U.S. flag

An official website of the United States government

Format

Send to:

Choose Destination

Chronic Limb-Threatening Ischemia

MedGen UID:
1782264
Concept ID:
C1142264
Disease or Syndrome
Synonyms: Chronic Limb Threatening Ischemia; Critical Limb Ischemia; Ischemia, Chronic Limb-Threatening; Ischemia, Critical Limb; Limb Ischemia, Critical; Limb-Threatening Ischemia, Chronic

Definition

A severe form of peripheral artery disease in which a hypoperfusion of the BLOOD through an organ or tissue is caused by occlusion of peripheral arterial vessels. It is associated with the presence of chronic ischemic rest pain, ulceration or GANGRENE. [from MeSH]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVChronic Limb-Threatening Ischemia

Professional guidelines

PubMed

Primary Panel:, Abramson BL, Al-Omran M, Anand SS, Albalawi Z, Coutinho T, de Mestral C, Dubois L, Gill HL, Greco E, Guzman R, Herman C, Hussain MA, Huckell VF, Jetty P, Kaplovitch E, Karlstedt E, Kayssi A, Lindsay T, Mancini GBJ, McClure G, McMurtry MS, Mir H, Nagpal S, Nault P, Nguyen T, Petrasek P, Rannelli L, Roberts DJ, Roussin A, Saw J, Srivaratharajah K, Stone J, Szalay D, Wan D; Secondary Panel:, Cox H, Verma S, Virani S
Can J Cardiol 2022 May;38(5):560-587. doi: 10.1016/j.cjca.2022.02.029. PMID: 35537813
Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, Mills JL, Ricco JB, Suresh KR, Murad MH, Aboyans V, Aksoy M, Alexandrescu VA, Armstrong D, Azuma N, Belch J, Bergoeing M, Bjorck M, Chakfé N, Cheng S, Dawson J, Debus ES, Dueck A, Duval S, Eckstein HH, Ferraresi R, Gambhir R, Gargiulo M, Geraghty P, Goode S, Gray B, Guo W, Gupta PC, Hinchliffe R, Jetty P, Komori K, Lavery L, Liang W, Lookstein R, Menard M, Misra S, Miyata T, Moneta G, Munoa Prado JA, Munoz A, Paolini JE, Patel M, Pomposelli F, Powell R, Robless P, Rogers L, Schanzer A, Schneider P, Taylor S, De Ceniga MV, Veller M, Vermassen F, Wang J, Wang S; GVG Writing Group for the Joint Guidelines of the Society for Vascular Surgery (SVS), European Society for Vascular Surgery (ESVS), and World Federation of Vascular Societies (WFVS)
Eur J Vasc Endovasc Surg 2019 Jul;58(1S):S1-S109.e33. Epub 2019 Jun 8 doi: 10.1016/j.ejvs.2019.05.006. PMID: 31182334Free PMC Article
Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, Mills JL, Ricco JB, Suresh KR, Murad MH; GVG Writing Group
J Vasc Surg 2019 Jun;69(6S):3S-125S.e40. Epub 2019 May 28 doi: 10.1016/j.jvs.2019.02.016. PMID: 31159978Free PMC Article

Recent clinical studies

Etiology

Shishehbor MH, Powell RJ, Montero-Baker MF, Dua A, Martínez-Trabal JL, Bunte MC, Lee AC, Mugglin AS, Mills JL, Farber A, Clair DG; PROMISE II Investigators
N Engl J Med 2023 Mar 30;388(13):1171-1180. doi: 10.1056/NEJMoa2212754. PMID: 36988592
Farber A, Menard MT, Conte MS, Kaufman JA, Powell RJ, Choudhry NK, Hamza TH, Assmann SF, Creager MA, Cziraky MJ, Dake MD, Jaff MR, Reid D, Siami FS, Sopko G, White CJ, van Over M, Strong MB, Villarreal MF, McKean M, Azene E, Azarbal A, Barleben A, Chew DK, Clavijo LC, Douville Y, Findeiss L, Garg N, Gasper W, Giles KA, Goodney PP, Hawkins BM, Herman CR, Kalish JA, Koopmann MC, Laskowski IA, Mena-Hurtado C, Motaganahalli R, Rowe VL, Schanzer A, Schneider PA, Siracuse JJ, Venermo M, Rosenfield K; BEST-CLI Investigators
N Engl J Med 2022 Dec 22;387(25):2305-2316. Epub 2022 Nov 7 doi: 10.1056/NEJMoa2207899. PMID: 36342173
Lanzer P, Hannan FM, Lanzer JD, Janzen J, Raggi P, Furniss D, Schuchardt M, Thakker R, Fok PW, Saez-Rodriguez J, Millan A, Sato Y, Ferraresi R, Virmani R, St Hilaire C
J Am Coll Cardiol 2021 Sep 14;78(11):1145-1165. doi: 10.1016/j.jacc.2021.06.049. PMID: 34503684Free PMC Article
Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, Mills JL, Ricco JB, Suresh KR, Murad MH, Aboyans V, Aksoy M, Alexandrescu VA, Armstrong D, Azuma N, Belch J, Bergoeing M, Bjorck M, Chakfé N, Cheng S, Dawson J, Debus ES, Dueck A, Duval S, Eckstein HH, Ferraresi R, Gambhir R, Gargiulo M, Geraghty P, Goode S, Gray B, Guo W, Gupta PC, Hinchliffe R, Jetty P, Komori K, Lavery L, Liang W, Lookstein R, Menard M, Misra S, Miyata T, Moneta G, Munoa Prado JA, Munoz A, Paolini JE, Patel M, Pomposelli F, Powell R, Robless P, Rogers L, Schanzer A, Schneider P, Taylor S, De Ceniga MV, Veller M, Vermassen F, Wang J, Wang S; GVG Writing Group for the Joint Guidelines of the Society for Vascular Surgery (SVS), European Society for Vascular Surgery (ESVS), and World Federation of Vascular Societies (WFVS)
Eur J Vasc Endovasc Surg 2019 Jul;58(1S):S1-S109.e33. Epub 2019 Jun 8 doi: 10.1016/j.ejvs.2019.05.006. PMID: 31182334Free PMC Article
Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, Mills JL, Ricco JB, Suresh KR, Murad MH; GVG Writing Group
J Vasc Surg 2019 Jun;69(6S):3S-125S.e40. Epub 2019 May 28 doi: 10.1016/j.jvs.2019.02.016. PMID: 31159978Free PMC Article

Diagnosis

Primary Panel:, Abramson BL, Al-Omran M, Anand SS, Albalawi Z, Coutinho T, de Mestral C, Dubois L, Gill HL, Greco E, Guzman R, Herman C, Hussain MA, Huckell VF, Jetty P, Kaplovitch E, Karlstedt E, Kayssi A, Lindsay T, Mancini GBJ, McClure G, McMurtry MS, Mir H, Nagpal S, Nault P, Nguyen T, Petrasek P, Rannelli L, Roberts DJ, Roussin A, Saw J, Srivaratharajah K, Stone J, Szalay D, Wan D; Secondary Panel:, Cox H, Verma S, Virani S
Can J Cardiol 2022 May;38(5):560-587. doi: 10.1016/j.cjca.2022.02.029. PMID: 35537813
Polonsky TS, McDermott MM
JAMA 2021 Jun 1;325(21):2188-2198. doi: 10.1001/jama.2021.2126. PMID: 34061140
Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, Mills JL, Ricco JB, Suresh KR, Murad MH, Aboyans V, Aksoy M, Alexandrescu VA, Armstrong D, Azuma N, Belch J, Bergoeing M, Bjorck M, Chakfé N, Cheng S, Dawson J, Debus ES, Dueck A, Duval S, Eckstein HH, Ferraresi R, Gambhir R, Gargiulo M, Geraghty P, Goode S, Gray B, Guo W, Gupta PC, Hinchliffe R, Jetty P, Komori K, Lavery L, Liang W, Lookstein R, Menard M, Misra S, Miyata T, Moneta G, Munoa Prado JA, Munoz A, Paolini JE, Patel M, Pomposelli F, Powell R, Robless P, Rogers L, Schanzer A, Schneider P, Taylor S, De Ceniga MV, Veller M, Vermassen F, Wang J, Wang S; GVG Writing Group for the Joint Guidelines of the Society for Vascular Surgery (SVS), European Society for Vascular Surgery (ESVS), and World Federation of Vascular Societies (WFVS)
Eur J Vasc Endovasc Surg 2019 Jul;58(1S):S1-S109.e33. Epub 2019 Jun 8 doi: 10.1016/j.ejvs.2019.05.006. PMID: 31182334Free PMC Article
Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, Mills JL, Ricco JB, Suresh KR, Murad MH; GVG Writing Group
J Vasc Surg 2019 Jun;69(6S):3S-125S.e40. Epub 2019 May 28 doi: 10.1016/j.jvs.2019.02.016. PMID: 31159978Free PMC Article
Almasri J, Adusumalli J, Asi N, Lakis S, Alsawas M, Prokop LJ, Bradbury A, Kolh P, Conte MS, Murad MH
J Vasc Surg 2018 Aug;68(2):624-633. Epub 2018 May 24 doi: 10.1016/j.jvs.2018.01.066. PMID: 29804736

Therapy

Farber A, Menard MT, Conte MS, Kaufman JA, Powell RJ, Choudhry NK, Hamza TH, Assmann SF, Creager MA, Cziraky MJ, Dake MD, Jaff MR, Reid D, Siami FS, Sopko G, White CJ, van Over M, Strong MB, Villarreal MF, McKean M, Azene E, Azarbal A, Barleben A, Chew DK, Clavijo LC, Douville Y, Findeiss L, Garg N, Gasper W, Giles KA, Goodney PP, Hawkins BM, Herman CR, Kalish JA, Koopmann MC, Laskowski IA, Mena-Hurtado C, Motaganahalli R, Rowe VL, Schanzer A, Schneider PA, Siracuse JJ, Venermo M, Rosenfield K; BEST-CLI Investigators
N Engl J Med 2022 Dec 22;387(25):2305-2316. Epub 2022 Nov 7 doi: 10.1056/NEJMoa2207899. PMID: 36342173
Primary Panel:, Abramson BL, Al-Omran M, Anand SS, Albalawi Z, Coutinho T, de Mestral C, Dubois L, Gill HL, Greco E, Guzman R, Herman C, Hussain MA, Huckell VF, Jetty P, Kaplovitch E, Karlstedt E, Kayssi A, Lindsay T, Mancini GBJ, McClure G, McMurtry MS, Mir H, Nagpal S, Nault P, Nguyen T, Petrasek P, Rannelli L, Roberts DJ, Roussin A, Saw J, Srivaratharajah K, Stone J, Szalay D, Wan D; Secondary Panel:, Cox H, Verma S, Virani S
Can J Cardiol 2022 May;38(5):560-587. doi: 10.1016/j.cjca.2022.02.029. PMID: 35537813
Bonaca MP, Hamburg NM, Creager MA
Circ Res 2021 Jun 11;128(12):1868-1884. Epub 2021 Jun 10 doi: 10.1161/CIRCRESAHA.121.318258. PMID: 34110910
Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, Mills JL, Ricco JB, Suresh KR, Murad MH, Aboyans V, Aksoy M, Alexandrescu VA, Armstrong D, Azuma N, Belch J, Bergoeing M, Bjorck M, Chakfé N, Cheng S, Dawson J, Debus ES, Dueck A, Duval S, Eckstein HH, Ferraresi R, Gambhir R, Gargiulo M, Geraghty P, Goode S, Gray B, Guo W, Gupta PC, Hinchliffe R, Jetty P, Komori K, Lavery L, Liang W, Lookstein R, Menard M, Misra S, Miyata T, Moneta G, Munoa Prado JA, Munoz A, Paolini JE, Patel M, Pomposelli F, Powell R, Robless P, Rogers L, Schanzer A, Schneider P, Taylor S, De Ceniga MV, Veller M, Vermassen F, Wang J, Wang S; GVG Writing Group for the Joint Guidelines of the Society for Vascular Surgery (SVS), European Society for Vascular Surgery (ESVS), and World Federation of Vascular Societies (WFVS)
Eur J Vasc Endovasc Surg 2019 Jul;58(1S):S1-S109.e33. Epub 2019 Jun 8 doi: 10.1016/j.ejvs.2019.05.006. PMID: 31182334Free PMC Article
Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, Mills JL, Ricco JB, Suresh KR, Murad MH; GVG Writing Group
J Vasc Surg 2019 Jun;69(6S):3S-125S.e40. Epub 2019 May 28 doi: 10.1016/j.jvs.2019.02.016. PMID: 31159978Free PMC Article

Prognosis

Cheng HS, Pérez-Cremades D, Zhuang R, Jamaiyar A, Wu W, Chen J, Tzani A, Stone L, Plutzky J, Ryan TE, Goodney PP, Creager MA, Sabatine MS, Bonaca MP, Feinberg MW
JCI Insight 2023 May 22;8(10) doi: 10.1172/jci.insight.163041. PMID: 37097749Free PMC Article
Lanzer P, Hannan FM, Lanzer JD, Janzen J, Raggi P, Furniss D, Schuchardt M, Thakker R, Fok PW, Saez-Rodriguez J, Millan A, Sato Y, Ferraresi R, Virmani R, St Hilaire C
J Am Coll Cardiol 2021 Sep 14;78(11):1145-1165. doi: 10.1016/j.jacc.2021.06.049. PMID: 34503684Free PMC Article
Aday AW, Matsushita K
Circ Res 2021 Jun 11;128(12):1818-1832. Epub 2021 Jun 10 doi: 10.1161/CIRCRESAHA.121.318535. PMID: 34110907Free PMC Article
Benedetto F, Spinelli D, Pipitò N, Barillà D, Stilo F, De Caridi G, Barillà C, Spinelli F
Vasc Med 2021 Apr;26(2):187-194. Epub 2021 Jan 6 doi: 10.1177/1358863X20978468. PMID: 33407009
Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, Mills JL, Ricco JB, Suresh KR, Murad MH; GVG Writing Group
J Vasc Surg 2019 Jun;69(6S):3S-125S.e40. Epub 2019 May 28 doi: 10.1016/j.jvs.2019.02.016. PMID: 31159978Free PMC Article

Clinical prediction guides

Varcoe RL, DeRubertis BG, Kolluri R, Krishnan P, Metzger DC, Bonaca MP, Shishehbor MH, Holden AH, Bajakian DR, Garcia LA, Kum SWC, Rundback J, Armstrong E, Lee JK, Khatib Y, Weinberg I, Garcia-Garcia HM, Ruster K, Teraphongphom NT, Zheng Y, Wang J, Jones-McMeans JM, Parikh SA; LIFE-BTK Investigators
N Engl J Med 2024 Jan 4;390(1):9-19. Epub 2023 Oct 25 doi: 10.1056/NEJMoa2305637. PMID: 37888915
Castro-Dominguez Y, Shishehbor MH
Curr Cardiol Rep 2022 Mar;24(3):217-223. Epub 2022 Feb 7 doi: 10.1007/s11886-022-01643-2. PMID: 35129740
Polonsky TS, McDermott MM
JAMA 2021 Jun 1;325(21):2188-2198. doi: 10.1001/jama.2021.2126. PMID: 34061140
Benedetto F, Spinelli D, Pipitò N, Barillà D, Stilo F, De Caridi G, Barillà C, Spinelli F
Vasc Med 2021 Apr;26(2):187-194. Epub 2021 Jan 6 doi: 10.1177/1358863X20978468. PMID: 33407009
Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, Mills JL, Ricco JB, Suresh KR, Murad MH; GVG Writing Group
J Vasc Surg 2019 Jun;69(6S):3S-125S.e40. Epub 2019 May 28 doi: 10.1016/j.jvs.2019.02.016. PMID: 31159978Free PMC Article

Recent systematic reviews

Shan LL, Yang LS, Tew M, Westcott MJ, Spelman TD, Choong PF, Davies AH
Eur J Vasc Endovasc Surg 2022 Dec;64(6):666-683. Epub 2022 Aug 8 doi: 10.1016/j.ejvs.2022.07.051. PMID: 35952907
Shan LL, Wang J, Westcott MJ, Tew M, Davies AH, Choong PF
Ann Vasc Surg 2022 Sep;85:9-21. Epub 2022 May 11 doi: 10.1016/j.avsg.2022.04.036. PMID: 35561892
Goodney P, Shah S, Hu YD, Suckow B, Kinlay S, Armstrong DG, Geraghty P, Patterson M, Menard M, Patel MR, Conte MS
J Vasc Surg 2022 May;75(5):1762-1775. Epub 2022 Jan 24 doi: 10.1016/j.jvs.2021.11.057. PMID: 35085747Free PMC Article
Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, Mills JL, Ricco JB, Suresh KR, Murad MH; GVG Writing Group
J Vasc Surg 2019 Jun;69(6S):3S-125S.e40. Epub 2019 May 28 doi: 10.1016/j.jvs.2019.02.016. PMID: 31159978Free PMC Article
Almasri J, Adusumalli J, Asi N, Lakis S, Alsawas M, Prokop LJ, Bradbury A, Kolh P, Conte MS, Murad MH
J Vasc Surg 2018 Aug;68(2):624-633. Epub 2018 May 24 doi: 10.1016/j.jvs.2018.01.066. PMID: 29804736

Supplemental Content

Table of contents

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.
    • Bookshelf
      See practice and clinical guidelines in NCBI Bookshelf. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Recent activity

    Your browsing activity is empty.

    Activity recording is turned off.

    Turn recording back on

    See more...