What are the ESC/ESVS treatment guidelines for chronic limb-threatening ischemia (CLTI) in peripheral arterial occlusive disease (PAOD)?

Updated: Sep 12, 2019
  • Author: Josefina A Dominguez, MD; Chief Editor: Vincent Lopez Rowe, MD  more...
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Answer

Recommendations for management of CLTI are as follows:

  • Early recognition of tissue loss or infection and referral to the vascular team is mandatory to improve limb salvage (class I recommendation; evidence level C)
  • Assessment of the risk of amputation is indicated (class I recommendation; evidence level C)
  • In patients with CLTI and diabetes, optimal glycemic control is recommended (class I recommendation; evidence level C)
  • For limb salvage, revascularization is indicated whenever feasible (class I recommendation; evidence level B)
  • In CLTI patients with below-the-knee lesions, angiography (including foot runoff) should be considered before revascularization (class IIa recommendation; evidence level C)
  • Stem cell or gene therapy is not indicated for CLTI (class III recommendation; evidence level B)

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