EuroPCR Presents Guidelines to Avoid Amputations

Every 30 seconds a leg is amputated. Avoiding this personal trauma is one of the most important challenges for peripheral interventionists. An estimated 35% to 40% of all amputations (180,000 per year in Europe alone) are considered avoidable using new endovascular treatments that have been developed.

An estimated 35% to 40% of all amputations are considered avoidable using new endovascular treatments.
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A person who suffers from advanced stages in peripheral occlusive disease – critical limb ischemia – has a severely reduced quality of life due to low walking capacity, pain and tissue damage. At EuroPCR, held in Barcelona, Spain, May 22-25, Professor Giancarlo Biamino judged as “extremely satisfying” the increased interest in the superficial femoral artery and below-the-knee lesions shown by participants. He stated that “the amputation rate can be dramatically reduced” thanks to improved materials like low-profile balloons, long balloons, dedicated guidewires and dedicated stents.

This also will be assisted by improved noninvasive diagnoses, provided by new imaging systems that are more precise and, therefore, will reduce costs as the therapy becomes more accurate.

According to Dr. Gian Battista Danzi, the four key prognostic factors for success are:

  • Extension of local tissue involvement and infection that are strongly influenced by the time delay of the surgical debridement and antibiotic treatment
  • Renal function
  • Restoration of direct flow to the foot
  • Increase in local transcutaneous oxygen tension values.

The European Society of Cardiology presented its new guidelines on management of non-ST segment elevation acute coronary syndromes, which covers issues not previously addressed, including the management of complications.

In particular, the guidelines focus special attention on bleeding, an issue now considered serious with a catastrophic impact on outcomes and a four-fold increase in death and myocardial infarction 30 days and in the long term. Additionally the guidelines focus on the needs of special populations: diabetics, the elderly, anemic patients and patients suffering from chronic kidney disease. The new guidelines are designed to be a comprehensive guide to practice, addressing issues encountered by cardiologists in their daily practice, with a real focus on user-friendliness.

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