Critical Limb Ischemia

1. Front Matter

   Pages I-IX

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2. Epidemiology of critical limb ischemia

   1. Front Matter

      Pages 1-1

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   2. Definition, incidence and epidemiology of critical limb ischemia

      • W. Fonteyne, D. Duprez

      Pages 2-6

   3. Natural history and evolution of peripheral arterial disease

      • D. Duprez

      Pages 7-12

   4. Patient prognosis with critical limb ischemia: an update of 164 patients

      • J. C. Wautrecht, P. Lefebvre, C. Galle, G. Vincent, S. Motte, J. P. Dereume

      Pages 13-17

3. Conservative management of critical limb ischemia

   1. Front Matter

      Pages 19-19

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   2. Investigation and management of patients with chronic critical limb ischemia due to peripheral arterial occlusive disease

      • L. Claeys

      Pages 21-27

   3. The role of Prostaglandin E1 in patients with critical leg ischemia

      • Curt Diehm

      Pages 29-44

   4. Antithrombotic therapy in chronic leg arterial disease

      • R. Verhaeghe

      Pages 45-51

   5. Hemodilution in patients with peripheral obstructive arterial disease

      • J. Koscielny, H. Kiesewetter, F. Jung

      Pages 53-60

4. Assessment of microcirculation

   1. Front Matter

      Pages 61-61

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   2. Assessment of the microcirculation by videocapillaroscopy in patients with critical limb ischemia

      • L. Claeys, K. Ktenidis, S. Horsch

      Pages 63-67

5. Angioplasty

   1. Front Matter

      Pages 69-69

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   2. Percutaneous transluminal angioplasty for crural obliterations

      • E. Zeitler, S. A. Beyer-Enke, W. Ritter

      Pages 71-80

   3. Complications during and after percutaneous transluminal angioplasty (PTA) of iliac and peripheral arteries

      • D. Beyer, Ch. Kaiser, M. Kress, S. Horsch

      Pages 81-86

   4. Efficacy and tolerance of recombinant tissue-type plasminogen activator in patients with thrombotic or embolic occlusions of leg-arteries

      • F. A. Spengel, G. Küffer, H. Stiegler

      Pages 87-91

6. Angioplasty and combined procedures

   1. Front Matter

      Pages 93-93

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   2. Below-knee excimer laser angioplasty associated with femoro-popliteal bypass grafting

      • H. Nigbur, K. Ktenidis, L. Claeys, S. Horsch

      Pages 95-97

   3. Single-stage angioplasty and vascular reconstruction

      • L. De Kock, F. Ameye, J. De Roose, F. Vermassen

      Pages 99-103

   4. Combined endoluminal and surgical vascular reconstructions

      • B. Steckmeier, A. Parzhuber, C. Reininger, F. A. Spengel, C. Wolfertz, G. Küffer et al.

      Pages 105-114

Chronic critical limb ischemia remains one of the most frequent causes of illness and hospitalization in the western world. Interest in critical limb ischemia has increased markedly in recent years. There have been significant achievements in diagnostic pro­ cedures as well as in the medical, invasive, and surgical treatment of patients with critical limb ischemia. Despite a considerable research effort, the pathophysiological mechanisms of critical limb ischemia in humans remains to be established. Prominent is the increasing interest in the microcirculation, as well as in the hemorheological, hemostatic and inflammatory changes which may promote critical limb ischemia. Further research is necessary to quantify the relevance of microcirculatory in­ vestigations in terms of predicting the prognosis or to evaluate the effects of new therapies. Our main task is to offer the patient the best possible therapy in order to avoid limb loss and to improve quality of life. The various methods of treatment, their suc­ cess rates, and their complications, must be carefully evaluated and discussed. This volume presents the complex field of diagnosis and treatment of critical limb ischemia. The diagnosis and treatment involves different specialists including angio­ logists, interventional radiologists, vascular surgeons, plastic surgeons, diabeto­ logists, etc. Individual chapters have been written by Belgian and German experts in the various specialities, who present their own experience. We are very grateful that these experts have joined us to produce this book on the epidemiology, pathophysiology, and rational therapy.

• Bypass
• Laser
• Stent
• Surgery
• arteries
• circulation

• Klinik für Allgemeinchirurgie — Gefäßchirurgie und Traumatologie, Krankenhaus Porz am Rhein Akademisches Lehrkrankenhaus der Universität zu Köln, Köln, Germany

  Svante Horsch, Luc Claeys

Policies and ethics