L'Angioplastica nel Trattamento dell'Arteriopatia Periferica agli arti inferiori

ANGIOPLASTIC PROCEDURES IN THE TREATMENT OF PERIPHERAL ARTERIAL DISEASE IN THE LEGS - Atherosclerosis is a widespread disease and, together with cancer, a leading cause of death. The symptoms on lower limbs indicate an advanced stage of the pathology, with frequent coronary and carotid silent lesions, which have to be detected and treated, if necessary, as a priority, thus enhabling prevention of deaths from myocardial infarction or stroke. Arterial disease in the limbs progresses from claudication to rest pain, critical ischemia with trophic ulcers and risk of limb amputation. Diabetic Arteriopaty is a different disease, for its malignant evolution, and requires a multidisciplinary combined approach. Therapy of peripheral arteriopaty in the limbs aims to stop the pain, heal ulcers, give the patient standing, mobility and better quality of life and life expectancy. The choice between surgery, with above the knee bypass, and endovascular angioplasty, is nowadays more frequently for the latter, thanks to the reduced invasiveness and techniques and materials increasing evolution. PTA, in addition to low-profile balloons, provides medicated and cutting balloons. Stents, expecially drug-eluting, have improved long-term results, but not enough to recommend their standard use below the knee. Taking a careful Protocol of Diagnosis and Treatment, we have obtained very satisfactory results, even in this difficult disease.