Clinical Decision-Making for Patients with Chronic Limb-Threatening Ischemia.

The treatment of chronic limb-threatening ischemia (CLTI) is complex and centers on prompt revascularization, control of infection, and long-term surveillance. These patients have a shortened life expectancy due to multiple comorbidities escalating procedural risk. Randomized trials comparing open surgery (OS) with endovascular therapy (EVT) have shown that both options are viable depending on patient-specific variables. This update highlights the diagnosis of CLTI, reviews patient-specific/lesion-specific characteristics that may favor OS or EVT, contrasts most common OS with EVT techniques used, and suggests a follow-up algorithm.