Galmer Andrew M, Selim Samy M, Giri Jay, Lau Joe F, Weinberg Mitchell D
Department of Cardiology:Vascular Medicine and Peripheral Vascular Intervention Program, Northwell Health, 300 Community Drive, Manhasset, NY, USA.
Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA, 19104, USA.
Curr Treat Options Cardiovasc Med. 2016 Aug;18(8):50. doi: 10.1007/s11936-016-0476-4.
The need to develop highly qualified, multidisciplinary critical limb ischemia (CLI) programs has gained significant momentum. Due to the systemic nature of the disease, patients with CLI are inherently medically complex and often present with multiple comorbidities. Successful care for these patients depends on community screening, early referral, accurate diagnosis, risk stratification, risk factor modification, invasive and non-invasive treatment strategies, and appropriate surveillance. Patients with CLI are often treated by multiple subspecialists-often lacking a unified team which could lead to inefficiencies and redundancy. Establishing an effective critical limb ischemia program relies on the joint efforts of multiple physician specialists, nurses, technicians, wound care specialists, researchers, and administrators who together form an integrated network that is easily accessible to the patient. This article will focus on the various modalities needed to build an advanced critical limb ischemia program, while addressing the challenges facing the medical community in caring for this population.
发展高素质、多学科的严重肢体缺血(CLI)项目的需求已获得显著动力。由于该疾病的全身性,CLI患者本质上在医学方面较为复杂,且常常伴有多种合并症。对这些患者的成功护理取决于社区筛查、早期转诊、准确诊断、风险分层、风险因素修正、侵入性和非侵入性治疗策略以及适当的监测。CLI患者常常由多个亚专科医生治疗——这些医生往往缺乏一个统一的团队,这可能导致效率低下和工作冗余。建立一个有效的严重肢体缺血项目依赖于多个内科专科医生、护士、技术人员、伤口护理专家、研究人员和管理人员的共同努力,他们共同构成一个患者易于接入的综合网络。本文将重点关注建立一个先进的严重肢体缺血项目所需的各种模式,同时探讨医学界在护理这一群体时面临的挑战。