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Critical limb ischemia: current challenges and future prospects

Authors Uccioli L, Meloni M, Izzo V, Giurato L, Merolla S, Gandini R

Received 25 July 2017

Accepted for publication 5 December 2017

Published 26 April 2018 Volume 2018:14 Pages 63—74

DOI https://doi.org/10.2147/VHRM.S125065

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 4

Editor who approved publication: Dr Konstantinos Tziomalos


Luigi Uccioli,1 Marco Meloni,1 Valentina Izzo,1 Laura Giurato,1 Stefano Merolla,2 Roberto Gandini2

1Department of Systems Medicine, 2Department of Interventional Radiology, Università di Tor Vergata Roma, Rome, Italy

Abstract: Critical limb ischemia (CLI) is considered the most severe pattern of peripheral artery disease. It is defined by the presence of chronic ischemic rest pain, ulceration or gangrene attributable to the occlusion of peripheral arterial vessels. It is associated with a high risk of major amputation, cardiovascular events and death. In this review, we presented a complete overview about physiopathology, diagnosis and holistic management of CLI. Revascularization is the first-line treatment, but several challenging cases are not treatable by conventional techniques. Unconventional techniques for the treatment of complex below-the-knee arterial disease are described. Furthermore, the state-of-the-art on gene and cell therapy for the treatment of no-option patients is reported.

Keywords: peripheral arterial disease, critical limb ischemia, medical therapy, revascularization, cell therapy

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