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Chronic Limb-Threatening Ischemia: Evaluation and Management

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Peripheral Arterial Interventions

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

Chronic limb-threatening ischemia (CLTI) is characterized by rest pain, nonhealing ulcer/wound, or gangrene. In the USA, the prevalence of CLTI is estimated to be between 2 and 3.4 million. Approximately 29% of CLTI patients have major amputation or death within the first year. Although establishing and maintaining direct arterial blood flow with revascularization remain the key for CLTI, concomitant guideline-directed medical therapy and aggressive cardiovascular risk factor management are equally important. There is no consensus on whether surgical or endovascular therapy is a first approach. However, endovascular therapy has been proven to be effective and safe. Patients with CLTI often present with multilevel disease, and treatment of both inflow and outflow diseases is necessary for wound healing. Multidisciplinary team approach in decision-making and postrevascularization comprehensive wound care are essential for limb preservation and wound healing.

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Authors and Affiliations

  1. University of Tennessee at Nashville, Nashville, TN, United States

    Timir K. Paul

  2. Department of Medicine, University of Texas Southwestern Medical Center at Dallas, VA North Texas Health Care System, Dallas, TX, USA

    Subhash Banerjee

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  1. Midwest Cardiovascular Research Foundation, Davenport, IA, USA

    Nicolas W. Shammas

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Paul, T.K., Banerjee, S. (2022). Chronic Limb-Threatening Ischemia: Evaluation and Management. In: Shammas, N.W. (eds) Peripheral Arterial Interventions. Contemporary Cardiology. Springer, Cham. https://doi.org/10.1007/978-3-031-09741-6_16

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  • DOI: https://doi.org/10.1007/978-3-031-09741-6_16

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