46
Treatment
Table 18. Anatomic Classification of the "No Option" Patient
With CLTI
Type
Conventional
Revascularization
Options
No or
Poor
Option Description
I. Desert
foot pedal
anatomy
No No option No patent pedal vessels
Should be staged with the WIf I
and GLASS staging classifications
(including pedal modifier)
II. Inadequate
venous
conduit
No No option Patent pedal target without
adequate venous conduit for
bypass
No endovascular options
III. Extensive
tissue loss
Yes Poor
option
Tissue loss with exposure of
vital structures precluding limb
salvage of a functional foot
Modified from page 189 of Kim et al. Copyright © 2021 by SAGE Publications, by
permission of SAGE Publications.
10.3.3. Approach to the "No Option" Patient With CLTI
COR LOE
Recommendations
2b B-R
1. In patients with CLTI for whom revascularization is not
an option and a lack of outflow to the foot is observed, the
usefulness of prostanoids is uncertain.
2b B-NR
2. In patients with CLTI for whom revascularization is not an
option, arterial intermittent pneumatic compression devices
may be considered to augment wound healing or ameliorate
ischemic rest pain.
2b B-NR
3. In patients with CLTI for whom arterial revascularization is
not an option and a lack of outflow to the foot is observed,
venous arterialization may be considered for limb preservation.
