| Theme | New perspectives in the management of patients with diabetes undergoing dialysis | |
|---|---|---|
| Title | Revascularization in patients with peripheral arterial disease | |
| Publish Date | 2019/01 | |
| Author | Akio Kodama | Division of Vascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine |
| Author | Kimihiro Komori | Division of Vascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine |
| [ Summary ] | The indications for revascularization in patients with peripheral arterial disease differ between those with claudication and those with critical limb ischemia. Patients with claudication must necessarily focus on initial risk factor modification followed by revascularization. In contrast, patients with critical limb ischemia need to undergo urgent revascularization for limb and gait salvage with simultaneous pain control and drainage measures, if the ischemic wound is infected. Patients with diabetes and hemodialysis-dependent renal failure often show diseased vessels in the infrapopliteal region. Revascularization of these vessels is difficult. Revascularization should be performed after considering patients' clinical goals based on their life expectancy, limb prognosis, and quality of life. | |