ABC of arterial and venous disease: Chronic lower limb ischaemia

doi:10.1136/bmj.320.7238.854

BMJ 2000;320:854-857 ( 25 March )

Clinical review

ABC of arterial and venous disease

Chronic lower limb ischaemia

Jonathan D Beard.

The first 150 words of the full text of this article appear below.

Peripheral vascular disease commonly affects the arteries supplying the leg and is mostly caused by atherosclerosis. Restrictionof blood flow, due to arterial stenosis or occlusion, often leadspatients to complain of muscle pain on walking (intermittent claudication).Any further reduction in blood flow causes ischaemic pain at rest,which affects the foot. Ulceration and gangrene may then superveneand can result in loss of the limb if not treated. The Fontainescore is useful when classifying the severity of ischaemia.

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Although many patients with claudication remain stable, about 150-200 per million of the population progress to critical limbischaemia (Fontaine III or IV) each year. Many patients with criticallimb ischaemia can undergo revascularisation, which has a reasonablechance of saving the limb. A recent audit by the Vascular SurgicalSociety found a success rate of over 70% for these patients. However,many patients still require major amputation. Rehabilitation of. . . [Full text of this article]

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