| Autor: |
White, William B., Caralis, Dennis G., Bakris, George L., Jacobs, Chad E., McCarthy, Walter J. |
| Zdroj: |
Lower Extremity Arterial Disease; 2005, p269-292, 24p |
| Abstrakt: |
Innovations in surgery, radiology, and medical management during the past 30 years have allowed patients who once faced certain amputation as a result of leg ischemia to be offered a variety of alternatives. Patients with limb-threatening ischemia differ from those with intermittent claudication in regard to both natural history and treatment requirements. Management of patients with claudication involves risk factor modification, exercise regimens, and pharmacologic intervention. This group rarely requires amputation. Patients with critical limb ischemia are most often treated surgically in order to preserve limb functionality. Five year rates of limb salvage for this patient population have been shown to be 81 % for femoropopliteal bypass and 47% for infrapopliteal bypass (1). However, despite continued additions to our treatment armamentarium, it has been shown that amputation rates have remained the same over the past decade (2). The mortality from major amputations is generally reported to be 3 to 10% (3), but in selected populations, such as those over 80 years old, mortality may be as high as 82% (4). In addition, the rehabilitation outcome after amputation for nonrecon-structible arterial disease is usually overestimated. One recent study (5) reported that only 26% of patients were able to ambulate outdoors with a prosthesis 2 years after major amputation. Another study predicted that the number of amputations performed in the geriatric population will double by the year 2030 (6). [ABSTRACT FROM AUTHOR] |
| Databáze: |
Supplemental Index |
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