Mohammed Al-Omran, MD, MSc, and Yaron Sternbach, MD, Division of Vascular Surgery, Toronto General Hospital and the University of Toronto.
Arterial occlusive disease of the lower extremities is an important cause of disability in older adults and those with risk factors for atherosclerosis. The process may be asymptomatic or manifest as a progression from claudication to ulceration. Identification of patients at risk is vital to careful surveillance and early intervention. Revascularization remains the mainstay of therapy for critically ischemic limbs. Catheter-based techniques such as angioplasty are useful for focal disease. Conventional bypass surgery remains the mainstay of therapy for more extensive disease with ulceration and may be supplemented by adjunctive plastic surgery procedures for soft tissue coverage and limb salvage. Amputation is performed when reconstruction is not feasible or in the setting of severe progressive infection. The current article provides a more detailed review of lower extremity ischemia.
Key words: Peripheral arterial occlusive disease (PAOD), atherosclerosis risk factors, bypass, angioplasty, patency rates.