Open Surgery Often The Best Option In Patients With Critical Limb Ischemia?

There are certain clinical situations in which an endovascular-first approach may be pose greater risk than with an open
approach; in these situations, open surgery should be the initial procedure to maximize the short and long-term success of the
procedure for critical limb ischemia (CLI).


Peter F. Lawrence, M.D., Chief of Vascular Surgery and Director of the Gonda Vascular Center at UCLA, described anatomic situations in which open surgery should be the first choice: "Open surgery is the best initial option for patients with extensive disease in the common femoral artery that extends into the profunda femoris artery. Open surgery should be the first choice also in patients with TASC D disease of the infrapopliteal vessels and CLI".


Dr. Lawrence also specifically identified diabetics with CLI as a group of patients for which often open surgery is more favorable, as it is essential that
pulsatile blood flow is delivered to the lower leg.


He has found that endovascular procedures frequently recanalize only a segment of
the vessels of the lower extremity and do not provide pulsatile flow to the foot.


Importantly, Dr. Lawrence believes that when an
open procedure is selected as the initial therapy, the procedure should be minimally invasive to be comparable in morbidity
and mortality with an endovascular procedure.


VEITH SYMPOSIUM - New York, November 19th to 23rd


Now in its fourth decade, VEITH SYMPOSIUM provides vascular surgeons, interventional radiologists, interventional cardiologists and other vascular specialists with a unique and exciting format to learn the most current information about what is new and important in the treatment of vascular disease. The 5-day event features rapid-fire presentations from world renowned vascular specialists with emphasis on the latest advances, changing concepts in diagnosis and management, pressing controversies and new techniques.


VEITHsymposium is sponsored by Cleveland Clinic, Cleveland, OH.


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Source

Pauline T. Mayer

ptmhcm