PMID- 34642041
OWN - NLM
STAT- MEDLINE
DCOM- 20211028
LR  - 20221221
IS  - 1558-4518 (Electronic)
IS  - 0895-7967 (Print)
IS  - 0895-7967 (Linking)
VI  - 34
IP  - 3
DP  - 2021 Sep
TI  - Influence of the COVID-19 pandemic on the management of chronic limb-threatening 
      ischemia.
PG  - 89-95
LID - S0895-7967(21)00042-9 [pii]
LID - 10.1053/j.semvascsurg.2021.05.006 [doi]
AB  - The COVID-19 pandemic negatively impacted patients with conditions that are 
      associated with significant morbidity, but might not be immediately 
      life-threatening. Patients with chronic limb-threatening ischemia (CLTI) were 
      affected by delays in care, potentially increasing major limb amputations. This 
      study sought to review strategies employed, and limb salvage outcomes reported, 
      during the COVID-19 pandemic. We performed a literature review of the electronic 
      database PubMed from December 2019 to December 2020. Articles subjected to 
      analysis must have had a specific CLTI group before the pandemic to compare to 
      the pandemic group. Case reports, case series, and non-CLTI comparisons were 
      excluded. The literature search yielded 55 articles for review, of which 6 
      articles met criteria for analysis. The main classifications used for disease 
      stratification included Rutherford, Fontaine, and SVS WIfI (Wound, Ischemia, Foot 
      Infection). Overall, a decrease in vascular clinical volume was reported, ranging 
      from 29% to 54%. A higher major limb amputation rate (2.6% to 32.2%) during the 
      pandemic surge was reported in 5 of 6 publications. Four of 6 studies also 
      reported minor amputations; 3 of these demonstrated an increase in minor 
      amputations (7% to 17.7%). The CLTI population is vulnerable and it appears that 
      both minor and major amputation rates increased in this population during the 
      pandemic. The limited data available in CLTI patients during the COVID-19 
      pandemic and use of different stratifications schemes in areas impacted to 
      variable extents prevent recommendations for the best treatment strategy. Further 
      data are required to improve strategies for treating this population to minimize 
      negative outcomes.
CI  - Copyright (c) 2021 Elsevier Inc. All rights reserved.
FAU - Miranda, Jorge A
AU  - Miranda JA
AD  - Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey 
      Department of Surgery, Baylor College of Medicine, One Baylor Plaza, BCM 390, 
      Houston, TX, 77030.
FAU - Chung, Jayer
AU  - Chung J
AD  - Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey 
      Department of Surgery, Baylor College of Medicine, One Baylor Plaza, BCM 390, 
      Houston, TX, 77030.
FAU - Mills, Joseph L
AU  - Mills JL
AD  - Division of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey 
      Department of Surgery, Baylor College of Medicine, One Baylor Plaza, BCM 390, 
      Houston, TX, 77030. Electronic address: joseph.mills@bcm.edu.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20210716
PL  - United States
TA  - Semin Vasc Surg
JT  - Seminars in vascular surgery
JID - 8809602
SB  - IM
MH  - Amputation, Surgical
MH  - *COVID-19
MH  - Chronic Disease
MH  - Humans
MH  - Ischemia/diagnosis/epidemiology/surgery
MH  - Limb Salvage
MH  - Pandemics
MH  - *Peripheral Arterial Disease/diagnosis/epidemiology/therapy
MH  - Retrospective Studies
MH  - Risk Factors
MH  - SARS-CoV-2
MH  - Treatment Outcome
PMC - PMC9761861
EDAT- 2021/10/14 06:00
MHDA- 2021/10/29 06:00
PMCR- 2021/07/16
CRDT- 2021/10/13 05:47
PHST- 2021/04/19 00:00 [received]
PHST- 2021/05/18 00:00 [revised]
PHST- 2021/05/24 00:00 [accepted]
PHST- 2021/10/13 05:47 [entrez]
PHST- 2021/10/14 06:00 [pubmed]
PHST- 2021/10/29 06:00 [medline]
PHST- 2021/07/16 00:00 [pmc-release]
AID - S0895-7967(21)00042-9 [pii]
AID - 10.1053/j.semvascsurg.2021.05.006 [doi]
PST - ppublish
SO  - Semin Vasc Surg. 2021 Sep;34(3):89-95. doi: 10.1053/j.semvascsurg.2021.05.006. 
      Epub 2021 Jul 16.