UNIGE document Scientific Article
previous document  unige:99418  next document
add to browser collection

Chapter III: Management of cardiovascular risk factors and medical therapy

Diehm, N
Schmidli, J
Setacci, C
Ricco, J-B
de Donato, G
Cao, P
show hidden authors show all authors [1 - 16]
Published in European Journal of Vascular and Endovascular Surgery. 2011, vol. 42 Suppl 2, p. S33-42
Abstract 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.
Keywords Adrenergic beta-Antagonists/therapeutic useArterial Occlusive Diseases/prevention & controlCritical IllnessDiabetes Mellitus/prevention & controlDiabetic Foot/prevention & controlDietExercise Therapy/contraindicationsGenetic TherapyHumansHyperlipidemias/prevention & controlHypertension/prevention & controlIschemia/prevention & controlLower Extremity/blood supplyPeripheral Vascular Diseases/prevention & controlPlatelet Aggregation Inhibitors/therapeutic useProstaglandins/therapeutic useRisk AssessmentRisk FactorsSmoking CessationStem Cell TransplantationVascular Surgical Procedures
PMID: 22172471
Full text
Article (Published version) (142 Kb) - document accessible for UNIGE members only Limited access to UNIGE
Research group La maladie thromboembolique veineuse (808)
(ISO format)
DIEHM, N et al. Chapter III: Management of cardiovascular risk factors and medical therapy. In: European Journal of Vascular and Endovascular Surgery, 2011, vol. 42 Suppl 2, p. S33-42. doi: 10.1016/S1078-5884(11)60011-7 https://archive-ouverte.unige.ch/unige:99418

269 hits

0 download


Deposited on : 2017-11-22

Export document
Format :
Citation style :