Kawarada Osami, Zen Kan, Hozawa Koji, Ayabe Shinobu, Huang Hsuan-Li, Choi Donghoon, Kim Su Hong, Kim Jiyoun, Kato Taku, Tsubakimoto Yoshinori, Nakama Tasuya, Ichihashi Shigeo, Fujimura Naoki, Higashimori Akihiro, Fujihara Masahiko, Sato Tomoyasu, Yan Bryan Ping-Yen, Pang Skyi Yin-Chun, Wongwanit Chumpol, Leong Yew Pung, Chua Benjamin, George Robbie K, Yokoi Yoshiaki, Motomura Hisashi, Obara Hideaki
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 5-7-1 Fujishiro-dai, Suita, 565-8565, Japan.
Department of Cardiovascular Medicine, Ikuwakai Memorial Hospital, Osaka, Japan.
Cardiovasc Interv Ther. 2018 Oct;33(4):297-312. doi: 10.1007/s12928-018-0523-z. Epub 2018 Apr 13.
The burden of peripheral artery disease (PAD) and diabetes in Asia is projected to increase. Asia also has the highest incidence and prevalence of end-stage renal disease (ESRD) in the world. Therefore, most Asian patients with PAD might have diabetic PAD or ESRD-related PAD. Given these pandemic conditions, critical limb ischemia (CLI) with diabetes or ESRD, the most advanced and challenging subset of PAD, is an emerging public health issue in Asian countries. Given that diabetic and ESRD-related CLI have complex pathophysiology that involve arterial insufficiency, bacterial infection, neuropathy, and foot deformity, a coordinated approach that involves endovascular therapy and wound care is vital. Recently, there is increasing interaction among cardiologists, vascular surgeons, radiologists, orthopedic surgeons, and plastic surgeons beyond specialty and country boundaries in Asia. This article is intended to share practical Asian multidisciplinary consensus statement on the collaboration between endovascular therapy and wound care for CLI.
预计亚洲外周动脉疾病(PAD)和糖尿病的负担将会增加。亚洲也是世界上终末期肾病(ESRD)发病率和患病率最高的地区。因此,大多数亚洲PAD患者可能患有糖尿病性PAD或ESRD相关性PAD。鉴于这些普遍情况,糖尿病或ESRD相关的严重肢体缺血(CLI)作为PAD最严重且最具挑战性的亚型,正成为亚洲国家一个新出现的公共卫生问题。鉴于糖尿病和ESRD相关的CLI具有涉及动脉供血不足、细菌感染、神经病变和足部畸形的复杂病理生理学,一种涉及血管内治疗和伤口护理的协调方法至关重要。最近,亚洲的心脏病专家、血管外科医生、放射科医生、骨科医生和整形外科医生之间跨越专业和国家界限的互动日益增加。本文旨在分享关于CLI血管内治疗与伤口护理协作的实用亚洲多学科共识声明。