Current state of diagnosis and management of critical limb ischemia.

Critical limb ischemia represents the most severe form of peripheral arterial disease and carries with it severe morbidity and mortality risks. Because of comorbidity risks, early diagnosis and aggressive medical management make up an important part of the treatment paradigm for these individuals. However, in addition to managing these comorbid conditions, the physician caring for these individuals must be able to provide revascularization options that will improve arterial flow to the threatened extremity and assure healing of complicated wounds.

Endovascular native vessel recanalization to maintain limb perfusion after infected prosthetic vascular graft excision.

Prosthetic vascular graft infection is an uncommon yet serious condition. Traditional management has included debridement, excision of the infected graft, and revascularization as needed. We report on two cases in which limb viability was maintained by using endovascular native vessel recanalization after excision of infected prosthetic grafts.

Initial management and outcome of aortic endograft limb occlusion.

Objective: The purpose of this study was to determine the differences in outcome related to initial management of aortic endograft limb occlusion (ELO).

Methods: During a 7-year period, 823 endovascular aneurysm repairs (EVARs) resulted in 25 ELOs in 22 patients. The initial management and outcome of these ELOs were reviewed.

A statewide experience with endovascular abdominal aortic aneurysm repair: rapid diffusion with excellent early results.

Objective: The purpose of this study was to compare survival and outcomes of endovascular versus open repair of abdominal aortic aneurysms (AAAs) in New York State (NYS).

Methods: We used the NYS discharge dataset Statewide Planning and Research Cooperative System (SPARCS) to analyze the outcomes of elective admission for nonruptured (International Classification of Diseases-9th revision [ICD-9] 441.4) open aneurysm repair (38.

Broadening the applicability of endovascular aneurysm repair: the use of iliac conduits.

Objective: Suboptimal iliac anatomy has sometimes precluded endovascular repair of abdominal aortic aneurysm (AAA). In an effort to increase the applicability of endovascular repair, a limited retroperitoneal approach and iliac conduit was used in some patients with unsuitable iliac anatomy at high risk for open repair.

Methods: Charts and imaging studies of 312 patients who underwent endovascular (AAA) repair at the Cleveland Clinic Foundation between June 1999 and November 2000 were reviewed.