Vascular Surgery
Critical Limb Ischaemia
Rest pain / non-healing ulcer / gangrene; ankle-brachial index; angiography; revascularisation (bypass / endovascular) or amputation.
Source: NICE NG147; ESC PAD
Step 1 of ~3
info
Recognise — Rutherford 4–6
Critical limb ischaemia (CLI) — chronic limb-threatening ischaemia (CLTI):
• Rest pain at night (relieved by hanging foot).
• Non-healing ulcer / gangrene.
• Ankle-brachial index <0.4 typically.
• Toe pressure <30 mmHg.
• Transcutaneous oxygen <30 mmHg.
Rutherford classification:
• 0–3: claudication.
• 4: rest pain.
• 5: minor tissue loss.
• 6: major tissue loss.
Always assess for diabetes, smoking, hyperlipidaemia, HTN, kidney disease, cardiovascular disease.
Urgency: same-day vascular referral. Limb-threatening — revascularisation within days.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Birch bark extracts (betulin) · Topical wound healing agent
- Methoxyflurane · Inhaled Analgesic — Acute Pain
- Fentanyl Transdermal Patch (Elderly Chronic Pain) · Opioid Analgesic — Transdermal Patch
- Morphine Slow-Release (Elderly Chronic Pain) · Opioid Analgesic — Modified-Release Oral
- Recombinant Factor VIIa · Bypass Agent — Haemophilia with Inhibitors
- Amitriptyline (Neuropathic Pain / Migraine) · Tricyclic Antidepressant / Neuropathic Pain Agent
Pathways
Decision support only. Always apply local guidelines and clinical judgement.