干旱区生态环境知识资源中心(Arid): A Review and Proposed Classification System for the No-Option Patient With Chronic Limb-Threatening Ischemia

Arid

DOI	10.1177/1526602820963911
	A Review and Proposed Classification System for the No-Option Patient With Chronic Limb-Threatening Ischemia
	Kim, Tanner I.; Vartanian, Shant S.; Schneider, Peter A.
通讯作者	Schneider, PA
来源期刊	JOURNAL OF ENDOVASCULAR THERAPY
ISSN	1526-6028
EISSN	1545-1550
英文摘要	A growing, but poorly defined subset of patients with chronic limb-threatening ischemia (CLTI) have "no option" for revascularization. One notable subgroup includes patients with severe ischemia and advanced pedal artery occlusive disease, termed "desert foot," who are at high risk for major amputation due to a lack of conventional revascularization options. Although new therapies are being developed for no-option patients with desert foot anatomy, this subgroup and the broader group of no-option patients are not well defined, limiting the ability to evaluate outcomes. Based on a systematic review, a classification of the no-option CLTI patient was constructed for use in clinical practice and studies. Several no-option conditions were identified, including type I-severe and pedal occlusive disease (desert foot anatomy) for which there is no accepted method of repair; type II-lack of suitable venous conduit for bypass in the setting of an acceptable target for bypass; type III-extensive tissue loss with exposure of vital structures that renders salvage impossible; type IV-advanced medical comorbidities for which available revascularization options would pose a prohibitive risk; and type V-presence of a nonfunctional limb. While type I and type II patients may have no option for revascularization, type III and type V patients have wounds, infection, comorbidities, or functional status that may leave them with few options for revascularization. As treatment strategies continue to evolve and novel methods of revascularization are developed, the ability to identify no-option patients in a standardized fashion will aid in treatment selection and assessment of outcomes.
英文关键词	amputation bypass graft comorbidities critical limb ischemia desert foot endovascular therapy infection ischemic wound limb salvage peripheral vascular disease revascularization tissue loss
类型	Review ; Early Access
语种	英语
收录类别	SCI-E
WOS记录号	WOS:000577448800001
WOS关键词	DISTAL VENOUS ARTERIALIZATION ; AMPUTATION-FREE SURVIVAL ; DEEP-VEIN ARTERIALIZATION ; MARROW MONONUCLEAR-CELLS ; GREATER SAPHENOUS-VEIN ; CRITICAL LEG ISCHEMIA ; PEDAL ARCH PATENCY ; DOUBLE-BLIND ; DIABETIC FOOT ; ANGIOSOME REVASCULARIZATION
WOS类目	Surgery ; Peripheral Vascular Disease
WOS研究方向	Surgery ; Cardiovascular System & Cardiology
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/328341
作者单位	[Kim, Tanner I.] Yale Sch Med, Dept Surg, Div Vasc Surg, New Haven, CT USA; [Vartanian, Shant S.; Schneider, Peter A.] Univ Calif San Francisco, Sch Med, Div Vasc & Endovasc Surg, 400 Parnassus Ave,A-501, San Francisco, CA 94143 USA
推荐引用方式 GB/T 7714	Kim, Tanner I.,Vartanian, Shant S.,Schneider, Peter A.. A Review and Proposed Classification System for the No-Option Patient With Chronic Limb-Threatening Ischemia[J].
APA	Kim, Tanner I.,Vartanian, Shant S.,&Schneider, Peter A..
MLA	Kim, Tanner I.,et al."A Review and Proposed Classification System for the No-Option Patient With Chronic Limb-Threatening Ischemia".JOURNAL OF ENDOVASCULAR THERAPY