This April, in honor of limb loss awareness month, it’s important to bring discussions around Critical Limb Ischemia (CLI), a serious yet underrecognized condition, to the forefront. This advanced form of Peripheral Arterial Disease (PAD) restricts blood flow to the arteries in the legs or foot, and if left untreated could lead to amputation. Between 220,000 and 240,000 advanced PAD-related toe, leg or foot amputations have been estimated to occur annually in the U.S. and Europe. 1
Studies estimate a five-year mortality rate for patients who have had an amputation to be between 50-74 percent. 2 According to one retrospective study, 67 percent of advanced PAD patients in the U.S. had primary amputation as their initial treatment – many of which might have been prevented with other forms of intervention. 3
The good news is, in some cases, there are other treatment options for CLI patients to help restore blood flow and reduce the risk of amputation. Since 2016, the American Heart Association and the American Association for Clinical Chemistry Guideline on the Management of Patients with Lower Extremity PAD recommends surgical or endovascular revascularization in CLI to allow blood flow to the foot in order to help decrease ischemic pain and promote wound healing. 4 An important step in determining whether amputation is necessary is through contrast angiography – a medical procedure that takes pictures of the blood vessels for physicians to observe and determine treatment.
In some cases, lower limb amputations resulting from vascular disease can be prevented; therefore, it’s critical that patients research all their options. BD's Physician Finder Network provides a resource for PAD specialists to help referring physicians or patients find health care professionals in their area who can provide counsel.
Visit the Love Your Limbs treatment page to learn more about minimally invasive procedures that can help open blocked arteries and restore blood flow.
- Allie, D. E. et al. (2009). 24-carat gold, 14-carat gold, or platinum standards in the treatment of critical limb ischemia: bypass surgery or endovascular intervention?. Journal of Endovascular Therapy, 16(1_suppl), 134-146.
- Robbins, J. M. et al. (2008). Mortality rates and diabetic foot ulcers: is it time to communicate mortality risk to patients with diabetic foot ulceration?. J Am Podiat Med Assn, 98(6), 489-493.
- Allie, D. E. et al. (2005). Critical limb ischemia: a global epidemic. A critical analysis of current treatment unmasks the clinical and economic costs of CLI. EuroIntervention: journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology, 1(1), 75-84.
- Gerhard-Herman, M. D. et al. (2017). 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology, 69(11), 1465-1508.
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