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Semin Vasc Surg. 1999 Jun;12(2):142-7.

The fate of patients with critical leg ischemia.

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Department of Vascular Surgery, St George's Hospital Medical School, London, England, United Kingdom.


In some highly specialized and aggressive units, 90% of patients with critical leg ischemia (CLI) will undergo some form of surgical or endovascular procedure; however, in most, the figure is nearer 50 to 60%. The primary amputation rate varies from around 10% to 40%. The mortality rate in these patients with standard therapy is around 20% at 1 year and between 40% and 70% at 5 years. Virtually all (95%) patients who present with ischemic gangrene, and 80% of those presenting with rest pain, are dead within 10 years. There appears to be a decline in overall major amputation rates associated with a corresponding increase in revascularizations. However, although technical advances may have resulted in a steadying or even decrease in amputations, comparisons of total amputations over a longer period suggest an increase, presumably attributable to an aging population. Some forward projections predict that major amputations will be doubled in the next 30 years.

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