REVIEW  SAVE THE SEVERELY ISCHEMIC LIMB: THE JOINT PRACTICAL APPROACHES Free access

Italian Journal of Vascular and Endovascular Surgery 2020 December;27(4):175-181

DOI: 10.23736/S1824-4777.21.01484-4

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

The vascular districts involved

Alberto M. SETTEMBRINI ✉

Vascular Surgery, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, Milan, Italy

In this chapter the author makes the point on the diagnostic approach in the patient affected by critical limb ischemia. In the last years some changes in the clinical and operative management of these patients have been made. After years in which second level examinations were considered the gold standard in the preoperative evaluation, duplex ultrasound is increasing again its wide use and diffusion because of the flow analysis, especially in below-the-knee tract, could be considered mandatory before endovascular or surgical treatment: different comparisons between invasive exams and duplex revealed that duplex is able to detect patent arteries even though characterized by a very low flow, sometimes useful for a distal bypass. Aim of this study was to analyze which is the better diagnostic pathway to evaluate the chance of a peripheral revascularization and the real-life behavior in a vascular surgery unit in case of critical limb ischemia.

KEY WORDS: Ischemia; Peripheral arterial disease; Ultrasonography, Doppler, duplex