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FältnamnIndikatorerMetadata
00010349naa a2201105 4500
001oai:DiVA.org:uu-390918
003SwePub
008190815s2019 | |||||||||||000 ||eng|
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-3909182 URI
0247 a https://doi.org/10.1016/j.ejvs.2019.05.0062 DOI
040 a (SwePub)uu
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Conte, Michael S.u Univ Calif San Francisco, Div Vasc & Endovasc Surg, 400 Parnassus Ave,Ste A581, San Francisco, CA 94143 USA4 aut
2451 0a Global Vascular Guidelines on the Management of Chronic Limb-Threatening Ischemia
264 1b Saunders Elsevier,c 2019
338 a print2 rdacarrier
500 a Correction in: EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, Volume: 59, Issue: 3, Pages: 492-493, DOI: 10.1016/j.ejvs.2019.11.025Correction in: EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY, Volume: 60, Issue: 1, Pages: 158-159, DOI: 10.1016/j.ejvs.2020.04.033
520 a 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.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kirurgi0 (SwePub)302122 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Surgery0 (SwePub)302122 hsv//eng
653 a Chronic limb-threatening ischemia
653 a Critical limb ischemia
653 a Peripheral artery disease
653 a Diabetes
653 a Foot ulcer
653 a Endovascular intervention
653 a Bypass surgery
653 a Practice guideline
653 a Evidence-based medicine
7001 a Bradbury, Andrew W.u Univ Birmingham, Dept Vasc Surg, Birmingham, W Midlands, England4 aut
7001 a Kolh, Philippeu Univ Hosp Liege, Dept Biomed & Preclin Sci, Wallonia, Belgium4 aut
7001 a White, John, Vu Advocate Lutheran Gen Hosp, Dept Surg, Niles, IL USA4 aut
7001 a Dick, Florianu Kantonsspital St Gallen, Dept Vasc Surg, St Gallen, Switzerland;Univ Bern, Bern, Switzerland4 aut
7001 a Fitridge, Robertu Univ Adelaide, Med Sch, Dept Vasc & Endovasc Surg, Adelaide, SA, Australia4 aut
7001 a Mills, Joseph L.u Baylor Coll Med, Div Vasc Surg & Endovasc Therapy, Houston, TX 77030 USA4 aut
7001 a Ricco, Jean-Baptisteu Univ Hosp Poitiers, Dept Clin Res, Poitiers, France4 aut
7001 a Suresh, Kalkunte R.u Jain Inst Vasc Sci, Bangalore, Karnataka, India4 aut
7001 a Murad, M. Hassanu Mayo Clin, Evidence Based Practice Ctr, Rochester, MN USA4 aut
7001 a Aboyans, Victoru Univ Hosp, Dept Cardiol, Dupuytren, France4 aut
7001 a Aksoy, Muratu Amer Hosp, Dept Vasc Surg, Istanbul, Turkey4 aut
7001 a Alexandrescu, Vlad-Adrianu Univ Liege, CHU Sart Tilman Hosp, Liege, Belgium4 aut
7001 a Armstrong, Davidu Univ Southern Calif, Los Angeles, CA USA4 aut
7001 a Azuma, Nobuyoshiu Asahikawa Med Univ, Asahikawa, Hokkaido, Japan4 aut
7001 a Belch, Jillu Univ Dundee, Ninewells Hosp, Dundee, Scotland4 aut
7001 a Bergoeing, Michelu Pontificia Univ Catolica Chile, Escuela Med, Santiago, Chile4 aut
7001 a Björck, Martinu Uppsala universitet,Kärlkirurgi4 aut0 (Swepub:uu)mabjo425
7001 a Chakfe, Nabilu Univ Hosp Strasbourg, Strasbourg, France4 aut
7001 a Cheng, Stephenu Univ Hong Kong, Hong Kong, Peoples R China4 aut
7001 a Dawson, Josephu Royal Adelaide Hosp, Adelaide, SA, Australia;Univ Adelaide, Adelaide, SA, Australia4 aut
7001 a Debus, Eike S.u Univ Hosp Hamburg Eppendorf, Univ Heart Ctr Hamburg, Hamburg, Germany4 aut
7001 a Dueck, Andrewu Univ Toronto, Schulich Heart Ctr, Sci Ctr, Sunnybrook Hlth, Toronto, ON, Canada4 aut
7001 a Duval, Susanu Univ Minnesota, Med Sch, Cardiovasc Div, Minneapolis, MN 55455 USA4 aut
7001 a Eckstein, Hans H.u Tech Univ Munich, Munich, Germany4 aut
7001 a Ferraresi, Robertou Ist Clin, Intervent Cardiovasc Unit, Cardiol Dept, Milan, Italy4 aut
7001 a Gambhir, Raghvinderu Kings Coll Hosp London, London, England4 aut
7001 a Garguilo, Maurou Univ Bologna, Diagnost & Sperimentale, Bologna, Italy4 aut
7001 a Geraghty, Patricku Washington Univ, Sch Med, St Louis, MO USA4 aut
7001 a Goode, Steveu Sheffield Vasc Inst, Sheffield, S Yorkshire, England4 aut
7001 a Gray, Bruceu Greenville Hlth Syst, Greenville, SC USA4 aut
7001 a Guo, Weiu 301 Gen Hosp PLA, Beijing, Peoples R China4 aut
7001 a Gupta, Prem C.u Care Hosp, Banjara Hills, Hyderabad, India4 aut
7001 a Hinchliffe, Robertu Univ Bristol, Bristol, Avon, England4 aut
7001 a Jetty, Prasadu Ottawa Hosp, Div Vasc & Endovasc Surg, Ottawa, ON, Canada;Univ Ottawa, Ottawa, ON, Canada4 aut
7001 a Komori, Kimihirou Nagoya Univ, Grad Sch Med, Nagoya, Aichi, Japan4 aut
7001 a Lavery, Lawrenceu UT Southwestern Med Ctr, Dallas, TX USA4 aut
7001 a Liang, Weiu Shanghai Jiao Tong Univ, Renji Hosp, Sch Med, Shanghai, Peoples R China4 aut
7001 a Lookstein, Robertu Icahn Sch Med Mt Sinai, Div Vasc & Intervent Radiol, New York, NY 10029 USA4 aut
7001 a Menard, Matthewu Brigham & Womens Hosp, Boston, MA 02115 USA4 aut
7001 a Misra, Sanjayu Mayo Clin, Rochester, MN USA4 aut
7001 a Miyata, Tetsurou Sanno Hosp, Tokyo, Japan;Sanno Med Ctr, Tokyo, Japan4 aut
7001 a Moneta, Gregu Oregon Hlth & Sci Univ, Portland, OR 97201 USA4 aut
7001 a Prado, Jose A. Munoau Clin Venart, Tuxtla Gutierrez, Mexico4 aut
7001 a Munoz, Albertou Colombia Natl Univ, Bogota, Colombia4 aut
7001 a Paolini, Juan E.u Univ Buenos Aires, Sanatoria Dr Julio Mendez, Buenos Aires, DF, Argentina4 aut
7001 a Patel, Maneshu Duke Univ Hlth Syst, Div Cardiol, Durham, NC USA4 aut
7001 a Pomposelli, Franku St Elizabeths Med Ctr, Boston, MA USA4 aut
7001 a Powell, Richardu Dartmouth Hitchcock, Lebanon, NH USA4 aut
7001 a Robless, Peteru Mt Elizabeth Hosp, Singapore, Singapore4 aut
7001 a Rogers, Leeu Amputat Prevent Ctr Amer, White Plains, NY USA4 aut
7001 a Schanzer, Andresu Univ Massachusetts, Amherst, MA 01003 USA4 aut
7001 a Schneider, Peteru Kaiser Fdn Hosp Honolulu, Honolulu, HI USA;Hawaii Permanente Med Grp, Kahului, HI USA4 aut
7001 a Taylor, Spenceu USC Sch Med Greenville, Greenville Hlth Ctr, Greenville, SC USA4 aut
7001 a De Ceniga, Melina, Vu Hosp Galdakao Usansolo, Bizkaia, Spain4 aut
7001 a Veller, Martinu Univ Witwatersrand, Johannesburg, South Africa4 aut
7001 a Vermassen, Franku Ghent Univ Hosp, Ghent, Belgium4 aut
7001 a Wang, Jinsongu Sun Yat Sen Univ, Affiliated Hosp 1, Guangzhou, Guangdong, Peoples R China4 aut
7001 a Wang, Shenmingu Sun Yat Sen Univ, Affiliated Hosp 1, Guangzhou, Guangdong, Peoples R China4 aut
7102 a Univ Calif San Francisco, Div Vasc & Endovasc Surg, 400 Parnassus Ave,Ste A581, San Francisco, CA 94143 USAb Univ Birmingham, Dept Vasc Surg, Birmingham, W Midlands, England4 org
7730 t European Journal of Vascular and Endovascular Surgeryd : Saunders Elsevierg 58:1, s. S1-S109q 58:1<S1-S109x 1078-5884x 1532-2165
8564 u http://www.ejves.com/article/S1078588419303806/pdf
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-390918
8564 8u https://doi.org/10.1016/j.ejvs.2019.05.006

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