L’ischemia critica degli arti inferiori

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COD: 317-330 Categorie: ,

Antonella Russo

Ann. Ital. Chir., 2010; 81: 317-329

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AIM: To focus the attention on critical limb ischemia, high risk condition not for the limb only,
but involving the survey of the patient itself.
MATERIAL OF STUDY: Etiology, diagnosis and therapy of arterial occlusive critical pathology (AOCP).
Genetics and life style prophylaxis are shortly treated.
RESULTS: AOCP is often asymptomatic pathology, underestimated by physicians themselves, though
long term death rate is the same between subjects affected by occlusive arteriopathy and cardiological
failure.
DISCUSSION: Interventional therapy, ranging from endovascular procedures (PTCA, stenting) to open
surgery (by-passes, TEA, prostheses), remains the only effective weapon against critical acute limb
ischemia, offering excellent revascularization rates (80-90%). Conservative treatment, comprehending thrombolysis,
prostanoids and anticoagulant drugs recruit the role of invasive methods or are limited, alone, to ineligible patients.
Genetics is still far from certain and durable results.
CONCLUSION: AOCP is a long term severe condition; multifactoriality and asymptomatology in a great number of patients,
often justify misdiagnosed cases. In emergency the acute ischemia involves also demolitive surgery, with short and long
term poor prognosis.

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