率。这些目标可以通过药物治疗、血管内介入、开放手术或截肢来实现，需要多学科的方法，包括疼痛管理、伤口护理、降低风险因素和治疗合并症。无选择的患者是新型血管生成治疗的潜在候选者。应用基因、分子和细胞为基础的方法，即所谓的治疗性血管生成，在治疗动脉阻塞性疾病方面并未显示出一致的疗效。本文总结了目前 CLI 患者管理方面的现状，并讨论了治疗性血管生成的新兴方法的最新发现。
