The Selection of Revascularization in the Treatment of Critical Limb Ischemia :

From the Viewpoint of Plastic Surgeons

Abstract

In the treatment of critical limb ischemia, revascularization of the affected extremity through surgical bypass or endovascular therapy plays a crucial role in limb salvage. There is no evidence on the choice of revascularization, making the decision difficult for plastic surgeons who are not adept at revascularization. We analyzed whether or not the conditions of leg ulcers （extent and infection） could be used as selection criteria for revascularization. For foot ulcers distal to MTP joints and for uninfected ones, EVT should be the first option. On the other hand, for those extending proximal to MTP joints, on the heel, or that are infected, bypass surgery should be the first option, especially in that the rate of major amputations is higher in EVT cases.