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Management of Cardiovascular Risk Factors and Medical Therapy

Diehm, N.; Schmidli, J.; Setacci, C.; Ricco, J. -B.; de Donato, G.; Becker, F.; Robert-Ebadi, H.; Cao, P.; Eckstein, H. H. and De Rango, P., et al. (2011) In European Journal of Vascular and Endovascular Surgery 42(Suppl. 2). p.33-42
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... (More)
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. (Less)
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publication status
published
subject
keywords
Conservative treatment, Medication, Risk factor modification
in
European Journal of Vascular and Endovascular Surgery
volume
42
issue
Suppl. 2
pages
33 - 42
publisher
Elsevier
external identifiers
  • wos:000298517700004
  • scopus:83455203485
ISSN
1532-2165
DOI
10.1016/S1078-5884(11)60011-7
language
English
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yes
id
55394e60-a904-4005-9a34-84a3885a18fc (old id 2348407)
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2012-03-01 11:20:33
date last changed
2017-06-11 04:04:18
@article{55394e60-a904-4005-9a34-84a3885a18fc,
  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. (C) 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.},
  author       = {Diehm, N. and Schmidli, J. and Setacci, C. and Ricco, J. -B. and de Donato, G. and Becker, F. and Robert-Ebadi, H. and Cao, P. and Eckstein, H. H. and De Rango, P. and Teraa, M. and Moll, F. L. and Dick, F. and Davies, A. H. and Lepantalo, M. and Apelqvist, Jan},
  issn         = {1532-2165},
  keyword      = {Conservative treatment,Medication,Risk factor modification},
  language     = {eng},
  number       = {Suppl. 2},
  pages        = {33--42},
  publisher    = {Elsevier},
  series       = {European Journal of Vascular and Endovascular Surgery},
  title        = {Management of Cardiovascular Risk Factors and Medical Therapy},
  url          = {http://dx.doi.org/10.1016/S1078-5884(11)60011-7},
  volume       = {42},
  year         = {2011},
}