Peripheral Artery Disease Surgery
Özet
Peripheral artery disease (PAD) is a progressive systemic disorder primarily caused by atherosclerosis, with key risk factors including smoking, diabetes, hypertension, obesity, and aging. Patients with PAD face significantly elevated risks of severe cardiovascular events like myocardial infarction or stroke, making meticulous risk management and clinical evaluation essential. Diagnostic assessment relies on pulse examination, ankle-brachial index (ABI) measurements, Doppler ultrasound, and conventional angiography, which remains the diagnostic gold standard. Chronic limb-threatening ischemia (CLTI) is staged using Fontaine or Rutherford classifications, and clinical decisions are guided by the WIfI (Wound, Ischemia, and foot Infection) scoring system alongside the PLAN (Patient risk, Limb severity, Anatomic complexity) framework. Acute limb ischemia mandates urgent heparin administration and close monitoring for reperfusion injury. When revascularization is necessary, femoropopliteal bypass is preferred, ideally utilizing an autologous saphenous vein graft due to its superior patency compared to prosthetic PTFE or Dacron grafts. For high-risk patients, extra-anatomic surgical alternatives like axillofemoral, femorofemoral, or obturator bypasses are employed. Ultimately, these therapeutic interventions aim to alleviate symptoms like intermittent claudication, enhance overall quality of life, and successfully salvage the threatened extremity.
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