Sandbox:ssw 2
Recommendation for Revascularization for CLI:
| Class I |
| "1.In patients with CLI, revascularization should be performed when possible to minimize tissue loss.(Level of Evidence: B-NR)" |
| "2.An evaluation for revascularization options should be performed by an interdisciplinary care team before amputation in the patient with CLI.(Level of Evidence: C-EO)" |
Recommendations for Endovascular Revascularization for CLI:
| Class I |
| "1.Endovascular procedures are recommended to establish in-line blood flow to the foot in patients with nonhealing wounds or gangrene.(Level of Evidence: B-R)" |
| Class IIa |
| "1. A staged approach to endovascular procedures is reasonable in patients with ischemic rest pain. (Level of Evidence: C-LD)" |
| "2. Evaluation of lesion characteristics can be useful in selecting the endovascular approach for CLI.(Level of Evidence: B-R)" |
| Class IIb |
| "1.Use of angiosome-directed endovascular therapy may be reasonable for patients with CLI and nonhealing wounds or gangrene. (Level of Evidence: B-NR)" |
Recommendations for Surgical Revascularization for CLI:
| Class I |
| "1. When surgery is performed for CLI, bypass to the popliteal or infrapopliteal arteries (i.e., tibial, pedal) should be constructed with suitable autogenous vein.(Level of Evidence: A)" |
| "2. Surgical procedures are recommended to establish in-line blood flow to the foot in patients with nonhealing wounds or gangrene. (Level of Evidence: C-LD)" |
| Class IIa |
| "1. In patients with CLI for whom endovascular revascularization has failed and a suitable autogenous vein is not available, prosthetic material can be effective for bypass to the below-knee popliteal and tibial arteries. (Level of Evidence: B-NR)" |
| "2. A staged approach to surgical procedures is reasonable in patients with ischemic rest pain. (Level of Evidence: C-LD)" |
Recommendation for Wound Healing Therapy:
| Class I |
| "1. An interdisciplinary care team should evaluate and provide comprehensive care for patients with CLI and tissue loss to achieve complete wound healing and a functional foot(Level of Evidence: B-NR)" |
| "2. In patients with CLI, wound care after revascularization should be performed with the goal of complete wound healing(Level of Evidence: C-LD)" |
| Class III (No Benefit) |
| "1. Prostanoids are not indicated in patients with CLI. (Level of Evidence: B-R)" |
| Class IIb |
| "1. In patients with CLI, intermittent pneumatic compression (arterial pump) devices may be considered to augment wound healing and/or ameliorate severe ischemic rest pain. (Level of Evidence: B-NR)" |
| "2. patients with CLI, the effectiveness of hyperbaric oxygen therapy for wound healing is unknown. (Level of Evidence: C-LD)" |