Karimi Ashkan, Lauria Alexis L, Aryavand Behdad, Neville Richard F
Carient Heart and Vascular, Manassas, VA, 20109, USA.
Walter Reed National Military Medical Center, Bethesda, MD, 20889, USA.
Curr Cardiol Rep. 2022 May;24(5):513-517. doi: 10.1007/s11886-022-01669-6. Epub 2022 Feb 22.
This review intends to discuss the latest endovascular and surgical advancement in the treatment of critical limb-threatening ischemia (CLTI).
We discuss novel endovascular technological advancements such as intravascular lithotripsy, the Tack endovascular stent, the PQ Bypass DETOUR system, and the LimFlow System for deep venous arterialization (DVA) in the very high risk "no-option" CLTI population. We also discuss the increasing adoption of radial and pedal approaches for endovascular revascularization and the tibiopedal arterial minimally invasive (TAMI) technique. On the surgical front, we discuss the distal vein patch technique and surgical and hybrid DVA. Recent advancements in the treatment options of CLTI will likely lead to reducing the rate of major amputations if they are adopted in a collaborative environment in order to apply the most appropriate treatment option to each individual patient based on the anatomy, comorbidities, functional status, and local expertise.
本综述旨在探讨治疗严重肢体缺血（CLTI）的最新血管内和外科进展。
我们讨论了新型血管内技术进展，如血管内碎石术、Tack血管内支架、PQ旁路DETOUR系统以及用于极高风险“无选择”CLTI人群的LimFlow深静脉动脉化（DVA）系统。我们还讨论了血管内血运重建中桡动脉和足背动脉入路以及胫足动脉微创（TAMI）技术的应用增加情况。在外科方面，我们讨论了远端静脉补片技术以及外科和混合DVA。如果在协作环境中采用CLTI治疗选择的最新进展，以便根据每位患者的解剖结构、合并症、功能状态和当地专业知识应用最合适的治疗方案，可能会降低大截肢率。
