Volume 3 Issue 8 - 2020
Prevention of Amputation among the Cases of Chronic Critical Limb Ischaemia with Limited Treatment Option: Current Modalities of Therapy and Future Perspectives
Moniruddin Chowdhury1*, Md Rabiul Islam2 and ABM Alauddin Chowdhury3
1Faculty of Medicine, Lincoln University College, Malaysia
2Department of Health Promotion and Health Education, Faculty of Public Health, Bangladesh University of Health Sciences, Dhaka, Bangladesh
3Department of Public Health, Daffodil International University, Dhaka, Bangladesh
*Corresponding Author: Moniruddin Chowdhury, Associate Professor, Faculty of Medicine, Lincoln University College, Malaysia.
Received: July 15, 2020; Published: July 29, 20200

Peripheral arterial disease (PAD) is a chronic vascular disease where blood flow in the limb arteries is obstructed [1,2]. The chance of PAD increases as age advances and affects a considerable proportion of the elderly population (> 20% in > 80-year old individuals) [3]. The overall prevalence of PAD among the general population has been found to be 12 - 14%, affecting up to 20% of those over 70 [4]. Worldwide, PAD was estimated as 202 million and 236.62 million in 2010 and 2015 respectively [5].

Major subtypes of PAD are Atherosclerotic Obliterans (ASO), Buerger’s disease (Thromboangiitis Obliterans, TAO) and PAD due to connective tissue diseases. TAO is strongly associated with cigarette smoking. Underlying risk factors leading to ASO are older age, hypertension, cigarette smoking, hyperlipidemia and/or diabetes mellitus. According to the current recommendations, to prevent vascular damage and improve functional status, patients with PAD should receive an intensive program of guideline-based medical therapy including structured exercise and lifestyle modifications. Symptomatic PAD patients are needed to take antiplatelet therapy with either aspirin alone (range, 75 - 325 mg/day) or clopidogrel alone (75 mg/day) [6]. All patients with PAD should be treated with a statin medication [6]. Patients with PAD who smoke cigarettes or use any other forms of tobacco should be counseled at every visit to quit. For patients with symptoms of claudication, Cilostazol is an effective initial therapy to improve symptoms and increase walking distance [6]. Unfortunately, even with all conservative measures, many of those patients progress towards severe rest pain and/or limb ulceration. When severe rest pain and/or ulcerations of ischemic limbs are developed, this is defined as the state of chronic critical limb ischaemia (CLI). Chronic CLI is associated with a high risk of major amputation, cardiovascular events and death. Around 25% of the patients require amputation within a year after the onset of chronic CLI [7].


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Citation: Moniruddin Chowdhury., et al. “Prevention of Amputation among the Cases of Chronic Critical Limb Ischaemia with Limited Treatment Option: Current Modalities of Therapy and Future Perspectives”. EC Clinical and Experimental Anatomy 3.8 (2020): 19-22.

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