Lower-Limb Ischemia in the Young Patient: Management Strategies in an Endovascular Era
Background The aim of this paper is to review the potential role of endovascular interventions for young patients with lower-limb ischaemia. Methods A literature search was performed of PubMed and Medline databases using appropriate search terms and limits. Case reports, retrospective studies, and p...
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| Veröffentlicht in: | Annals of vascular surgery 2012-05, Vol.26 (4), p.591-599 |
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| container_title | Annals of vascular surgery |
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| creator | Morbi, Abigail Gohel, Manj S Hamady, Mohamed Cheshire, Nicholas J.W Bicknell, Colin D |
| description | Background The aim of this paper is to review the potential role of endovascular interventions for young patients with lower-limb ischaemia. Methods A literature search was performed of PubMed and Medline databases using appropriate search terms and limits. Case reports, retrospective studies, and prospective studies evaluating treatment of lower-limb ischemia in patients aged |
| doi_str_mv | 10.1016/j.avsg.2011.06.008 |
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Methods A literature search was performed of PubMed and Medline databases using appropriate search terms and limits. Case reports, retrospective studies, and prospective studies evaluating treatment of lower-limb ischemia in patients aged <50 years were scrutinized. Articles published between 1966 and 2010 were included in this review. Results Premature atherosclerosis is likely to represent the commonest cause of lower-limb ischemia in patients aged <50 years, although the incidence of nonatherosclerotic causes such as popliteal entrapment syndrome, cystic adventitial disease, and arteritis in these patients is greater than in older patients. As with older patients, endovascular interventions may be beneficial for patients with symptoms secondary to atherosclerosis. At present, the perceived durability of open surgery may be more preferable to patients aged <50 years, but the development of new endovascular technology is challenging this view. Endovascular interventions such as catheter-directed thrombolysis have specific roles in the treatment of lower-limb ischemia due to nonatherosclerotic causes. Conclusion The use of angioplasty and stenting procedures to treat young patients with lower-limb ischemia is increasing and has specific roles. However, many developmental causes and nonatherosclerotic conditions still require primary surgical correction.</description><identifier>ISSN: 0890-5096</identifier><identifier>EISSN: 1615-5947</identifier><identifier>DOI: 10.1016/j.avsg.2011.06.008</identifier><identifier>PMID: 22050881</identifier><language>eng</language><publisher>Netherlands: Elsevier Inc</publisher><subject>Age Factors ; Disease Management ; Endovascular Procedures - standards ; Global Health ; Humans ; Incidence ; Ischemia - epidemiology ; Ischemia - therapy ; Leg - blood supply ; Practice Guidelines as Topic ; Risk Factors ; Surgery</subject><ispartof>Annals of vascular surgery, 2012-05, Vol.26 (4), p.591-599</ispartof><rights>Annals of Vascular Surgery Inc.</rights><rights>2012 Annals of Vascular Surgery Inc.</rights><rights>Copyright © 2012 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c477t-8edad485d67ed57d0c1282aaa700d45cf8edb20f0c689e662632a6b018421c0b3</citedby><cites>FETCH-LOGICAL-c477t-8edad485d67ed57d0c1282aaa700d45cf8edb20f0c689e662632a6b018421c0b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.avsg.2011.06.008$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22050881$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Morbi, Abigail</creatorcontrib><creatorcontrib>Gohel, Manj S</creatorcontrib><creatorcontrib>Hamady, Mohamed</creatorcontrib><creatorcontrib>Cheshire, Nicholas J.W</creatorcontrib><creatorcontrib>Bicknell, Colin D</creatorcontrib><title>Lower-Limb Ischemia in the Young Patient: Management Strategies in an Endovascular Era</title><title>Annals of vascular surgery</title><addtitle>Ann Vasc Surg</addtitle><description>Background The aim of this paper is to review the potential role of endovascular interventions for young patients with lower-limb ischaemia. Methods A literature search was performed of PubMed and Medline databases using appropriate search terms and limits. Case reports, retrospective studies, and prospective studies evaluating treatment of lower-limb ischemia in patients aged <50 years were scrutinized. Articles published between 1966 and 2010 were included in this review. Results Premature atherosclerosis is likely to represent the commonest cause of lower-limb ischemia in patients aged <50 years, although the incidence of nonatherosclerotic causes such as popliteal entrapment syndrome, cystic adventitial disease, and arteritis in these patients is greater than in older patients. As with older patients, endovascular interventions may be beneficial for patients with symptoms secondary to atherosclerosis. At present, the perceived durability of open surgery may be more preferable to patients aged <50 years, but the development of new endovascular technology is challenging this view. Endovascular interventions such as catheter-directed thrombolysis have specific roles in the treatment of lower-limb ischemia due to nonatherosclerotic causes. Conclusion The use of angioplasty and stenting procedures to treat young patients with lower-limb ischemia is increasing and has specific roles. However, many developmental causes and nonatherosclerotic conditions still require primary surgical correction.</description><subject>Age Factors</subject><subject>Disease Management</subject><subject>Endovascular Procedures - standards</subject><subject>Global Health</subject><subject>Humans</subject><subject>Incidence</subject><subject>Ischemia - epidemiology</subject><subject>Ischemia - therapy</subject><subject>Leg - blood supply</subject><subject>Practice Guidelines as Topic</subject><subject>Risk Factors</subject><subject>Surgery</subject><issn>0890-5096</issn><issn>1615-5947</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFu1DAQhi0EokvhBTggH7kkjL2J4yCEhKoFKi0CqYDgZE3s2a2XxCl2sqhvj6MtHDhw8hy-_5fnG8aeCigFCPXiUOIx7UsJQpSgSgB9j62EEnVRt1Vzn61At1DU0Koz9iilA4CQutIP2ZmUUIPWYsW-bsdfFIutHzp-mew1DR65D3y6Jv59nMOef8LJU5he8g8YcE9DnvnVFHGivae0sBj4JrjxiMnOPUa-ifiYPdhhn-jJ3XvOvrzdfL54X2w_vru8eLMtbNU0U6HJoat07VRDrm4c2PxDiYgNgKtqu8tAJ2EHVumWlJJqLVF1IHQlhYVufc6en3pv4vhzpjSZwSdLfY-BxjkZAdAK2bYVZFSeUBvHlCLtzE30A8bbDJnFpzmYxadZfBpQJvvMoWd3_XM3kPsb-SMwA69OAOUtj56iSTbrsuR8JDsZN_r_97_-J257H7zF_gfdUjqMcwzZnxEmSQPmarnoclCRF1u38tv6NwPPmuo</recordid><startdate>20120501</startdate><enddate>20120501</enddate><creator>Morbi, Abigail</creator><creator>Gohel, Manj S</creator><creator>Hamady, Mohamed</creator><creator>Cheshire, Nicholas J.W</creator><creator>Bicknell, Colin D</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20120501</creationdate><title>Lower-Limb Ischemia in the Young Patient: Management Strategies in an Endovascular Era</title><author>Morbi, Abigail ; Gohel, Manj S ; Hamady, Mohamed ; Cheshire, Nicholas J.W ; Bicknell, Colin D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c477t-8edad485d67ed57d0c1282aaa700d45cf8edb20f0c689e662632a6b018421c0b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Age Factors</topic><topic>Disease Management</topic><topic>Endovascular Procedures - standards</topic><topic>Global Health</topic><topic>Humans</topic><topic>Incidence</topic><topic>Ischemia - epidemiology</topic><topic>Ischemia - therapy</topic><topic>Leg - blood supply</topic><topic>Practice Guidelines as Topic</topic><topic>Risk Factors</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Morbi, Abigail</creatorcontrib><creatorcontrib>Gohel, Manj S</creatorcontrib><creatorcontrib>Hamady, Mohamed</creatorcontrib><creatorcontrib>Cheshire, Nicholas J.W</creatorcontrib><creatorcontrib>Bicknell, Colin D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of vascular surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Morbi, Abigail</au><au>Gohel, Manj S</au><au>Hamady, Mohamed</au><au>Cheshire, Nicholas J.W</au><au>Bicknell, Colin D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lower-Limb Ischemia in the Young Patient: Management Strategies in an Endovascular Era</atitle><jtitle>Annals of vascular surgery</jtitle><addtitle>Ann Vasc Surg</addtitle><date>2012-05-01</date><risdate>2012</risdate><volume>26</volume><issue>4</issue><spage>591</spage><epage>599</epage><pages>591-599</pages><issn>0890-5096</issn><eissn>1615-5947</eissn><abstract>Background The aim of this paper is to review the potential role of endovascular interventions for young patients with lower-limb ischaemia. Methods A literature search was performed of PubMed and Medline databases using appropriate search terms and limits. Case reports, retrospective studies, and prospective studies evaluating treatment of lower-limb ischemia in patients aged <50 years were scrutinized. Articles published between 1966 and 2010 were included in this review. Results Premature atherosclerosis is likely to represent the commonest cause of lower-limb ischemia in patients aged <50 years, although the incidence of nonatherosclerotic causes such as popliteal entrapment syndrome, cystic adventitial disease, and arteritis in these patients is greater than in older patients. As with older patients, endovascular interventions may be beneficial for patients with symptoms secondary to atherosclerosis. At present, the perceived durability of open surgery may be more preferable to patients aged <50 years, but the development of new endovascular technology is challenging this view. Endovascular interventions such as catheter-directed thrombolysis have specific roles in the treatment of lower-limb ischemia due to nonatherosclerotic causes. Conclusion The use of angioplasty and stenting procedures to treat young patients with lower-limb ischemia is increasing and has specific roles. However, many developmental causes and nonatherosclerotic conditions still require primary surgical correction.</abstract><cop>Netherlands</cop><pub>Elsevier Inc</pub><pmid>22050881</pmid><doi>10.1016/j.avsg.2011.06.008</doi><tpages>9</tpages></addata></record> |
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| subjects | Age Factors Disease Management Endovascular Procedures - standards Global Health Humans Incidence Ischemia - epidemiology Ischemia - therapy Leg - blood supply Practice Guidelines as Topic Risk Factors Surgery |
| title | Lower-Limb Ischemia in the Young Patient: Management Strategies in an Endovascular Era |
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