Revascularization for the peripheral arterial disease (PAD) : Surgical reconstruction and endovascular treatment

Abstract

Acute lower limb ischemia requires as prompt revascularization as possible. If an irreversible change to the tissue is confirmed, a judgment concerning amputation is required. Most cases of chronic lower limbs ischemia are arteriosclerosis obliterans. The disease structure becomes complicated, and diabetes and dialysis cases increase the possibility of complications. Chronic lower limb ischemia is divided into intermittent claudication and critical limb ischemia, and timings of the revascularization intervention are totally different. Intermittent claudication is given conservative treatment, and revascularization is considered when a symptom remains. Revascularization at the earliest possible moment is necessary for critical limb ischemia. Even if an abnormality is pointed out with a CT imaging and a ABI test value, we revascularize it but do not intervene in cases without a symptom.