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Management of Cardiovascular Risk Factors and Medical Therapy

In English

Författare

  • N. Diehm
  • J. Schmidli
  • C. Setacci
  • J. -B. Ricco
  • G. de Donato
  • F. Becker
  • H. Robert-Ebadi
  • P. Cao
  • H. H. Eckstein
  • P. De Rango
  • M. Teraa
  • F. L. Moll
  • F. Dick
  • A. H. Davies
  • M. Lepantalo
  • Jan Apelqvist
Visa allt

Summary, in English

Critical limb ischaemia (CLI) is a particularly severe manifestation of lower limb atherosclerosis posing a major threat to both limb and life of affected patients. Besides arterial revascularisation, risk-factor modification and administration of antiplatelet therapy is a major goal in the treatment of CLI patients. Key elements of cardiovascular risk management are smoking cessation and treatment of hyperlipidaemia with dietary modification or statins. Moreover, arterial hypertension and diabetes mellitus should be adequately treated. In CLI patients not suitable for arterial revascularisation or subsequent to unsuccessful revascularisation, parenteral prostanoids may be considered. CLI patients undergoing surgical revascularisation should be treated with beta blockers. At present, neither gene nor stem-cell therapy can be recommended outside clinical trials. Of note, walking exercise is contraindicated in CLI patients due to the risk of worsening pre-existing or causing new ischaemic wounds. CLI patients are oftentimes medically frail and exhibit significant comorbidities. Co-existing coronary heart and carotid as well as renal artery disease should be managed according to current guidelines. Considering the above-mentioned treatment goals, interdisciplinary treatment approaches for CLI patients are warranted. Aim of the present manuscript is to discuss currently existing evidence for both the management of cardiovascular risk factors and treatment of co-existing disease and to deduct specific treatment recommendations. (C) 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

Publiceringsår

2011

Språk

Engelska

Sidor

33-42

Publikation/Tidskrift/Serie

European Journal of Vascular and Endovascular Surgery

Volym

42

Issue

Suppl. 2

Dokumenttyp

Artikel i tidskrift

Förlag

Elsevier

Ämne

  • Surgery

Nyckelord

  • Conservative treatment
  • Medication
  • Risk factor modification

Status

Published

Forskningsgrupp

  • Translational Muscle Research

ISBN/ISSN/Övrigt

  • ISSN: 1532-2165