OBJECTIVES: Chronic limb ischemia (CLI) is the most severe stage of peripheral arterial disease and is characterized by chronic pain at rest, tissue loss, and a high risk of amputation and death. CLI is a major burden for patients and healthcare systems, requiring costly interventions to restore blood flow and prevent limb loss.

This study aimed to provide an overview of primary procedures performed on inpatients with CLI in the superficial femoral and popliteal arteries (SFA/PA).

METHODS: Patients diagnosed with CLI between April 2022 and March 2023 were identified from the Hospital Episode Statistics (HES) dataset based on specific diagnosis (ICD) and procedure (OPSC) codes. Primary procedures and delivery setting were analyzed.

RESULTS: The study identified 7,325 CLI patients who had undergone revascularization of the SFA/PA.

Percutaneous transluminal angioplasty (PTA), performed in 52% of all cases (77% elective, 23% non-elective), was the most common procedure, followed by open repairs (e.g. thrombectomy, enterectomy) in 13% (47% elective, 53% non-elective) and stenting in 12% as the primary procedure. In this group, 87% of the stents used were metal and 13% entailed other types (i.e. stent grafts, bioabsorbable, drug, or coated stents). Percutaneous embolectomy and thrombolysis accounted for 2% of cases and other procedures 11%. Surgical bypass was performed in 4% of cases (63% elective, 37% non-elective). Amputations were necessary in 7% of cases, 86% of which were non-elective.

CONCLUSIONS: PTA was the most common intervention for CLI in the SFA/PA. Overall, 66% of procedures were minimally invasive, thus reflecting current clinical preferences. The high proportion of non-elective amputations underlines the critical nature of some cases, emphasizing the need for timely diagnosis and intervention. These findings underscore the importance of optimizing early interventional strategies with a view to reducing severe disease stages and improving outcomes for CLI patients.