SVS Guidelines Bundle

Chronic Limb-Threatening Ischemia

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23 Summary of Recommendations Recommendation Grade/ LOE 10.10 Offer intervention for DUS-detected vein gra lesions with an associated PSV of >300 cm/s and a PSV ratio >3.5 or gras with low velocity (midgra PSV <45 cm/s) to maintain patency. 1-B 10.11 Maintain long-term surveillance aer surgical or catheter-based revision of a vein gra, including DUS gra scanning where available, to detect recurrent gra-threatening lesions. 1-B 10.12 Consider arterial imaging aer endovascular intervention for failure to improve (wound healing, rest pain) or a recurrence of symptoms to detect restenosis or progression of pre-existing disease. 2-C 10.13 Consider reintervention for patients with DUS-detected restenosis lesions >70% (PSV ratio >3.5, PSV >300 cm/s) if symptoms of CLTI are unresolved or on a selective basis in asymptomatic patients aer catheter-based interventions. 2-C 10.14 Provide mechanical ooading as a primary component for care of all CLTI patients with pedal wounds. 1-A 10.15 Provide counseling on continued protection of the healed wound and foot to include appropriate shoes, insoles, and monitoring of inflammation. 1-A

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