Management of Patients with Chronic Limb Threatening Ischemia

Abstract

This article provides a comprehensive overview of the treatment of chronic limb threatening ischemia (CLTI). In order to understand the optimal treatment strategy for CLTI, the following six essential aspects are discussed: (1) the PLAN concept, (2) wound treatment, (3) nutritional intervention, (4) rehabilitation, (5) drug and adjuvant therapy, and (6) major amputation. In recent years, a new comprehensive concept called CLTI has been introduced internationally, focusing not only on ischemia but also on factors such as tissue loss and infection, leading to a restructuring of treatment strategies. The goal of treatment for CLTI is not simply to save the limb, but to save the limb functionally with an emphasis on quality of life (QOL). In CLTI, which requires a multidisciplinary approach and individualized assessment and treatment strategies, clinical decisions based on the latest guidelines and evidence from Japan and overseas are important.