Societies share new recommendations for endovascular specialists treating chronic limb-threatening ischemia

Acknowledging the complexity and multifaceted nature of caring for patients with chronic limb-threatening ischemia (CLTI), eight medical societies cooperated to develop and release a position statement outlining guidelines for the endovascular specialists who treat them. 

“Standardizing expected competencies for endovascular specialists is an important step to ensure that patient-centric and evidence-based therapy is delivered," said Beau M. Hawkins, MD, chair of the writing group for the document in a statement about its release. "This new framework is a starting point to enable training programs, professional medical societies, and other entities to develop curricula that address the needs of this unique patient population."

CLTI, characterized by tissue loss or constant pain in the lower leg or feet, affects nearly two million Americans and puts them at high risk for amputation, heart attack, and death. As the position statement notes, nearly one in five CLTI patients dies within one year. Additionally, the statement notes that many patients receive amputations without appropriate vascular assessments or procedures that could potentially eliminate the need for amputation.  

To improve outcomes for these high-risk patients, the guidelines classify competencies into six categories: medical knowledge, patient care and procedural skills, systems-based practice, practice-based learning and improvement, professionalism, and interpersonal and communication skills. 

It also includes a discussion on required resources to meet these core competencies, as well as recommendations for formal training or independent courses that can help providers achieve the necessary skill set. 

The eight multi-specialty medical societies endorsing the position statement were: the American College of Radiology, American Podiatric Medical Association, Society for Cardiovascular Angiography and Interventions, Society for Interventional Radiology, Society for Vascular Medicine, Society for Vascular Surgery, Society for Clinical Vascular Surgery, and Vascular and Endovascular Surgical Society

"I hope that these efforts will evolve and translate into better care for these high-risk patients at risk of limb loss," said Mehdi Shishehbor, DO, MPH, PhD, president, Harrington Heart and Vascular Institute, University Hospitals Cleveland, and co-chair of the writing group. 

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