CHRONIC LIMB THREATENING ISCHEMIA — EPIDEMIOLOGY, PATHOGENESIS, DIAGNOSTICS AND TREATMENT STRATEGIES
Abstract
Chronic limb threatening ischemia (CLTI) is a syndrome of chronic obliterating diseases of peripheral arteries, different in etiology and pathogenesis. Diseases caused by degenerative damage to the arterial bed can lead to CLTI, causing aneurysm and long chronic occlusions. Such diseases include: Marfan syndrome, Ehlers–Danlos, Erdheim tumor, neurofibromatosis, fibrotic dysplasia. Multiple vasculitis are found in systemic vasculitis and connective tissue diseases. The most common cause of CLTI is atherosclerosis and vascular complications associated with diabetes mellitus. In the vast majority of cases (75–80%), atherosclerosis is the pathogenetic mechanism leading to the development of chronic obliterating diseases of the lower limb arteries. All these diseases lead to a significant reduction of perfusion blood flow at the level of microcirculation, causing severe metabolic disorders. Over time, the rheological properties of the blood are impaired, contributing to the progression of tissue ischemia. With CLTI, many of the body’s compensatory capabilities have been exhausted, but conducting revascularization of the lower limb is still possible.
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