Critical Limb Ischemia: An Expert Statement

Mehdi H. Shishehbor, Christopher J. White, Bruce H. Gray, Matthew T. Menard, Robert Lookstein, Kenneth Rosenfield, Michael R. Jaff

Research output: Contribution to journalReview articlepeer-review

131 Scopus citations

Abstract

Critical limb ischemia (CLI), the most advanced form of peripheral artery disease, is associated with significant morbidity, mortality, and health care resource utilization. It is also associated with physical, as well as psychosocial, consequences such as amputation and depression. Importantly, after a major amputation, patients are at heightened risk of amputation on the contralateral leg. However, despite the technological advances to manage CLI with minimally invasive technologies, this condition often remains untreated, with significant disparities in revascularization and amputation rates according to race, socioeconomic status, and geographic region. Care remains disparate across medical specialties in this rapidly evolving field. Many challenges persist, including appropriate reimbursement for treating complex patients with difficult anatomy. This paper provides a comprehensive summary that includes diagnostic assessment and analysis, endovascular versus open surgical treatment, regenerative and adjunctive therapies, and other important aspects of CLI.

Original languageEnglish
Pages (from-to)2002-2015
Number of pages14
JournalJournal of the American College of Cardiology
Volume68
Issue number18
DOIs
StatePublished - 1 Nov 2016
Externally publishedYes

Keywords

  • amputation
  • endovascular
  • open bypass
  • peripheral artery disease

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