Uccioli Luigi, Meloni Marco, Izzo Valentina, Giurato Laura, Merolla Stefano, Gandini Roberto
Department of Systems Medicine.
Department of Interventional Radiology, Università di Tor Vergata Roma, Rome, Italy.
Vasc Health Risk Manag. 2018 Apr 26;14:63-74. doi: 10.2147/VHRM.S125065. eCollection 2018.
Critical limb ischemia (CLI) is considered the most severe pattern of peripheral artery disease. It is defined by the presence of chronic ischemic rest pain, ulceration or gangrene attributable to the occlusion of peripheral arterial vessels. It is associated with a high risk of major amputation, cardiovascular events and death. In this review, we presented a complete overview about physiopathology, diagnosis and holistic management of CLI. Revascularization is the first-line treatment, but several challenging cases are not treatable by conventional techniques. Unconventional techniques for the treatment of complex below-the-knee arterial disease are described. Furthermore, the state-of-the-art on gene and cell therapy for the treatment of no-option patients is reported.
严重肢体缺血（CLI）被认为是外周动脉疾病最严重的形式。它的定义是存在慢性缺血性静息痛、归因于外周动脉血管闭塞的溃疡或坏疽。它与大截肢、心血管事件和死亡的高风险相关。在本综述中，我们全面介绍了CLI的病理生理学、诊断和整体管理。血运重建是一线治疗方法，但一些具有挑战性的病例无法通过传统技术治疗。本文描述了治疗复杂的膝下动脉疾病的非常规技术。此外，还报告了针对无其他治疗选择患者的基因和细胞治疗的最新进展。
