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#VascularSurgery #LECAD #PeripheralArteryDisease #CLTI #Claudication #AortoiliacDisease #InfrainguinalDisease #Amputation #RutherfordsVascular #LimbSalvage Based on Rutherford's Vascular and Endovascular Therapy (10th Ed, Sections 15, Chapters 107-115), this video provides a detailed overview of Lower Extremity Chronic Arterial Disease (LECAD). It covers epidemiology, noting increased prevalence globally and disparities in the US, particularly affecting Black populations. Key risk factors include age, male sex, hypertension, BMI, diabetes, smoking, and cholesterol. LECAD presents on a spectrum from asymptomatic to Critical Limb-Threatening Ischemia (CLTI), classified by systems like Rutherford and WIFI. Diagnosis involves history, physical exam, and non-invasive tests like ABI. Imaging (Duplex, CTA, MRA, arteriography) guides intervention planning, but should be selective. Treatment options discussed are open surgery, endovascular therapy, and hybrid approaches. For aortoiliac disease, both open bypass (aorta-bifemoral) offering durability and endovascular techniques (PTA, stenting, stent grafts) are used, with endo often being the first choice for many patients. For infrainguinal disease, medical therapy is foundational. Intervention is for severe claudication failing medical care or, critically, for CLTI. Autogenous vein is the preferred bypass conduit, offering better long-term patency than prosthetics. Endovascular infrainguinal options include PBA, stents, and drug-coated devices, though restenosis is a challenge and the paclitaxel safety concern is noted. Post-intervention, antiplatelets and surveillance are crucial. Amputation is covered as a reconstructive option for irreversible ischemia, failed salvage, or severe infection. The goal is functional healing, with Below-Knee Amputation (BKA) generally offering better rehab potential than Above-Knee (AKA). Healing potential assessment methods like TCPO2 are discussed. Amputation management requires a multidisciplinary team, focusing on perioperative risks, level selection, and long-term rehabilitation, addressing physical and psychological needs. Complications include infection, pain (including phantom), and systemic events. Disparities and the complexity of decision-making are highlighted.