Single-Center Limb Salvage Program Leads to 80% Decrease in Amputation Rates

February 3, 2015—A study presented at ISET 2015: the 27^th annual International Symposium on Endovascular Therapy in Hollywood, Florida, demonstrated that the implementation of a system to ensure that patients with peripheral arterial disease (PAD) get tested and treated with endovascular therapy resulted in an approximately 80% decrease in amputation rates at Martin Health System in Stuart, Florida.

Julio Sanguily III, MD, a vascular surgeon at Martin Health System, served as the lead investigator of the study. In the ISET press release, Dr. Sanguily commented, “Most PAD patients don’t undergo testing to analyze blood flow first, they just have a leg or foot amputated. In recent years, there has been a revolution in endovascular therapy and we’re able to treat calcified and smaller vessels, meaning we can significantly improve blood flow and save limbs that once weren’t considered salvageable. And that saves lives.”

Dr. Sanguily said the key is twofold: first, to educate physicians who treat elderly patients and those with diabetes or kidney failure—who are at highest risk for these problems—regarding the improved options; and second, to provide them the ability to refer patients to a limb salvage program that features a multidisciplinary team, including endovascular therapy specialists, podiatrists, and other support staff. 

As summarized in the ISET announcement, the number of amputations at Martin Health System decreased by 79% over 5 years after the center implemented a limb salvage program ensuring that patients with PAD undergo angiography. Significantly more people were evaluated, as well, because of a program to increase awareness about PAD among patients and educate physicians regarding the options for their patients with PAD.

Whenever possible, the patients then received treatment to increase blood flow in the legs, including angioplasty, atherectomy, and hyperbaric oxygen therapy. Atherectomy was particularly helpful in treating patients with hardened or calcified plaque, noted Dr. Sanguily.

Each year, significantly more Martin Health System patients were evaluated, yet the number who had amputations plummeted. In 2010, 24 of the 84 patients (29%) who were evaluated had amputations; in 2011, 18 of 146 patients (12%) who were evaluated had amputations; in 2012, 10 of 228 patients who were evaluated had amputations (4%); and in 2013, 6 of 249 patients (2%) had amputations. Finally in 2014, 500 patients were evaluated, and five (1%) had amputations, according to ISET.