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INTERNATIONAL ANGIOLOGY

Rivista di Angiologia


Official Journal of the International Union of Angiology, the International Union of Phlebology and the Central European Vascular Forum
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International Angiology 2000 Giugno;19(2):97-125

lingua: Inglese

A clinical approach to the management of the patient with coronary (Co) and/or carotid (Ca) artery disease who presents with leg ischaemia (Lis)

Clement D. L., Boccalon H. 1, Dormandy J. 2, Durand-Zaleski I. 3, Fowkes G. 4, Brown T. 5

From the Depart­ment of Car­di­o­vas­cu­lar Dis­ease, Uni­ver­sity Hos­pi­tal, Ghent, Bel­gium
1 Ser­vice ­d’Angiologie, CHU Ran­gueil, Tou­louse, ­France
2 Depart­ment of Vas­cu­lar Sur­gery, St. ­George’s Hos­pi­tal, Lon­don, UK
3 Hôpital Henri Men­dor, Cre­teil, ­France
4 Wol­fson Unit for Pre­ven­tion of Periph­er­al Vas­cu­lar Dis­eas­es, Uni­ver­sity of Edin­burgh, Edin­burgh, UK
5 Merck Lipha SA, Lyon, ­France


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The pur­pose of this doc­u­ment is to pro­vide the cli­ni­cian with easy-to-use guide­lines when faced with a ­patient with ­severe ischae­mia in the limbs requir­ing inter­ven­tion­al treat­ment; the CoC­aL­is doc­u­ment does not focus on the man­age­ment of the lower limb ischae­mia, but rath­er on the best pos­sible ­approach to the asso­ciat­ed cor­o­nary and/or carot­id ­artery dis­ease. The first part of the text deals with the epi­dem­i­olog­i­cal ­aspects of this con­di­tion fol­lowed by a descrip­tion of, and pro­po­sals for, the man­age­ment of risk fac­tors. The next part deals with the ­approach to the cor­o­nary cir­cu­la­tion and the carot­id ter­ri­to­ry. In each part atten­tion is main­ly given to the prac­ti­cal ­aspects in terms of both diag­no­sis and treat­ment; for each of these steps the costs ­involved are con­sid­ered and atten­tion given to bal­anc­ing the clin­i­cal deci­sions ­against the costs. The rec­om­men­da­tions given are ‘evi­dence ­based’ when such evi­dence ­exists and, if not, the pro­po­sals are based on the con­sen­sus of the mem­bers of the group. In many instanc­es it was appar­ent that the nec­es­sary infor­ma­tion is not avail­able in the lit­er­a­ture. The ­authors hope that the CoC­aL­is doc­u­ment may not only ­improve the man­age­ment of the vas­cu­lar ­patient but also stim­u­late fur­ther ­research in this dif­fi­cult clin­i­cal con­di­tion which car­ries a sig­nif­i­cant­ly ­increased risk for the ­patient.

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