Page 41 - Virtual Vascular Vol 9

Critical Limb Ischemia There was an ischaemic ulcer on the medial plantar aspect of the left hallux.

This patient fulfilled the diagnostic criteria of chronic critical limb ischemia as

This patient presented with one month’s history of rest pain. Clinical defined by the Second European consensus document on chronic critical leg
examination showed loss of hair, thin skin, and trophic changes in the nails. ischemia (Dormandy 1991).
The ankle brachial pressure index was 0.4 on the left foot.
Criteria for diagnosis include either one of the following:
(1) more than two weeks of recurrent foot pain at rest that requires regular use of
analgesics and is associated with an ankle systolic pressure of 50 mm Hg or

less, or a toe systolic pressure of 30 mm Hg or less, or
(2) a non-healing wound or gangrene of the foot or toes, with similar
hemodynamic measurements.

Reference:

Dormandy J, Verstraete M, Andreani D, et al. Second European consensus document on chronic critical leg
ischemia. Circulation. 1991; 84(suppl 4): 1–26.

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