Arterial diseases: therapeutic possibilities and their complications. Types of amputation

1. Big picture

Arterial disease becomes a surgical problem when reduced arterial flow threatens function, wound healing, limb viability, or life. The treatment decision is not simply “operate or not.” The surgeon must decide:

1. Is the limb viable?
2. Is ischemia acute or chronic?
3. Is the problem stenosis, thrombosis, embolus, aneurysm, trauma, or infection?
4. Can the limb be saved by revascularization?
5. If not, what level of amputation gives healing + best function?

The main treatment possibilities are:

Best medical therapy
+ exercise and risk-factor control
+ endovascular treatment
+ open arterial reconstruction
+ hybrid surgery
+ wound care/debridement
+ amputation when limb salvage is impossible or unsafe

Chronic limb-threatening ischemia means peripheral arterial disease with ischemic rest pain, non-healing ulcer, or gangrene, and management combines cardiovascular risk reduction, wound care, and revascularization when possible. ([Wikipedia][1])

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