Between 2005 and 2014, the number of veterans who were hospitalized, required amputation or died due to critical blockages in leg arteries declined, according to new research published today in Circulation: Cardiovascular Interventions , a journal of the American Heart Association.
Critical narrowing of leg arteries, called critical limb ischemia (CLI), is an advanced state of disease in arteries that can lead to severe leg pain even at rest, wounds that don't heal and a very poor quality of life. Without proper treatment, CLI can lead to amputation, which further decreases mobility for daily living and severely impacts quality of life. Patients with CLI are also at high risk to have a heart attack or stroke.
The improvements in patient outcomes paralleled an increase in the number of veterans with CLI who underwent procedures to restore blood flow, either via surgical bypass or a less-invasive endovascular procedure to insert a stent to hold the artery open. These revascularization procedures can be effective in alleviating pain, improving wound healing and avoiding amputation.
In this retrospective analysis, researchers found overall positive trends among veterans treated for CLI at Veterans Affairs (VA) medical centers, yet there were potential areas for improvement. Many veterans were not taking recommended statin medications, and almost half of those who underwent amputation did not first receive a procedure to try to restore blood flow to the impacted limb.
All patients with CLI should be evaluated to determine if they could benefit from a procedure to restore blood flow. In addition, patients with CLI should be aggressively treated with medications, including statins, blood pressure medications if they are hypertensive, and drugs to reduce platelet stickiness in order to reduce the risk of heart attack and stroke." Saket Girotra, M.D., S.M., senior author of the study and assistant professor of cardiovascular medicine at the University of Iowa Carver College of Medicine in Iowa City Related Stories
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