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Disclaimer
is pocket guide attempts to define principles of practice that should produce high-quality
patient care. It focuses on the needs of primary care practice, but also is applicable to providers
at all levels. is pocket guide should not be considered exclusive of other methods of care
reasonably directed at obtaining the same results. e ultimate judgment concerning the
propriety of any course of conduct must be made by the clinician aer consideration of each
individual patient situation.
Neither IGC, the medical associations, nor the authors endorse any product or service
associated with the distributor of this clinical reference tool.
Source
Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, Mills JL, Ricco JB,
Suresh KR, Murad MH. Global vascular guideline on the management of chronic limb-
threatening ischemia. J Vasc Surg. 2019;69(6s):1-122.
Abbreviations
ABI, ankle-brachial index; AI, aortoiliac; AKA, above-knee amputation; AP, ankle
pressure; AT, anterior tibial; BKA, below-knee amputation; CE-MRA, contrast-enhanced
MRA; CFA, common femoral artery; CLTI, chronic limb-threatening ischemia;
CTA, computed tomography angiography; DAPT, dual antiplatelet therapy; DM,
diabetes mellitus; DUS, duplex ultrasound; EBR, evidence-based revascularization;
ESVS, European Society for Vascular Surgery; FP, femoropopliteal; GLASS, Global
Limb Anatomic Staging System; GRADE, Grading of Recommendations Assessment,
Development, and Evaluation; GSV, great saphenous vein; HBOT, hyperbaric oxygen
therapy; HRQL, health-related quality of life; IPC, intermittent pneumatic compression;
LS, lumbar sympathectomy; MRA, magnetic resonance angiography; OPG, objective
performance goal; PAD, peripheral artery disease; PFA, profunda femoris artery; PLAN,
Patient risk estimation, Limb staging, ANatomic pattern of disease; PROM, patient-
reported outcomes measure; PSV, peak systolic velocity; PVR, pulse volume recording ;
RCT, randomized controlled trial; SCS, spinal cord stimulation; SVS, Society for
Vascular Surgery; TAP, target arterial path; TBI, toe-brachial index; TKA, through-knee
amputation; TP, toe pressure; WFVS, World Federation of Vascular Societies; WIf I,
Wound, Ischemia, foot Infection
Recommendation Grading
Strength of Recommendation Level of Evidence
1 – Strong Benefit clearly outweighs risk A High
2 – Weak Benefits and risks are more closely matched and
are more dependent on specific clinical scenarios
B Moderate
C Low
GPS Good Practice Statement – Ungraded