Fewer U.S. veterans are having leg amputations or dying due to serious blockages in leg arteries, a new study finds.
These blockages are called critical limb ischemia (CLI). They can cause severe leg pain, wounds that don't heal and poor quality of life, according to the study published recently in the journal Circulation: Cardiovascular Interventions.
"All patients with CLI should be evaluated to determine if they could benefit from a procedure to restore blood flow," said study senior author Dr. Saket Girotra, an assistant professor of cardiovascular medicine at the University of Iowa College of Medicine.
"In addition, patients with CLI should be aggressively treated with medications, including statins, blood pressure medications if they are hypertensive, and drugs to reduce platelet stickiness in order to reduce the risk of heart attack and stroke," Girotra said in a journal news release.
Without proper treatment, the blockages can lead to amputation. Patients also have a high risk of heart attack and stroke.
In this study, researchers analyzed data from nearly 21,000 veterans, average age 68, hospitalized for CLI at U.S. Veterans Affairs facilities nationwide between 2005 and 2014.
During that time, the amputation rate fell from 20% to 13% and the death rate fell from 12% to 10%.
Patients who had procedures to restore blood flow in the legs (revascularization) were 55% less likely to die and 77% less likely to have an amputation. However, there were significant differences between VA hospitals in the rates of patients who had revascularization, ranging from 13% to 53%.
The study also found that many patients weren't taking recommended cholesterol-lowering statin medications, and that nearly half of those who had leg amputations did not first undergo revascularization.
Because the patients in the study were mostly men and veterans, the findings may not apply to female veterans or to patients in the general population, the researchers noted.
Vascular Cures has more on critical limb ischemia.