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Archive » 2016 » 4 » | Archive » Medical field » Fields » Radiology »

The Role of Interventional Radiology in Management of Peripheral Arterial Disease

 
Abstract:

This post is also available in: enEnglish slSlovenščina (Slovenian)

Peripheral arterial disease is often chronic, acute critical ischemia is rare. In contrast to invasive cardiology, interventional radiology is mostly concerned with chronic arterial disease. Acute limb ischemia is often caused by embolism or thrombosis of previously stenosed artery and removal or dissolution of the thrombus is attempted. If the limb is not compromised, delayed recanalization is often performed to avoid distal arterial embolization with aggravation of symptoms. The leading symptom of chronic limb ischemia is claudication; aggravation can result in chronic critical limb ischemia with rest pain and/or ulceration. The primary goal is revascularization with guidewires and dilatation with balloon catheters. Such procedures mostly require hospitalization, which leads to prolonged waiting lists on referring wards and reduced accessibility to interventional radiology. In order to reduce hospitalizations and to facilitate the access to interventional radiology, a day hospital was set up by the Clinical Radiology Institute at the University Medical Centre Ljubljana in 2012. Between January 2013 and November 2015, 409 patients were hospitalized at the institute; the majority of the patients were admitted due to vascular pathology, mostly due to arterial pathology (213 patients, 52.1%). The majority of the patients treated (151/213, 70.9%) had chronic critical limb ischemia, the remaining had claudication. The primary success was 90.2%; only in eight patients stent was used for bail-out. Despite the serious pathology, severe complications were rare. En-
dovascular management of patients with peripheral arterial disease is multidisciplinary, special attention should be focused on patients with chronic critical limb ischemia. Introduction of day hospital at the Clinical Radiology Institute facilitated the access to interventional radiology for the patients outside of Ljubljana; such management proved to be safe and effective. In the future, the majority of patients with peripheral arterial disease should be treated this way.

Authors:
Kuhelj Dimitrij

Keywords:
peripheral arterial disease, endovascular management

Cite as:
Med Razgl. 2016; 55 (4): 419–25.

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