Limb Preservation for the Vascular Specialist

This book is a comprehensive guide to the essentials of arterial, venous, wound care, and multidisciplinary approaches to prevent major amputation and manage patients with critical limb threatening ischemia (CLTI). Limb preservation has become increasingly prioritized as endovascular techniques, equipment, understanding of multidisciplinary wound care, and other medical treatments have rapidly evolved. Quite often, these patients have CLTI, which is a primarily chronic arterial disease that carries a higher mortality rate than most cancers and cardiovascular diseases. Additionally, complex venous issues contribute to patients losing their limbs, causing significant morbidity to patients and immense cost to the medical system. Many of these patients have diabetes, kidney problems, and hypertension. Due to the advances in the treatment of CLTI and complex venous diseases, medical professionals have been able to decrease major amputations, which cause the higher mortality rate described above. The knowledge of all the approaches, techniques, and management of these patients, however, has been slow to be disseminated. Acting as a structured journey to all aspects of limb preservation, this book begins by covering the basics of understanding wound care patients. This involves beginning wound care management and properly diagnosing the potential underlying processes with non-invasive imaging. From here, clinical pearls and detailed guidance on considering arterial, venous, and lymphatic therapies are covered. Chapters then move into arterial and venous treatment algorithms, from unique to complex approaches, technique tips and tricks, infection and complication management, and future options. Understanding some of the newer approaches such as deep vein arterialization and hybrid surgical approaches is integral in the discussion. Finally, authors cover evaluating the wound post-procedure and long-term, deciding when re-intervention/surgery or amputation(and which type) is needed, and how to tackle the medication management of these complex patients (such as antiplatelets, anticoagulation, diabetes, and nutrition). Chapters are written by a multidisciplinary group of experts, all with an eye towards limb preservation. This is an ideal guide for endovascular specialists, surgeons, podiatrists, infectious disease specialists, and endocrinologists to be able to successfully increase the likeliness of limb preservation for their patients with CLTI and related conditions.