Current opinions about the definition of critical limb ischemia: A debate still open after three decades

Article type: Research Article

Authors: Martini, Romeo^{; *}

Affiliations: Unitá Operativa di Angiologia, Azienda Ospedaliera Universitaria di Padova, Padova, Italy

Correspondence: [*] Corresponding author: Romeo Martini, Unitá Operativa di Angiologia, Azienda Ospedaliera Universitaria di Padova, Padova, Italy. E-mail: romeo.martini@aopd.veneto.it.

Abstract: Critical limb ischemia (CLI) is the most advanced stage of peripheral arterial disease. It is clinically defined as rest pain with or without skin ulcer or gangrene and carries a very poor prognosis with a high rates of limb amputation and cardiovascular mortality. Despite the first definition of CLI has been published more than 30 years ago, the debate about what it really is, is still open. Over the years the hemodynamic parameters utilised to define the critical level of limb perfusion have changed. This has raised some question about the apparent confusion about the definition of CLI. Moreover, a new term such as “limb threatening ischemia” has replaced the definition of CLI in recent guideline. Therefore, it becomes necessary to understand the evolution of the concept and the definition of CLI, to interpret the future trend. Hence, this work analysing the guideline documents on peripheral arterial disease that have defined the CLI to date, aims to clarify the path that has brought to the current conceptual changes of the definition of CLI.

Keywords: Critical limb ischemia, limb amputation, risk chronic limb threatening ischemia

DOI: 10.3233/CH-190576

Journal: Clinical Hemorheology and Microcirculation, vol. 73, no. 2, pp. 341-346, 2019