Chronic limb-threatening ischemia: Optimizing endovascular and medical treatment

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    Peripheral arterial disease is a problem that affects many people. The therapy often consists of endovascular treatment combined with medical treatment. Despite the fact that there have been many developments in the endovascular field, many patients develop vascular disease again after treatment or still need to be amputated.
    Regarding endovascular treatment, drug-coated balloons do not show any advantage over standard endovascular treatment. Bioresorbable vascular scaffolds, however, may be a good option; comparative studies are needed to better investigate this. 2D perfusion angiography software could be used to better predict the outcome of treatment already during the endovascular intervention.
    Regarding medical treatment, it is particularly striking that hardly any good quality studies have been carried out. As a result, treatment options are limited and there is often no international consensus. For example, this is reflected in the prescription of platelet aggregation inhibitors, where there is uncertainty which type and duration give the best result. Dual platelet aggregation inhibition may have a better effect than single platelet aggregation inhibition, but a well-powered, comparative study is necessary to further investigate this.
    In conclusion, the technique of endovascular treatment shows promising developments. High quality research is of great importance to better explore the medical treatment options.
    Originele taal-2English
    KwalificatieDoctor of Philosophy
    Toekennende instantie
    • Rijksuniversiteit Groningen
    Begeleider(s)/adviseur
    • de Vries, Jean-Paul, Supervisor
    • Ünlü, Çağdaş, Supervisor, Externe Persoon
    Datum van toekenning14-jun-2021
    Plaats van publicatie[Groningen]
    Uitgever
    DOI's
    StatusPublished - 2021

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