Lower extremity amputation in peripheral artery disease: improving patient outcomes.

Journal Article (Review)

Peripheral artery disease affects over eight million Americans and is associated with an increased risk of mortality, cardiovascular disease, functional limitation, and limb loss. In its most severe form, critical limb ischemia, patients are often treated with lower extremity (LE) amputation (LEA), although the overall incidence of LEA is declining. In the US, there is significant geographic variation in the performing of major LEA. The rate of death after major LEA in the US is approximately 48% at 1 year and 71% at 3 years. Despite this significant morbidity and mortality, the use of diagnostic testing (both noninvasive and invasive testing) in the year prior to LEA is low and varies based on patient, provider, and regional factors. In this review we discuss the significance of LEA and methods to reduce its occurrence. These methods include improved recognition of the risk factors for LEA by clinicians and patients, strong advocacy for noninvasive and/or invasive imaging prior to LEA, improved endovascular revascularization techniques, and novel therapies.

Full Text

Duke Authors

Cited Authors

  • Swaminathan, A; Vemulapalli, S; Patel, MR; Jones, WS

Published Date

  • January 2014

Published In

Volume / Issue

  • 10 /

Start / End Page

  • 417 - 424

PubMed ID

  • 25075192

Electronic International Standard Serial Number (EISSN)

  • 1178-2048

International Standard Serial Number (ISSN)

  • 1176-6344

Digital Object Identifier (DOI)

  • 10.2147/vhrm.s50588

Language

  • eng