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Limb ischemia: cardiovascular diagnosis and management from head to toe.

Publication ,  Journal Article
Vemulapalli, S; Patel, MR; Jones, WS
Published in: Curr Cardiol Rep
July 2015

Peripheral arterial disease (PAD) affects an estimated 27 million people in Europe and North America. Limb ischemia, defined as ischemic rest pain, ischemic ulcerations, or ischemic gangrene, represents the most severe manifestation of PAD and is associated with significant cardiovascular and limb morbidity and mortality. Critical limb ischemia (CLI), defined as limb ischemia symptoms for greater than 2 weeks, is characterized by a cascade of hemodynamically significant macrovascular atherosclerotic obstruction and microvascular changes culminating in decreased muscle perfusion, disrupted muscle energy metabolism, and inflammation. In contrast, acute limb ischemia (ALI) is defined as limb ischemia symptoms characterized by sudden onset of less than 2 weeks duration resulting in hemodynamically compromised limb perfusion. Diagnosis of both ALI and CLI is dependent on history, physical examination, and a combination of anatomic and hemodynamic assessment of the limb. Given that the risk factors for ALI and CLI overlap with risk factors for atherosclerotic coronary and neurovascular disease, the management of limb ischemia is focused on both endovascular or surgical limb salvage and cardiovascular risk factor control. Despite advancements in endovascular and surgical revascularization techniques, limb morbidity remains high; clinical trials of angiogenic and cell-based therapies are ongoing. Cardiovascular risk reduction in patients with limb ischemia also remains suboptimal and future studies will focus on novel antiplatelet agents.

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Published In

Curr Cardiol Rep

DOI

EISSN

1534-3170

Publication Date

July 2015

Volume

17

Issue

7

Start / End Page

611

Location

United States

Related Subject Headings

  • Vascular Surgical Procedures
  • Vascular Patency
  • Upper Extremity
  • Risk Factors
  • Practice Guidelines as Topic
  • Platelet Aggregation Inhibitors
  • Peripheral Arterial Disease
  • Lower Extremity
  • Limb Salvage
  • Ischemia
 

Citation

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Vemulapalli, S., Patel, M. R., & Jones, W. S. (2015). Limb ischemia: cardiovascular diagnosis and management from head to toe. Curr Cardiol Rep, 17(7), 611. https://doi.org/10.1007/s11886-015-0611-y
Vemulapalli, Sreekanth, Manesh R. Patel, and W Schuyler Jones. “Limb ischemia: cardiovascular diagnosis and management from head to toe.Curr Cardiol Rep 17, no. 7 (July 2015): 611. https://doi.org/10.1007/s11886-015-0611-y.
Vemulapalli S, Patel MR, Jones WS. Limb ischemia: cardiovascular diagnosis and management from head to toe. Curr Cardiol Rep. 2015 Jul;17(7):611.
Vemulapalli, Sreekanth, et al. “Limb ischemia: cardiovascular diagnosis and management from head to toe.Curr Cardiol Rep, vol. 17, no. 7, July 2015, p. 611. Pubmed, doi:10.1007/s11886-015-0611-y.
Vemulapalli S, Patel MR, Jones WS. Limb ischemia: cardiovascular diagnosis and management from head to toe. Curr Cardiol Rep. 2015 Jul;17(7):611.
Journal cover image

Published In

Curr Cardiol Rep

DOI

EISSN

1534-3170

Publication Date

July 2015

Volume

17

Issue

7

Start / End Page

611

Location

United States

Related Subject Headings

  • Vascular Surgical Procedures
  • Vascular Patency
  • Upper Extremity
  • Risk Factors
  • Practice Guidelines as Topic
  • Platelet Aggregation Inhibitors
  • Peripheral Arterial Disease
  • Lower Extremity
  • Limb Salvage
  • Ischemia