Eric W Rudofker1, Shea E Hogan1,2, Ehrin J Armstrong3,4,5. 1. University of Colorado School of Medicine, Aurora, CO, USA. 2. Denver Health Medical Center, Denver, CO, USA. 3. University of Colorado School of Medicine, Aurora, CO, USA. ehrin.armstrong@gmail.com. 4. Veterans Affairs Eastern Colorado Health Care System, Denver, CO, USA. ehrin.armstrong@gmail.com. 5. Denver VA Medical Center, 1055 Clermont Street, Denver, CO, 80220, USA. ehrin.armstrong@gmail.com.
Abstract
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. RECENT FINDINGS: 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.
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. RECENT FINDINGS: 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.
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