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Defining risks and predicting adverse events after lower extremity bypass for critical limb ischemia
被引:18
|作者:
Siracuse, Jeffrey J.
[1
]
Huang, Zhen S.
[1
]
Gill, Heather L.
[1
]
Parrack, Inkyong
[1
]
Schneider, Darren B.
[1
]
Connolly, Peter H.
[1
]
Meltzer, Andrew J.
[1
]
机构:
[1] New York Presbyterian Hosp, Weill Cornell Med Coll, Div Vasc & Endovasc Surg, New York, NY USA
关键词:
critical limb ischemia;
bypass;
adverse events;
D O I:
10.2147/VHRM.S54350
中图分类号:
R6 [外科学];
学科分类号:
1002 ;
100210 ;
摘要:
Successful treatment of patients with critical limb ischemia (CLI), hinges on the adequacy of revascularization. However, CLI is associated with a severe burden of systemic atherosclerosis, and patients often suffer from multiple cardiovascular comorbidities. Therefore, CLI patients in general represent a cohort at increased risk for procedural complications and adverse events. Although endovascular therapy represents a minimally invasive alternative to open surgical bypass, the durability of surgical reconstruction is superior, and it remains the "gold standard" approach to revascularization in CLI. Therefore, selection of the optimal treatment modality for individual patients requires careful consideration of the procedural risks and likelihood of adverse events associated with surgery. Individualized decision-making with regard to revascularization strategy requires a comprehensive understanding of the likelihood of adverse outcomes after major surgery. Here we review the risks of surgical bypass in patients with CLI, with particular emphasis on the identification of preoperative variables that predict poor outcome.
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页码:367 / 374
页数:8
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