How critical is chronic critical leg ischaemia?
"Critical" according to the Oxford dictionary means: a "turning point" where an acute change for better or worse may be anticipated. Thus, the meaning of the word "critical" complies with its use in relation to ischaemia. We don't really know, prospectively, what will happen to the critically ischaemic limb, whether it will improve or worsen. The answer to the question "How critical is critical leg ischaemia (CLI)?" must be: "We don't know!" The addition of ankle systolic pressure as an objective haemodynamic measurement has not made the definition of the Second European Consensus Group significantly better than the original Fontaine classification, grade III and IV. For clinical practice the Fontaine classification will be sufficient. For scientific purposes macro- and microcirculatory assessments and information about the patient's risk profile should be added.
Department of Vascular Surgery, Aker Hospital, University of Oslo, Norway. andries.kroese@ioks.uio.no
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D002908:Chronic Disease; D016638:Critical Illness; D003661:Decision Support Techniques; D006801:Humans; D007511:Ischemia / Q000145:classification / Q000175:diagnosis* / Q000601:surgery; D007866:Leg / Q000098:blood supply*; D012307:Risk Factors; D016896:Treatment Outcome