[Recommended interventions for the treatment of peripheral artery disease : Keep the patients moving]. / Was ist gesichert in der interventionellen Therapie der peripheren arteriellen Verschlusskrankheit? : Mobilität der Patienten erhalten.
Internist (Berl)
; 60(12): 1235-1239, 2019 Dec.
Article
en De
| MEDLINE
| ID: mdl-31667527
BACKGROUND: Peripheral artery disease (PAD) is often diagnosed in an advanced stage. Accordingly, revascularization is also performed late. OBJECTIVES: In this paper, the authors describe the progression to critical limb ischemia and cardiovascular risk. Revascularization for secondary prevention is explained. Revascularization strategies according to lesion location and complexity of the stenosis or occlusion are discussed. MATERIALS AND METHODS: The current guidelines and randomized controlled studies and meta-analyses are analyzed. RESULTS: PAD is associated with a considerable level of suffering and a high cardiovascular risk. Up to 20% of patients with claudicants will progress to critical limb ischemia. Progression and risk of mortality increase during the course of the disease. Improvement of walking ability by revascularization is a major goal of secondary prevention. In the femoropopliteal segment, drug-coated balloon (DCB) angioplasty and bare-metal stent (BMS) implantation are the methods of choice. In long lesions, spot-stenting should be preferred. For treatment of in-stent restenosis, DCB have proven their effectiveness. In severely calcified or dissected lesions, BMS are well suited. Infrapopliteal lesions should be revascularized to provide in-line flow to the foot through the target arterial path. According to current evidence, DCB or drug-eluting stents are more effective than plain old balloon angioplasty or BMS.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Guías de Práctica Clínica como Asunto
/
Angioplastia de Balón
/
Extremidad Inferior
/
Enfermedad Arterial Periférica
Tipo de estudio:
Clinical_trials
/
Guideline
Límite:
Humans
Idioma:
De
Revista:
Internist (Berl)
Año:
2019
Tipo del documento:
Article
Pais de publicación:
Alemania