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Global Vascular Gui...
Global Vascular Guidelines on the Management of Chronic Limb-Threatening Ischemia
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- Conte, Michael S. (författare)
- Univ Calif San Francisco, Div Vasc & Endovasc Surg, 400 Parnassus Ave,Ste A581, San Francisco, CA 94143 USA
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- Bradbury, Andrew W. (författare)
- Univ Birmingham, Dept Vasc Surg, Birmingham, W Midlands, England
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- Kolh, Philippe (författare)
- Univ Hosp Liege, Dept Biomed & Preclin Sci, Wallonia, Belgium
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- White, John, V (författare)
- Advocate Lutheran Gen Hosp, Dept Surg, Niles, IL USA
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- Dick, Florian (författare)
- Kantonsspital St Gallen, Dept Vasc Surg, St Gallen, Switzerland;Univ Bern, Bern, Switzerland
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- Fitridge, Robert (författare)
- Univ Adelaide, Med Sch, Dept Vasc & Endovasc Surg, Adelaide, SA, Australia
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- Mills, Joseph L. (författare)
- Baylor Coll Med, Div Vasc Surg & Endovasc Therapy, Houston, TX 77030 USA
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- Ricco, Jean-Baptiste (författare)
- Univ Hosp Poitiers, Dept Clin Res, Poitiers, France
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- Suresh, Kalkunte R. (författare)
- Jain Inst Vasc Sci, Bangalore, Karnataka, India
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- Murad, M. Hassan (författare)
- Mayo Clin, Evidence Based Practice Ctr, Rochester, MN USA
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- Aboyans, Victor (författare)
- Univ Hosp, Dept Cardiol, Dupuytren, France
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- Aksoy, Murat (författare)
- Amer Hosp, Dept Vasc Surg, Istanbul, Turkey
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- Alexandrescu, Vlad-Adrian (författare)
- Univ Liege, CHU Sart Tilman Hosp, Liege, Belgium
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- Armstrong, David (författare)
- Univ Southern Calif, Los Angeles, CA USA
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- Azuma, Nobuyoshi (författare)
- Asahikawa Med Univ, Asahikawa, Hokkaido, Japan
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- Belch, Jill (författare)
- Univ Dundee, Ninewells Hosp, Dundee, Scotland
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- Bergoeing, Michel (författare)
- Pontificia Univ Catolica Chile, Escuela Med, Santiago, Chile
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- Björck, Martin (författare)
- Uppsala universitet,Kärlkirurgi
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- Chakfe, Nabil (författare)
- Univ Hosp Strasbourg, Strasbourg, France
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- Cheng, Stephen (författare)
- Univ Hong Kong, Hong Kong, Peoples R China
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- Dawson, Joseph (författare)
- Royal Adelaide Hosp, Adelaide, SA, Australia;Univ Adelaide, Adelaide, SA, Australia
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- Debus, Eike S. (författare)
- Univ Hosp Hamburg Eppendorf, Univ Heart Ctr Hamburg, Hamburg, Germany
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- Dueck, Andrew (författare)
- Univ Toronto, Schulich Heart Ctr, Sci Ctr, Sunnybrook Hlth, Toronto, ON, Canada
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- Duval, Susan (författare)
- Univ Minnesota, Med Sch, Cardiovasc Div, Minneapolis, MN 55455 USA
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- Eckstein, Hans H. (författare)
- Tech Univ Munich, Munich, Germany
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- Ferraresi, Roberto (författare)
- Ist Clin, Intervent Cardiovasc Unit, Cardiol Dept, Milan, Italy
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- Gambhir, Raghvinder (författare)
- Kings Coll Hosp London, London, England
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- Garguilo, Mauro (författare)
- Univ Bologna, Diagnost & Sperimentale, Bologna, Italy
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- Geraghty, Patrick (författare)
- Washington Univ, Sch Med, St Louis, MO USA
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- Goode, Steve (författare)
- Sheffield Vasc Inst, Sheffield, S Yorkshire, England
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- Gray, Bruce (författare)
- Greenville Hlth Syst, Greenville, SC USA
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- Guo, Wei (författare)
- 301 Gen Hosp PLA, Beijing, Peoples R China
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- Gupta, Prem C. (författare)
- Care Hosp, Banjara Hills, Hyderabad, India
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- Hinchliffe, Robert (författare)
- Univ Bristol, Bristol, Avon, England
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- Jetty, Prasad (författare)
- Ottawa Hosp, Div Vasc & Endovasc Surg, Ottawa, ON, Canada;Univ Ottawa, Ottawa, ON, Canada
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- Komori, Kimihiro (författare)
- Nagoya Univ, Grad Sch Med, Nagoya, Aichi, Japan
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- Lavery, Lawrence (författare)
- UT Southwestern Med Ctr, Dallas, TX USA
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- Liang, Wei (författare)
- Shanghai Jiao Tong Univ, Renji Hosp, Sch Med, Shanghai, Peoples R China
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- Lookstein, Robert (författare)
- Icahn Sch Med Mt Sinai, Div Vasc & Intervent Radiol, New York, NY 10029 USA
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- Menard, Matthew (författare)
- Brigham & Womens Hosp, Boston, MA 02115 USA
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- Misra, Sanjay (författare)
- Mayo Clin, Rochester, MN USA
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- Miyata, Tetsuro (författare)
- Sanno Hosp, Tokyo, Japan;Sanno Med Ctr, Tokyo, Japan
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- Moneta, Greg (författare)
- Oregon Hlth & Sci Univ, Portland, OR 97201 USA
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- Prado, Jose A. Munoa (författare)
- Clin Venart, Tuxtla Gutierrez, Mexico
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- Munoz, Alberto (författare)
- Colombia Natl Univ, Bogota, Colombia
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- Paolini, Juan E. (författare)
- Univ Buenos Aires, Sanatoria Dr Julio Mendez, Buenos Aires, DF, Argentina
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- Patel, Manesh (författare)
- Duke Univ Hlth Syst, Div Cardiol, Durham, NC USA
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- Pomposelli, Frank (författare)
- St Elizabeths Med Ctr, Boston, MA USA
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- Powell, Richard (författare)
- Dartmouth Hitchcock, Lebanon, NH USA
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- Robless, Peter (författare)
- Mt Elizabeth Hosp, Singapore, Singapore
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- Rogers, Lee (författare)
- Amputat Prevent Ctr Amer, White Plains, NY USA
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- Schanzer, Andres (författare)
- Univ Massachusetts, Amherst, MA 01003 USA
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- Schneider, Peter (författare)
- Kaiser Fdn Hosp Honolulu, Honolulu, HI USA;Hawaii Permanente Med Grp, Kahului, HI USA
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- Taylor, Spence (författare)
- USC Sch Med Greenville, Greenville Hlth Ctr, Greenville, SC USA
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- De Ceniga, Melina, V (författare)
- Hosp Galdakao Usansolo, Bizkaia, Spain
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- Veller, Martin (författare)
- Univ Witwatersrand, Johannesburg, South Africa
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- Vermassen, Frank (författare)
- Ghent Univ Hosp, Ghent, Belgium
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- Wang, Jinsong (författare)
- Sun Yat Sen Univ, Affiliated Hosp 1, Guangzhou, Guangdong, Peoples R China
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- Wang, Shenming (författare)
- Sun Yat Sen Univ, Affiliated Hosp 1, Guangzhou, Guangdong, Peoples R China
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(creator_code:org_t)
- Saunders Elsevier, 2019
- 2019
- Engelska.
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Ingår i: European Journal of Vascular and Endovascular Surgery. - : Saunders Elsevier. - 1078-5884 .- 1532-2165. ; 58:1, s. S1-S109
- Relaterad länk:
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http://www.ejves.com...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Chronic limb-threatening ischemia (CLTI) is associated with mortality, amputation, and impaired quality of life. These Global Vascular Guidelines (GVG) are focused on definition, evaluation, and management of CLTI with the goals of improving evidence-based care and highlighting critical research needs. The term CLTI is preferred over critical limb ischemia, as the latter implies threshold values of impaired perfusion rather than a continuum. CLTI is a clinical syndrome defined by the presence of peripheral artery disease (PAD) in combination with rest pain, gangrene, or a lower limb ulceration >2 weeks duration. Venous, traumatic, embolic, and nonatherosclerotic etiologies are excluded. All patients with suspected CLTI should be referred urgently to a vascular specialist. Accurately staging the severity of limb threat is fundamental, and the Society for Vascular Surgery Threatened Limb Classification system, based on grading of Wounds, Ischemia, and foot Infection (WIfI) is endorsed. Objective hemodynamic testing, including toe pressures as the preferred measure, is required to assess CLTI. Evidence-based revascularization (EBR) hinges on three independent axes: Patient risk, Limb severity, and ANatomic complexity (PLAN). Average-risk and high-risk patients are defined by estimated procedural and 2-year all-cause mortality. The GVG proposes a new Global Anatomic Staging System (GLASS), which involves defining a preferred target artery path (TAP) and then estimating limb-based patency (LBP), resulting in three stages of complexity for intervention. The optimal revascularization strategy is also influenced by the availability of autogenous vein for open bypass surgery. Recommendations for EBR are based on best available data, pending level 1 evidence from ongoing trials. Vein bypass may be preferred for average-risk patients with advanced limb threat and high complexity disease, while those with less complex anatomy, intermediate severity limb threat, or high patient risk may be favored for endovascular intervention. All patients with CLTI should be afforded best medical therapy including the use of antithrombotic, lipid-lowering, antihypertensive, and glycemic control agents, as well as counseling on smoking cessation, diet, exercise, and preventive foot care. Following EBR, long-term limb surveillance is advised. The effectiveness of nonrevascularization therapies (eg, spinal stimulation, pneumatic compression, prostanoids, and hyperbaric oxygen) has not been established. Regenerative medicine approaches (eg, cell, gene therapies) for CLTI should be restricted to rigorously conducted randomizsed clinical trials. The GVG promotes standardization of study designs and end points for clinical trials in CLTI. The importance of multidisciplinary teams and centers of excellence for amputation prevention is stressed as a key health system initiative.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- Chronic limb-threatening ischemia
- Critical limb ischemia
- Peripheral artery disease
- Diabetes
- Foot ulcer
- Endovascular intervention
- Bypass surgery
- Practice guideline
- Evidence-based medicine
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Conte, Michael S ...
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Bradbury, Andrew ...
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Kolh, Philippe
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White, John, V
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Dick, Florian
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Fitridge, Robert
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visa fler...
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Mills, Joseph L.
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Ricco, Jean-Bapt ...
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Suresh, Kalkunte ...
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Murad, M. Hassan
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Aboyans, Victor
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Aksoy, Murat
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Alexandrescu, Vl ...
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Armstrong, David
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Azuma, Nobuyoshi
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Belch, Jill
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Bergoeing, Miche ...
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Björck, Martin
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Chakfe, Nabil
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Cheng, Stephen
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Dawson, Joseph
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Debus, Eike S.
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Dueck, Andrew
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Duval, Susan
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Eckstein, Hans H ...
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Ferraresi, Rober ...
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Gambhir, Raghvin ...
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Garguilo, Mauro
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Geraghty, Patric ...
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Goode, Steve
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Gray, Bruce
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Guo, Wei
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Gupta, Prem C.
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Hinchliffe, Robe ...
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Jetty, Prasad
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Komori, Kimihiro
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Lavery, Lawrence
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Liang, Wei
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Lookstein, Rober ...
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Menard, Matthew
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Misra, Sanjay
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Miyata, Tetsuro
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Moneta, Greg
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Prado, Jose A. M ...
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Munoz, Alberto
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Paolini, Juan E.
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Patel, Manesh
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Pomposelli, Fran ...
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Powell, Richard
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Robless, Peter
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Rogers, Lee
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Schanzer, Andres
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Schneider, Peter
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Taylor, Spence
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De Ceniga, Melin ...
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Veller, Martin
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Vermassen, Frank
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Wang, Jinsong
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Wang, Shenming
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