Preventing Major Amputations in Patients with Critical Limb Ischemia
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Purpose of Review
This review summarizes the risks of lower extremity amputation associated with critical limb ischemia (CLI) and discusses current therapies that can prevent amputation in CLI.
CLI remains an under-recognized condition associated with high rates of major amputation and disparities in care. Optimal medical therapy can reduce the risk of major adverse cardiovascular and limb events, but revascularization combined with close wound care remains the cornerstone of amputation prevention. Endovascular revascularization has become more common over time and has been associated with a reduction in amputation rates. Ongoing clinical trials will help inform best practices for revascularization strategies and techniques.
Vascular care is inconsistent across the USA, with significant variation in access to care revascularization rates and rates of major amputation. Major amputation can be prevented in patients with CLI when optimal medical therapy, lifestyle modification, and revascularization are provided in a multidisciplinary setting.
KeywordsCritical limb ischemia Amputation Prevention Revascularization Management Disparities
Compliance with Ethical Standards
Conflict of Interest
Eric W. Rudofker and Shea E. Hogan declare that they have no conflict of interest.
Ehrin J. Armstrong reports being a consultant for Abbott Vascular, Boston Scientific, Cardiovascular Systems, Medtronic, and Philips.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major Importance
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