Chronic Limb Threatening Ischemia (CLTI)

CLTI is a more severe form of PAD with significant mortality, morbidity and higher use of health care resources3Conte MS, Bradbury AW, Kolh P, et. al, Global Vascular Guidelines on the Management of Chronic Limb-Threatening Ischemia. Eur J Vasc Endovasc Surg. 2019 Jul;58(1S):S1-S109.e33. doi: 10.1016/j.ejvs.2019.05.006.. The distal blood flow and microcirculatory function are severely compromised resulting in rest pain, ischemic ulcers and gangrene. CLTI is a clinical diagnosis but should be supported by objective vascular testing. Due to the high risk of calcified vessels with falsely normal or high ABI, even in non-diabetics, toe pressures, PVR and tcpO2 must be used in all patients.

  • 30% of all patients with confirmed CLTI have normal or high ABI.
  • All patients with suspected CLTI should have toe pressure or tcpO2 to assess perfusion according to WIfI classification4Mills JL, Conte MS, Armstrong DG, et al. The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System: Risk stratification based on Wound, Ischemia, and foot Infection (WIfI). J Vasc Surg. 2014;59(1):220034.e1-2..
  • The best modality to grade the level of ischemia and prioritize vascular procedures is tcpO2.
  • Due to the complex nature of CLTI, all patients that undergo vascular intervention should be reassessed with toe pressure or tcpO2 to guarantee restored perfusion.

References:

  1. Conte MS, Bradbury AW, Kolh P, et. al, Global Vascular Guidelines on the Management of Chronic Limb-Threatening Ischemia. Eur J Vasc Endovasc Surg. 2019 Jul;58(1S):S1-S109.e33. doi: 10.1016/j.ejvs.2019.05.006.
  2. Mills JL, Conte MS, Armstrong DG, et al. The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System: Risk stratification based on Wound, Ischemia, and foot Infection (WIfI). J Vasc Surg. 2014;59(1):220034.e1-2.

Please fill in the form to get more information

0 + 4 = ?

Disclaimer: It is possible that the products on the Perimed website may not be cleared for sale in all markets.