Metrics details. Advanced lower extremity peripheral artery disease PAD , whether presenting as acute limb ischemia ALI or chronic critical limb ischemia CLI , is associated with high rates of cardiovascular ischemic events, amputation, and death. Past research has focused on strategies of revascularization, but few data are available that prospectively evaluate the impact of key process of care factors spanning pre-admission, acute hospitalization, and post-discharge that might contribute to improving short and long-term health outcomes.
This hypothesis-driven registry was designed to evaluate the contributions of: i pre-hospital limb ischemia symptom duration, ii use of leg revascularization strategies, and iii use of risk-reduction pharmacotherapies, as pre-specified factors that may affect amputation-free survival.
Data including baseline demographics, functional status, co-morbidities, pre-hospital time segments, and use of medical therapies; hospital-based use of revascularization strategies, time segments, and pharmacotherapies; and rates of systemic ischemic events e. Advanced lower extremity peripheral artery disease PAD represents a relatively uncommon, but exceptionally high-risk, manifestation of systemic atherosclerosis.
Both traditional PAD classification systems and recent evidence-based PAD care guidelines have emphasized the potential benefit of more consistent case classification of advanced PAD into two distinct clinical syndromes, denoted as acute limb ischemia ALI or chronic critical limb ischemia CLI.
Both PAD syndromes represent manifestations of a severe compromise of arterial blood flow to the affected lower extremity, with the acuity of onset of ischemia and specific clinical signs used to distinguish between these syndromes [ 1 ]. Current evidence suggests an incidence of approximately to cases per million individuals annually [ 2 β 4 ]. Although ALI and CLI represent the primary etiology of most lower-limb amputations [ 5 ] and are associated with high short-term rates of systemic and limb ischemic events [ 6 , 7 ], uncertainty regarding the incidence, prevalence, and outcomes of the ALI and CLI syndromes is, in part, based on the lack of a uniform and applicable definition used in either field studies or in clinical practice outside of specialized vascular centers.
