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AIRS CLINIC 610 SOUTH FAIRMONT CLI FIGHTERS# AMPUTATION PREVENTION AIRS CLINIC 610 S FAIRMONT AVE LODI, CA LODI, CA 209 224 5236 The Truth About Critical Limb Ultrasound-Guided Tibial Pedal Ischemia CLI and Amputation Arterial Access: Growing Alternative Strategy in the Treatment Of Complex Peripheral Artery Disease Critical Limb Ischemia or CLI, describes late stage changes of peripheral vascular discase. CLI may have several presentations to include: Leg pain at rest, nonhealing ulcers or gangrenous changes in the soft tissue EDITORIAL of the legs and feet. Changes commonly seen in diabetics. Worth an Arm and a Leg The Critical Importance of Limb ischemia Avier A. Vale, MD, MSes; Stephen W. Waldo, MD CLI has a mortality rate of over 24% in a year and 60% in 5 years. To put this in perspective, when the top 22 cancers are evaluated only five have a higher 5 year death rate. These are the number of cancer deaths seen every 5 ears-Lung er 192,000, creatie cancer 51.000, Colorectal 40.000, Liver cancer 35,000 but CLI kills 58,000 in the same time. However, this does not capture the suffering associated with limb amputation. Many more patients will die each year from CLI than from many cancers considered to be the most lethal like: esophageal, brain, stomach, and ovarian, to name but a few. Critical Limb Ischemia: A Threat to Life and Limb Below-the-Knee Retrograde Access ahor for Peripheral mdind Ther Interventions: A ve Systematic Review SSACE Original Studies Tibia-Pedal Arterial Minimally Invasive Retrograde Revascularization in Patients with Advanced Peripheral Vascular Disease: The TAMI Technique, Original Case Series Limb amputation still continues to be an early consideration in many hospitals and clinics. 30% of patients present with rest pain and pain with walking but no evidence of actual tissue loss. Yet many of these patients will never have a diagnostic evaluation, and when compared to revascularization amputation doubles the risk of death over the following year. JA Mustapha, w. Fadi Saab, we. Theresa Larry Diaz-Sandoval, M ney 0o, and Barbara Karenko, oo ed peroherlay d t lerate femenal y CA ndtervention deo cmotes Thte t eere Even in patients with gangrene or tissue loss, many health care providers still see amputation as a first line treatment, however endovascular therapy doubles survival when compared to amputation. DO NOT CONSIDER AMPUTATION WITHOUT FIRST BEING EVALUATED FOR REVASCULARIZATION OR BYPASS SURGERY Endovascular therapy for CLI must include a certain skill set as described by Dr. Mustapha and Dr. Saab, two Internationally recognized CLI experts. This must include the ability to accurately interpret diagnostic imaging, manipulate an array of specialized equipment and a mastery of specialized techniques like pedal retrograde access, intravascular ultrasound and ultrasound directed Tibio-Pedal techniques. This diverse tool box allows the experienced operator the ability to target complex lesions and avold major amputation. The two images above show the use of intravascular ultrasound and nccurate measurement of theropy The two sets of images to the left show two cases of retrograde revascularization. Both patients had been considered for below knee amputation, both patients had severe limb ischemia and greater than 2 months later both patients have avolded major amputation. The majority of facts quoted in this article are derived from the literature cited above. Coll clinio for references AIRS CLINIC 610 SOUTH FAIRMONT CLI FIGHTERS# AMPUTATION PREVENTION AIRS CLINIC 610 S FAIRMONT AVE LODI, CA LODI, CA 209 224 5236 The Truth About Critical Limb Ultrasound-Guided Tibial Pedal Ischemia CLI and Amputation Arterial Access: Growing Alternative Strategy in the Treatment Of Complex Peripheral Artery Disease Critical Limb Ischemia or CLI, describes late stage changes of peripheral vascular discase. CLI may have several presentations to include: Leg pain at rest, nonhealing ulcers or gangrenous changes in the soft tissue EDITORIAL of the legs and feet. Changes commonly seen in diabetics. Worth an Arm and a Leg The Critical Importance of Limb ischemia Avier A. Vale, MD, MSes; Stephen W. Waldo, MD CLI has a mortality rate of over 24% in a year and 60% in 5 years. To put this in perspective, when the top 22 cancers are evaluated only five have a higher 5 year death rate. These are the number of cancer deaths seen every 5 ears-Lung er 192,000, creatie cancer 51.000, Colorectal 40.000, Liver cancer 35,000 but CLI kills 58,000 in the same time. However, this does not capture the suffering associated with limb amputation. Many more patients will die each year from CLI than from many cancers considered to be the most lethal like: esophageal, brain, stomach, and ovarian, to name but a few. Critical Limb Ischemia: A Threat to Life and Limb Below-the-Knee Retrograde Access ahor for Peripheral mdind Ther Interventions: A ve Systematic Review SSACE Original Studies Tibia-Pedal Arterial Minimally Invasive Retrograde Revascularization in Patients with Advanced Peripheral Vascular Disease: The TAMI Technique, Original Case Series Limb amputation still continues to be an early consideration in many hospitals and clinics. 30% of patients present with rest pain and pain with walking but no evidence of actual tissue loss. Yet many of these patients will never have a diagnostic evaluation, and when compared to revascularization amputation doubles the risk of death over the following year. JA Mustapha, w. Fadi Saab, we. Theresa Larry Diaz-Sandoval, M ney 0o, and Barbara Karenko, oo ed peroherlay d t lerate femenal y CA ndtervention deo cmotes Thte t eere Even in patients with gangrene or tissue loss, many health care providers still see amputation as a first line treatment, however endovascular therapy doubles survival when compared to amputation. DO NOT CONSIDER AMPUTATION WITHOUT FIRST BEING EVALUATED FOR REVASCULARIZATION OR BYPASS SURGERY Endovascular therapy for CLI must include a certain skill set as described by Dr. Mustapha and Dr. Saab, two Internationally recognized CLI experts. This must include the ability to accurately interpret diagnostic imaging, manipulate an array of specialized equipment and a mastery of specialized techniques like pedal retrograde access, intravascular ultrasound and ultrasound directed Tibio-Pedal techniques. This diverse tool box allows the experienced operator the ability to target complex lesions and avold major amputation. The two images above show the use of intravascular ultrasound and nccurate measurement of theropy The two sets of images to the left show two cases of retrograde revascularization. Both patients had been considered for below knee amputation, both patients had severe limb ischemia and greater than 2 months later both patients have avolded major amputation. The majority of facts quoted in this article are derived from the literature cited above. Coll clinio for references