Armstrong Ehrin J, Bishu Kalkidan, Waldo Stephen W
VA Eastern Colorado Healthcare System and Division of Cardiology, University of Colorado, Denver, CO, USA.
Curr Cardiol Rep. 2016 Apr;18(4):34. doi: 10.1007/s11886-016-0708-y.
Endovascular treatment of infrapopliteal disease is focused on the treatment of patients with rest pain or critical limb ischemia (CLI) due to severe atherosclerotic disease. While the evidence base surrounding the comparative effectiveness of endovascular intervention vs. surgery is lacking, many operators have adopted an "endovascular first" approach to the treatment of infrapopliteal atherosclerotic disease due to the lower morbidity of these procedures. This manuscript reviews current data on the endovascular treatment of CLI, including a comparison of endovascular and surgical approaches, current indications for and outcomes with balloon angioplasty of infrapopliteal PAD, angiosome-guided revascularization, and emerging technologies to improve long-term vessel patency after endovascular intervention.
腘动脉以下疾病的血管内治疗主要针对因严重动脉粥样硬化疾病导致静息痛或严重肢体缺血（CLI）的患者。虽然缺乏关于血管内介入治疗与手术治疗相对有效性的循证依据，但由于这些手术的发病率较低，许多操作者已采用“血管内优先”的方法来治疗腘动脉以下动脉粥样硬化疾病。本文综述了目前关于CLI血管内治疗的数据，包括血管内和手术方法的比较、腘动脉以下PAD球囊血管成形术的当前适应证和结果、血管分区引导的血运重建，以及改善血管内介入术后长期血管通畅性的新兴技术。
