An Update on Therapeutic Strategies for Japanese Patients with Critical Limb Ischemia

Revascularization is only one part of treatment for patients with critical limb ischemia (CLI). Adequate management and treatment of ischemic wound before and after revascularization are not easy process, therefore revascularization plan should be worked out from the view point of wound healing. The general condition, background diseases, daily activity, predictive foot function, and life prognosis are also important factors to make decision of therapeutic strategy for each patient with CLI. The therapeutic strategies for CLI patients are very complex due to the substantial heterogeneity of patients as well as the heterogeneity and complex relationships of persons who provide their specialized health care for CLI patients. Recently, several well-designed clinical researches have been done or are running, which are revealing features of Japanese CLI patients. We would like to discuss the reasonable algorithm for selecting endovascular treatment or bypass surgery according to the recent clinical research data. It would be appreciated if our discussion will develop and deepen how to improve clinical results of CLI therapy in terms of not only limb salvage and ulcer healing but also limb function and life prognosis.