Chirurgische und interventionelle Behandlung der chronisch-kritischen Beinischämie

Dick, Florian; von Allmen, Regula; Diehm, Nicolas Alexander (2011). Chirurgische und interventionelle Behandlung der chronisch-kritischen Beinischämie. Gefässchirurgie, 16(1), pp. 55-70. Berlin: Springer-Verlag 10.1007/s00772-010-0863-1

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Chronic critical limb ischemia (CLI) represents the most severe form of peripheral arterial occlusive disease and is associated with an increased risk for fatal cardiovascular events. However, most patients survive the first years after diagnosis and, to remain independent, depend on durable improvement of limb perfusion. This CME article summarizes the various surgical and endovascular options of revascularization in the context of CLI and discusses their durability. Available evidence is limited which is mainly due to a lack of a generally accepted outcome definition of clinical treatment success. A recently proposed clinically driven measure of success is discussed and how its use could improve definition of specific indications. As only few patients are clinically equally suitable for various treatment options, CLI patients will certainly remain to be managed best within interdisciplinary teams with close collaboration between surgeons and interventionalists.

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