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Multidisciplinary Care for Critical Limb Ischemia: Current Gaps and Opportunities for Improvement

Ehrin J Armstrong1, Syed Alam2, Steve Henao3

  • 11 Division of Cardiology, University of Colorado and Rocky Mountain Regional VA Medical Center, Denver, CO, USA.

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists
|February 2, 2019
PubMed

Insights

Critical limb ischemia (CLI) care is fragmented due to multiple specialists. This review highlights gaps and proposes solutions for better multidisciplinary management of CLI patients.

Area of Science:

  • Vascular Surgery
  • Cardiology
  • Wound Care

Background:

  • Critical limb ischemia (CLI) is the most severe form of peripheral artery disease, often requiring complex, multidisciplinary care.
  • Current care for CLI patients is frequently fragmented, lacking specific societal guidelines, which can negatively impact outcomes.
  • No single medical specialty can address all aspects of CLI management, necessitating a coordinated approach.

Purpose of the Study:

  • To identify current gaps in the multidisciplinary care of patients with critical limb ischemia.
  • To propose strategies for improving disease recognition, referral, and team composition for CLI.
  • To outline optimal revascularization and post-revascularization wound care practices for CLI.

Main Methods:

  • This is a review article.
  • It synthesizes current knowledge on critical limb ischemia management.
  • It focuses on identifying gaps in multidisciplinary care and proposing best practices.

Main Results:

  • Significant gaps exist in the coordinated care of CLI patients.
  • Timely referral and appropriate team composition are crucial for effective CLI management.
  • Standardized revascularization and wound care protocols are needed.

Conclusions:

  • Multidisciplinary care is essential for improving outcomes in critical limb ischemia.
  • Addressing care fragmentation through defined team roles and protocols can enhance patient management.
  • Further research and guideline development are needed to optimize CLI treatment pathways.

Keywords:
critical limb ischemiaendovascular therapymultidisciplinary careperipheral artery diseaserevascularizationwound care

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