PDF(Pubmed)
Abstract：
Peripheral arterial disease (PAD) represents one of the most prevalent cardiovascular disease processes and carries a high burden of morbidity and mortality. Patients with chronic limb-threatening ischemia (CLTI), the most severe manifestation of PAD, have the highest rates of cardiovascular morbidity and mortality of the overall PAD population. Patients with below-the-knee (BTK) PAD have an increased propensity toward CLTI due to small-vessel caliber and the frequently comorbid conditions of end-stage renal disease and diabetes mellitus, which tend to affect small artery beds preferentially. For those with BTK PAD with CLTI, the standard of care is revascularization. Early revascularization was performed using surgical bypass. However, endovascular techniques, starting with percutaneous transluminal angioplasty and expanding to the modern armamentarium of adjunctive devices and therapies, have become standard of care for most patients with CLTI due to BTK PAD. In this review, we will discuss the modern surgical and endovascular approaches to revascularization, as well as devices that are currently in development or preapproval study for the treatment of BTK PAD.
摘要：
外周动脉疾病（PAD）是最普遍的心血管疾病过程之一，具有很高的发病率和死亡率。慢性威胁肢体缺血（CLTI）患者，PAD最严重的表现，在整个PAD人群中，心血管疾病的发病率和死亡率最高。由于小血管口径以及终末期肾病和糖尿病的常见合并症，膝盖以下（BTK）PAD患者对CLTI的倾向增加。倾向于优先影响小动脉床。对于那些与BTKPAD与CLTI，护理标准是血运重建.早期血运重建采用外科搭桥术进行。然而,血管内技术,从经皮腔内血管成形术开始，扩展到辅助设备和疗法的现代设备，由于BTKPAD，已成为大多数CLTI患者的护理标准。在这次审查中,我们将讨论现代手术和血管内血管重建的方法，以及目前正在开发或预先批准的BTKPAD治疗装置。
