[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-437213-105":3,"doc-detail-437213-en":81,"detail-sidebar-cat-0-en-105":98},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","contemporary-chronic-limb-threatening-ischemia-care-in-the-united-states-part-1-a-path-toward-multispecialty-collaboration","Contemporary Chronic Limb-Threatening Ischemia Care in the United States - Part 1 - A Path Toward Multispecialty Collaboration","","Care for patients with chronic limb-threatening ischemia (CLTI) is complex and depends on collaboration across specialties and care settings. Rising major limb amputation rates among CLTI patients in the United States prompted a Vascular InterVentional Advances (VIVA) Foundation Vascular Leaders Forum in 2024. The meeting gathered multidisciplinary stakeholders, and it highlights challenges in delivery and access to CLTI care. Recommendations stress integrated CLTI teams beyond core vascular services to improve limb-salvage outcomes.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/contemporary-chronic-limb-threatening-ischemia-care-in-the-united-states-part-1-a-path-toward-multispecialty-collaboration/437213/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/contemporary-chronic-limb-threatening-ischemia-care-in-the-united-states-part-1-a-path-toward-multispecialty-collaboration/437213.png","ImageObject",300,407,{"name":42,"@type":43},"Stanley","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-10-30","2026-09-29",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",13,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"Why is CLTI care described as requiring multispecialty collaboration?","Question",{"text":63,"@type":64},"CLTI management is multidimensional and is most effective when multiple specialties coordinate medical therapy, wound care, vascular testing, and revascularization to achieve limb salvage.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"What prompted the 2024 VIVA Vascular Leaders Forum?",{"text":68,"@type":64},"A recent upward trend in major limb amputation among patients with CLTI in the United States led the VIVA Foundation to convene an open multispecialty discussion on the state of CLTI care and delivery and access challenges.",{"name":70,"@type":61,"acceptedAnswer":71},"What team components are recommended to be added to integrated CLTI care?",{"text":72,"@type":64},"Integrated teams should extend beyond vascular surgery, interventional cardiology, and interventional radiology to include vascular medicine, podiatry, wound care, diabetology, and dietetics.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},437213,1790817011,{"code":4,"msg":82,"data":83},"success",{"doc_id":79,"user_id":84,"nickname":42,"user_avatar":85,"doc_module":4,"category_id":86,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":87,"file_id":88,"file_url":89,"file_type":90,"file_size":91,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":86,"language":92,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":93,"faqs":94,"seo_title":95,"seo_description":12,"update_tm":96,"read_time":97,"preview_page_count":4},2336477405376,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0",7,"Journal of the Society for Cardiovascular Angiography & Interventions 4 (2025) 104013  \nProceedings  \nContemporary Chronic Limb-Threatening Ischemia Care in the United States—Part 1: A Path Toward Multispecialty Collaboration  \nEric A. Raghu  \nSecemsky, MD, MSc a, *, Ehrin J. Armstrong, Kolluri, MD, MS d, Parag J. Patel, MD, MS e,  \nMDb, Venita Chandra, MD c, Peter A. Schneider, MD f,  \nNiten Singh, MD g  \na Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; b Department of Interventional Cardiology, Advanced Heart and Vein Center, Denver, Colorado; c Division of Vascular Surgery, Stanford University Medical Center, Stanford, California; d Cardiovascular Service Line—OhioHealth Riverside Methodist Hospital, Columbus, Ohio; e Division of Interventional Radiology, Department of Radiology, Medical College of Wisconsin, Milwaukee, Wisconsin; f Division of Vascular and Endovascular Surgery, University of California, San Francisco, California; g Division of Vascular Surgery, Department of Surgery, Harborview Medical Center, Seattle, Washington  \n\n| A B S T R A C T |\n| --- |\n| Care for patients with chronic limb-threatening ischemia (CLTI) is complex, and it is most effective when conducted with collaboration across multiple specialties. A recent upward trend in major limb amputation among patients with CLTI warrants a renewed effort to optimize care for this multifaceted condition. The Vascular InterVentional Advances (VIVA) Foundation, a not-for-profit 501(c)(3) organization, convened a Vascular Leaders Forum in 2024 to initiate an open, multispecialty discussion about the state of CLTI care in the United States and current challenges around delivery and access to such care . The forum comprised representatives from vascular surgery, interventional cardiology, interventional radiology, vascular medicine, podiatry, regulators, medical device manufacturers, patient advocacy, and the CLTI and CLTI caregiver population. This article explores the central themes of challenges in CLTI care and ways in which collaboration across specialties and care settings could improve CLTI outcomes. In summary, it was recommended that integrated CLTI care teams extend beyond vascular surgery, interventional cardiology, and interventional radiology to include vascular medicine, podiatry, wound care, diabetology, and dietetics. Meeting the increasing demand for CLTIrevascularization will require these teams to span tertiary care hospitals, community hospitals, outpatient revascularization clinics, and primary care settings. |\n\nIntroduction  \nThe care of patients with chronic limb-threatening ischemia (CLTI) is multidimensional and is most effective when multiple specialties collaborate to optimize patient outcomes.1–3 Joint guidelines involving numerous specialty societies call for a combination of medical therapy, wound care, noninvasive and invasive vascular testing, and revascularization procedures to achieve limb salvage.3 ,4 As such, integrating care across medical specialties is recommended for successful treatment of individuals living with CLTI.  \nThe Vascular InterVentional Advances (VIVA) Foundation convened a Vascular Leaders Forum on April 12, 2024, in Washington, DC, to initiate an open discussion exploring the state of CLTI care in the  \nUnited States and current challenges around delivery and access to that care. The attendees comprised 52 US stakeholders, including representatives of vascular surgery (29%), interventional cardiology (26%), interventional radiology (24%), vascular medicine (7%), and podiatry (2%), as well as 2 US Food and Drug Administration representatives, 1 device manufacturer representative, 1 patient advocate, and 1 patient with CLTI and their caregiver. The practice settings were 70% academic tertiary care hospitals, 7% nonacademic community hospitals, 5% nonacademic tertiary care hospitals, and 5% officebased laboratories or ambulatory surgery centers. The list of attendees is avail","cbCaicAatPAfvhoO","https://ap.wps.com/l/cbCaicAatPAfvhoO","pdf",4641366,"English","# Introduction\n# Challenges in Contemporary CLTI Care in the United States","[{\"question\":\"Why is CLTI care described as requiring multispecialty collaboration?\",\"answer\":\"CLTI management is multidimensional and is most effective when multiple specialties coordinate medical therapy, wound care, vascular testing, and revascularization to achieve limb salvage.\"},{\"question\":\"What prompted the 2024 VIVA Vascular Leaders Forum?\",\"answer\":\"A recent upward trend in major limb amputation among patients with CLTI in the United States led the VIVA Foundation to convene an open multispecialty discussion on the state of CLTI care and delivery and access challenges.\"},{\"question\":\"What team components are recommended to be added to integrated CLTI care?\",\"answer\":\"Integrated teams should extend beyond vascular surgery, interventional cardiology, and interventional radiology to include vascular medicine, podiatry, wound care, diabetology, and dietetics.\"}]","Contemporary Chronic Limb-Threatening Ischemia Care in the United States - Part 1 - A Path Toward Multispecialty Collaboration | PDF",1790680682,18,{"code":4,"msg":82,"data":99},[100,104,108,112,117,122,125,130,135,138,142],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":101,"show_sort_weight":102,"slug":103},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":105,"show_sort_weight":106,"slug":107},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":109,"show_sort_weight":110,"slug":111},"Exam",70,"exam",{"id":113,"doc_module":4,"doc_module_name":25,"category_name":114,"show_sort_weight":115,"slug":116},5,"Comic",60,"comic",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":119,"show_sort_weight":120,"slug":121},6,"Technology",50,"technology",{"id":86,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":123,"slug":124},40,"healthcare",{"id":126,"doc_module":4,"doc_module_name":25,"category_name":127,"show_sort_weight":128,"slug":129},8,"Research & Report",30,"research-report",{"id":131,"doc_module":4,"doc_module_name":25,"category_name":132,"show_sort_weight":133,"slug":134},9,"Religion & Spirituality",20,"religion-spirituality",{"id":133,"doc_module":4,"doc_module_name":25,"category_name":136,"show_sort_weight":133,"slug":137},"World Cup","world-cup",{"id":139,"doc_module":4,"doc_module_name":25,"category_name":140,"show_sort_weight":139,"slug":141},10,"Lifestyle","lifestyle",{"id":143,"doc_module":4,"doc_module_name":25,"category_name":144,"show_sort_weight":113,"slug":145},19,"General","general"]