Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy.
Cardiovascular Internal Medicine Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Roma, Italy.
Int J Mol Sci. 2021 Feb 18;22(4):2002. doi: 10.3390/ijms22042002.
Peripheral artery disease (PAD) is a manifestation of atherosclerosis, which may affect arteries of the lower extremities. The most dangerous PAD complication is chronic limb-threatening ischemia (CLTI). Without revascularization, CLTI often causes limb loss. However, neither open surgical revascularization nor endovascular treatment (EVT) ensure long-term success and freedom from restenosis and revascularization failure. In recent years, EVT has gained growing acceptance among all vascular specialties, becoming the primary approach of revascularization in patients with CLTI. In clinical practice, different clinical outcomes after EVT in patients with similar comorbidities undergoing the same procedure (in terms of revascularization technique and localization of the disease) cause unsolved issues that need to be addressed. Nowadays, risk management of revascularization failure is one of the major challenges in the vascular field. The aim of this literature review is to identify potential predictors for lower extremity endovascular revascularization outcomes and possible prevention strategies.
外周动脉疾病(PAD)是动脉粥样硬化的一种表现形式,可能会影响下肢的动脉。PAD 最危险的并发症是慢性肢体威胁性缺血(CLTI)。如果不进行血运重建,CLTI 常导致肢体丧失。然而,开放手术血运重建或血管内治疗(EVT)都不能确保长期成功和免于再狭窄及血运重建失败。近年来,EVT 在所有血管专业中越来越被接受,成为 CLTI 患者血运重建的主要方法。在临床实践中,对于接受相同手术(在血运重建技术和疾病定位方面)且具有相似合并症的患者,EVT 后的不同临床结局导致了一些悬而未决的问题,需要加以解决。如今,血运重建失败的风险管理是血管领域的主要挑战之一。本文献综述的目的是确定下肢血管腔内血运重建结局的潜在预测因素和可能的预防策略。