Contemporary critical limb ischemia: Asian multidisciplinary consensus statement on the collaboration between endovascular therapy and wound care

Cardiovasc Interv Ther. 2018 Oct;33(4):297-312. doi: 10.1007/s12928-018-0523-z. Epub 2018 Apr 13.

Abstract

The burden of peripheral artery disease (PAD) and diabetes in Asia is projected to increase. Asia also has the highest incidence and prevalence of end-stage renal disease (ESRD) in the world. Therefore, most Asian patients with PAD might have diabetic PAD or ESRD-related PAD. Given these pandemic conditions, critical limb ischemia (CLI) with diabetes or ESRD, the most advanced and challenging subset of PAD, is an emerging public health issue in Asian countries. Given that diabetic and ESRD-related CLI have complex pathophysiology that involve arterial insufficiency, bacterial infection, neuropathy, and foot deformity, a coordinated approach that involves endovascular therapy and wound care is vital. Recently, there is increasing interaction among cardiologists, vascular surgeons, radiologists, orthopedic surgeons, and plastic surgeons beyond specialty and country boundaries in Asia. This article is intended to share practical Asian multidisciplinary consensus statement on the collaboration between endovascular therapy and wound care for CLI.

Keywords: Bacterial infection; Collaboration; Foot deformity; Interdisciplinary; Ischemia; Peripheral artery disease.

Publication types

  • Review

MeSH terms

  • Amputation, Surgical / methods
  • Asia
  • Consensus
  • Diabetic Foot / complications
  • Diabetic Foot / therapy*
  • Diagnosis, Differential
  • Endovascular Procedures / methods*
  • Humans
  • Intersectoral Collaboration
  • Ischemia / complications
  • Ischemia / therapy*
  • Kidney Failure, Chronic / complications
  • Lower Extremity / blood supply
  • Lower Extremity / surgery
  • Peripheral Arterial Disease / complications
  • Peripheral Arterial Disease / diagnosis
  • Peripheral Arterial Disease / therapy*
  • Risk Factors
  • Treatment Outcome
  • Wound Closure Techniques