The fate of patients with critical leg ischemia

Semin Vasc Surg. 1999 Jun;12(2):142-7.


In some highly specialized and aggressive units, 90% of patients with critical leg ischemia (CLI) will undergo some form of surgical or endovascular procedure; however, in most, the figure is nearer 50 to 60%. The primary amputation rate varies from around 10% to 40%. The mortality rate in these patients with standard therapy is around 20% at 1 year and between 40% and 70% at 5 years. Virtually all (95%) patients who present with ischemic gangrene, and 80% of those presenting with rest pain, are dead within 10 years. There appears to be a decline in overall major amputation rates associated with a corresponding increase in revascularizations. However, although technical advances may have resulted in a steadying or even decrease in amputations, comparisons of total amputations over a longer period suggest an increase, presumably attributable to an aging population. Some forward projections predict that major amputations will be doubled in the next 30 years.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Aged
  • Amputation, Surgical / mortality*
  • Amputation, Surgical / statistics & numerical data
  • Clinical Trials as Topic
  • Critical Illness / mortality
  • Female
  • Humans
  • Ischemia / diagnosis
  • Ischemia / mortality
  • Ischemia / surgery*
  • Leg / blood supply*
  • Leg / surgery
  • Male
  • Middle Aged
  • Peripheral Vascular Diseases / mortality
  • Peripheral Vascular Diseases / surgery
  • Prognosis
  • Survival Rate