The effectiveness of infrainguinal percutaneous transluminal angioplasty in the treatment of critical limb ischaemia

........................................................................................13 Table of contents INTRoDUCTIoN aND ReVIew oF THe LITeRaTURe Chronic critical limb ischaemia ....................................................... 17 Introduction ................................................................................... 17 Definition of CLI ............................................................................ 17 Incidence and natural history ......................................................18 Fate of the patient with CLI ...........................................................19 Risk factors for CLI ........................................................................... 20 Diabetes ........................................................................................ 20 Smoking .........................................................................................21 Dyslipidaemia ...............................................................................21 age .................................................................................................21 Diagnosis of CLI ...............................................................................21 Clinical presentation and physical examination .........................21 Pressure measurements ...............................................................23 ankle pressure and ankle-brachial index.................................23 Toe pressure and toe-brachial index ........................................23 Imaging techniques .......................................................................23 Digital subtraction angiography ..............................................24 Colour-assisted duplex ultrasonography ...............................24 Magnetic resonance angiography .......................................... 25 Computed tomography angiography ..................................... 25 evaluation of arterial lesion severity and extent ............................ 26 The Bollinger scoring method ..................................................... 26 TaSC ................................................................................................27 TaSC II ............................................................................................ 28 evaluation of outflow .................................................................... 29 Treatment of CLI ................................................................................ 29 Conservative treatment of CLI ...................................................... 31 Modification of atherosclerotic risk factors ............................ 31 Diabetes ................................................................................. 31 Smoking cessation ................................................................32 Dyslipidaemia ........................................................................33 Hypertension .........................................................................34 antithrombotic therapy ............................................................34 other medical and pharmacological treatment of CLI ..........35 Invasive treatment of CLI ..............................................................35 Basic principles of infrainguinal revascularization ................35 Bypass surgery .......................................................................35 endovascular revascularization ...........................................36 on choosing the revascularization strategy .........................37 amputation ................................................................................38 outcome prediction models ............................................................39 The Finnvasc risk score .................................................................39 The PIII risk score...........................................................................39 The BaSIL survival prediction model ..........................................39 17