Views: 1,283 | Downloads:
22
| Responses: 0
| XML | Respond to this article | Alert & updates | Request permissions | Email to a friend |
Original ArticleOpen Access
Conservative Regimen for Chronic Critical Limb Ischemia
Stapanavatr W 
,
Ungkittpaiboon W ,
Kamjanabatr B
,
Ungkittpaiboon W ,
Kamjanabatr B WAIGOON STAPANA V ATR, MD*,
WITHOON UNGKITTPAIBOON, MD*,
BURAPA KARNJANABATR,MD*
Objective : The objective of this study was to determine the effectiveness of the treatment
of chronic critical limb ischemia by conservative regimen.
Method : Data for all patients who underwent a conservative regimen at a single institution
from January 1997 to December 2001 were entered into the registry. Conservative regimen consisted
of cilostazol (Pletaal) 200 mg/day, a vegetarian diet, had completely stopped smoking and had progres-
sive walking training.
Results : A total of 53 patients (59 limbs) with chronic critical limb ischemia were treated with
a conservative regimen. The conservative regimen failed in 19limbs (32.2%). In the failed limbs, infra-
inguinal bypass was performed on 8 limbs, aortoiliac endarterectomy was performed on 1 limb and 6
had primary amputation. The other four limbs were treated conservatively until death because of very
poor cardiac function. Post-operatively, 2 grafts had thrombosis and led to amputation.
Conclusion : These early results appear to
be
promising with 67.8 per cent limb saving.
This conservative regimen may be appropriately performed in selected chronic critical limb ischemia,
especially those who presented with clinical severe claudication, rest pain or nonhealed ulcer. Cilostazol
administration may play a positive role in gangrenous limbs.
Key word : Conservative Regimen, Critical Limb Ischemia, Cilostazol
WITHOON UNGKITTPAIBOON, MD*,
BURAPA KARNJANABATR,MD*
Objective : The objective of this study was to determine the effectiveness of the treatment
of chronic critical limb ischemia by conservative regimen.
Method : Data for all patients who underwent a conservative regimen at a single institution
from January 1997 to December 2001 were entered into the registry. Conservative regimen consisted
of cilostazol (Pletaal) 200 mg/day, a vegetarian diet, had completely stopped smoking and had progres-
sive walking training.
Results : A total of 53 patients (59 limbs) with chronic critical limb ischemia were treated with
a conservative regimen. The conservative regimen failed in 19limbs (32.2%). In the failed limbs, infra-
inguinal bypass was performed on 8 limbs, aortoiliac endarterectomy was performed on 1 limb and 6
had primary amputation. The other four limbs were treated conservatively until death because of very
poor cardiac function. Post-operatively, 2 grafts had thrombosis and led to amputation.
Conclusion : These early results appear to
be
promising with 67.8 per cent limb saving.
This conservative regimen may be appropriately performed in selected chronic critical limb ischemia,
especially those who presented with clinical severe claudication, rest pain or nonhealed ulcer. Cilostazol
administration may play a positive role in gangrenous limbs.
Key word : Conservative Regimen, Critical Limb Ischemia, Cilostazol
Download:
PDF