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The Journal of Cardiovascular Surgery 2012 February;53(1):45-52

Copyright © 2012 EDIZIONI MINERVA MEDICA

language: English

Lesion characteristics of patients with chronic critical limb ischemia that determine choice of treatment modality

Van Den Berg J. C. ¹, Waser S. ², Trelle S. ³, Diehm N. ², Baumgartner I. ² ✉

¹ Service of Interventional Radiology, Ospedale Regionale di Lugano sede Civico, Lugano, Switzerland; ² Swiss Cardiovascular Center, Division of Clinical and Interventional Angiology, Inselspital, University of Bern, Bern, Switzerland; ³ Institute of Social and Preventive Medicine (ISPM), Division of Clinical Epidemiology and Biostatistics, University of Bern, Bern, Switzerland

This paper will review the literature in order to define lesion characteristics that determine decision for surgical or endovascular therapy in patients with chronic critical limb ischemia (CLI). The typical pattern of disease is multilevel, infrainguinal disease. The great majority of patients with CLI can be treated by endovascular means, and the pathoanatomical pattern of disease dictates the choice of treatment modality. Long iliac artery occlusions, in particular, if associated with common femoral artery pathology and long superficial femoral artery occlusions crossing the knee joint so far remain a domain of surgery. However, there is an ongoing shift from surgery to endovascular treatment.