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JAMA Network Clinical Guideline Synopsis
December 18, 2019

Review of the Global Vascular Guidelines on the Management of Chronic Limb-Threatening Ischemia

Author Affiliations
  • 1Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
JAMA Surg. 2020;155(2):161-162. doi:10.1001/jamasurg.2019.4928

In 2010, it was estimated that more than 200 million people worldwide were living with peripheral arterial disease. Chronic limb-threatening ischemia (CLTI) represents the end stage of peripheral arterial disease, which, left untreated, incurs a risk of major amputation, approaching 25% at 1 year. Despite the global scale and severe clinical consequences of CLTI, it has been poorly defined and variably managed. Prior guidelines, such as the Trans-atlantic Inter-society Consensus Document on the Management of Peripheral Arterial Disease (TASC II), have offered treatment recommendations based on disease anatomy alone.1 A more contemporary, nuanced definition of the problem and thorough understanding of the state of evidence are required to guide medical treatment, revascularization strategies, and future study.2

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