Multidisciplinary Care for Critical Limb Ischemia: Current Gaps and Opportunities for Improvement. (April 2019)

• Record Type: Journal Article
• Authors: Armstrong, Ehrin J.; Alam, Syed; Henao, Steve; Lee, Arthur C.; DeRubertis, Brian G.; Montero-Baker, Miguel; Mena, Carlos; Cua, Bennett; Palena, Luis Mariano; Kovach, Richard; Chandra, Venita; AlMahameed, Amjad; Walker, Craig M.
• Is Part Of: Journal of endovascular therapy. Volume 26:Number 2(2019:Apr.)
• Page Start: 199
• Page End: 212
• Publication Date: 2019-04
• Subjects: critical limb ischemia -- endovascular therapy -- multidisciplinary care -- peripheral artery disease -- revascularization -- wound care; Blood-vessels -- Endoscopic surgery -- Periodicals; Angioscopy -- Periodicals; Intravenous catheterization -- Periodicals; Peripheral vascular diseases -- Treatment -- Periodicals; Vascular Surgical Procedures -- Periodicals; Angioscopy -- Periodicals; Catheterization, Peripheral -- Periodicals; Peripheral Vascular Diseases -- therapy -- Periodicals; Angioscopie; Maladies vasculaires périphériques; 617.413
• DOI: 10.1177/1526602819826593
• Languages: English
• ISSNs: 1526-6028

Abstract

Critical limb ischemia (CLI), defined as ischemic rest pain or nonhealing ulceration due to arterial insufficiency, represents the most severe and limb-threatening manifestation of peripheral artery disease. A major challenge in the optimal treatment of CLI is that multiple specialties participate in the care of this complex patient population. As a result, the care of patients with CLI is often fragmented, and multidisciplinary societal guidelines have not focused specifically on the care of patients with CLI. Furthermore, multidisciplinary care has the potential to improve patient outcomes, as no single medical specialty addresses all the facets of care necessary to reduce cardiovascular and limb-related morbidity in this complex patient population. This review identifies current gaps in the multidisciplinary care of patients with CLI, with a goal toward increasing disease recognition and timely referral, defining important components of CLI treatment teams, establishing options for revascularization strategies, and identifying best practices for wound care post-revascularization.