Decision-Making in the CLTI Patient Series


These sessions will be helpful in expanding physician knowledge base and improving clinical confidence and effectiveness in treating patients with CLTI. 

Funding for this activity is provided by a grant from CMSS aimed to promote diagnostic excellence across the field of medicine.

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Pre- and Post-Surveys

Before you watch the recordings, you are encouraged to take the roundtable pre-survey to evaluate if the guideline recommendations are easy to translate into daily clinical practice.

Take the Pre-Survey

Once you have completed the recordings, you are encouraged to take the post-survey. This will help gauge what you have learned. If you are only going to watch one recording, please take the surveys before and after; if you are going to watch all of the recordings, take the pre-survey before you watch the first one and the post-survey after you watch the final one.

Take the Post-Survey


Session 1: Structured Decision-Making in the CLTI Patient: Understanding the PLAN 

The focus of this webinar will be to review the patient PLAN algorithm based on the Global Vascular Guidelines in CLTI. The importance of staging to guide the course of treatment and potential alterations in the treatment plan will be reviewed. The use of the VQI, WIfI, and GLASS applications to facilitate evidence-based decision-making for CLTI patients will be reviewed.

Case presentations will illustrate how to practically use the PLAN approach in specific clinical scenarios.

Session 2: Informed Decision-Making In CLTI

Held in-person at VAM24, this session will focus on shared, patient-centered decision making to individualize treatment recommendations. The importance of staging and setting patients’ expectations to facilitate decision making for CLTI patients will be reviewed.

This recording also includes a live patient panel.


Recommended Reading

  1. Mills Sr JL, Conte MS, Armstrong DG, Pomposelli FB, Schanzer A, Sidawy AN, et al. The Society for Vascular Surgery Lower Extremity Threatened Limb Classification System: risk stratification based on wound, ischemia, and foot infection (WIfI). J Vasc Surg 2014;59:220e234.e1-2.
  2. Conte MS, Bradbury AW, Kolh P, White JV, Dick F, Fitridge R, Mills JL, Ricco JB, Suresh KR, Murad MH. Global vascular guideline on the management of chronic limb-threatening ischemia. J Vasc Surg. 2019;69(6s):1-122.
  3. Armstrong DG, Tan TW, Boulton AJM, Bus SA. Diabetic Foot Ulcers: A Review. JAMA. 2023 Jul 3;3 Wijnand JGJ, Zarkowsky D, Wu B, van Haelst STW, Vonken EPA, Sorrentino TA, Pallister Z, Chung J, Mills JL, Teraa M, Verhaar MC, de Borst GJ, Conte MS. The Global Limb Anatomic Staging System (GLASS) for CLTI: Improving Inter-Observer Agreement. J Clin Med. 2021 Aug 4;10(16):3454.
  4. van Haelst STW, Teraa M, Moll FL, de Borst GJ, Verhaar MC, Conte MS. Prognostic value of the Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification in patients with no-option chronic limb-threatening ischemia. J Vasc Surg. 2018 Oct;68(4):1104-1113.e1. doi: 10.1016/j.jvs.2018.02.028. Epub 2018 May 22. PMID: 29802042.
  5. Leithead C, Novak Z, Spangler E, Passman MA, Witcher A, Patterson MA, Beck AW, Pearce BJ. Importance of postprocedural Wound, Ischemia, and foot Infection (WIfI) restaging in predicting limb salvage. J Vasc Surg. 2018 Feb;67(2):498-505.
  6. Bontinis V, Bontinis A, Koutsoumpelis A, Giannopoulos A, Ktenidis K. A systematic review and meta-analysis of GLASS staging system in the endovascular treatment of chronic limb-threatening ischemia. J Vasc Surg. 2023 Mar;77(3):957-963.e3.