0830_Fanelli.pdf

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1、Angiosomes:Concept and Amputation PreventionFabrizio Fanelli,MD,EBIRProfessor of Interventional RadiologyDirector Vascular and Interventional Radiology DepartmentCareggi University HospitalFlorence-ItalyDisclosures Consultant/Speaker/Proctor/Advisory Board Abbott BD Bard Boston Scientific Cook iVasc

2、ular Medtronic Merit Penumbra Philips Volcano W.L.Gore&Associates Zylox TonbridgeThe latest guidelines state that the angiosome concept should be considered when performing revascularization ofinfrapopliteal lesions in patients with CLI.Angiosomal anatomy is theorized to assist in predicting wound h

3、ealing in a specific area and determining optimaltargets for revascularizationThere have been several reports both of favorable and unfavorable results of angiosome-guided revascularizationAngiosome-guided tends to improve wound healing rather than amputation-free survival and overall survival.Indir

4、ect revascularization based on the angiosome concept with a good collateral flow may achieve good healingcomparable to that achieved by direct revascularizationBackgroundIn 1987,Taylor and Palmer1proposed the concept of the angiosome,which is a three-dimensional unit of tissue fed by a source artery

5、 to guide incisional strategies in plastic reconstructive surgery.In 2006 Attinger2extrapolated to the management of CLI1)Taylor GI,Palmer JH.The vascular territories(angiosomes)of the body:experimental study and clinical applications.Br J Plast Surg.1987;40(2):113412)Attinger CE,et al.Angiosomes of

6、 the foot and ankle and clinical implications for limb salvage:reconstruction,incisions,and revascularization.Plast Reconstr Surg.2006;117(Suppl 7):261S 93S.Angiosome6 angiosomes-3 on the plantar foot-posterior tibial artery-2 on the ankle and rear foot-peroneal artery-1 on the dorsum of the foot-an