Dermatol. praxi. 2009;3(5):239-242

Current view of the management of ischaemic ulcerations

MUDr.Ján Bulejčík

Centrum cévní a miniinvazivní chirurgie, Nemocnice Podlesí a. s. Třinec

The authors present the current diagnostic-therapeutic algorithm in patients with chronic ulcerations of ischaemic aetiology. The mainstay of

successful therapy of the defects is a precise diagnosis of the extent of arterial occlusion and an attempt of revascularization. Recently, the techniques

of surgical or endovascular revascularization have been expanded by the use of combined (hybrid) procedures, particularly in patients

with critical limb ischaemia (CLI). The authors present their cohort of 80 patients with CLI in a 5-year period managed with the hybrid procedure.

The limb was spared from amputation in 90 % and the primary patency of the reconstructions was 84 %. Eight patients (10 %) required

high amputation. In five patients, high amputation was not required despite a reconstruction occlusion. Revascularization procedures in

patients with CLI significantly affect the quality of life as well as lifetime prognosis. They may not only mean salvage of a limb destined for

amputation but also prevent the development of complications resulting from the immobilization of patients following amputation. The

precondition of success is correct indication and faultless revascularization which requires a multidisciplinary approach in many cases.

Keywords: chronic defects, critical limb ischaemia, hybrid procedures

Published: May 1, 2010  Show citation