Advancements in Limb Amputation Prevention

Critical limb centers can prevent the need for amputation in patients with peripheral artery disease.

Understanding Critical Limb Ischemia

Critical limb ischemia (CLI) is caused by a major blockage in the arteries that reduces blood to the lower legs. It’s a very serious form of peripheral artery disease (PAD) – a hardening and narrowing of the arteries – that can lead to severe pain in the feet or toes, tissue damage, and skin ulcers. If left untreated, amputation of the affected limb may become necessary. It is a chronic issue that will not resolve on its own.

Risk factors for CLI include age (men over 60 and women after menopause), diabetes, obesity, smoking, high cholesterol or blood pressure, and a family history of vascular disease. Unfortunately, CLI is often undiagnosed until it’s too late, making amputation necessary.

New Solutions

Luckily, there are advancing methods in place to minimize the occurrence of CLI-related limb amputations. Patient-centered interventional suites (or critical limb centers) are one option for ongoing vascular care. These suites allow physicians to perform peripheral vascular interventions in an outpatient facility and provide ongoing education, awareness, and care to patients and providers.

What to Expect

Critical limb centers use an accelerated triage-to-therapy approach, during which patients and their families work with highly trained vascular nurse practitioners to maximize overall care. These specialists will collect your health history, address risk factors, and perform diagnostic tests. Advanced endovascular techniques and surgical therapy for limb preservation can help patients with advanced stages of CLI reduce the need for amputation.

Benefits to Patients

The patient-focused approach to vascular care provided by critical limb centers is highly beneficial. Not only does it promote awareness and education for an underdiagnosed condition, but it also makes the experience highly personal. Working with specialists dedicated to vascular care means that the issue is addressed at a micro level, resulting in less amputations and a focus on prolonged amputation-free living.

An Expert Weighs In

“The Southeast has the highest amputation rates in the country. The Vascular Institute of Chattanooga was designed seven years ago as a regional critical limb center, having a team-based approach to preventing unnecessary amputations in our community. Our overall six-month limb salvage rate is 97.4% with a 93% limb preservation rate at five years. This is only possible with comprehensive support from primary care, podiatric surgery, and area wound centers. The ‘simple’ solution for CLI - major amputation of the leg - can have severe consequences: decreased mobility, additional surgeries, psychological stress, depression, and reduced longevity. Always ask for a second opinion for yourself or your family members. Amputation should be the last resort when all else fails. The VIC team is dedicated to eliminating unnecessary amputations in our region.”

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