Elevate the CLI Patient’s Voice: Why It Is So Important to Do the Right Thing

During the Wednesday afternoon CLI Wound session at AMP, Caroline E. Fife, MD, from Baylor College of Medicine in Houston, Texas, delivered a thought-provoking presentation on elevating the CLI patient’s voice and doing the right thing. She stressed the critical importance of proper diagnosis and timely intervention in managing critical limb ischemia (CLI) to prevent unnecessary suffering and amputations.

Dr. Fife shared several poignant case studies illustrating the devastating impact of missed or delayed diagnosis of CLI. She highlighted how patients, often suffering from severe pain and non-healing wounds, were frequently misdiagnosed or subjected to ineffective treatments, leading to prolonged suffering and avoidable amputations. In contrast, cases where appropriate vascular interventions were performed resulted in limb salvage and significant pain relief, underscoring the life-saving potential of doing the "right thing."

A key point in her presentation was the importance of arterial screening for patients with non-healing wounds, a practice that is often neglected despite clear guidelines.Dr. Fife criticized the reluctance and excuses some clinicians have for not performing arterial screenings, such as ankle-brachial indices (ABIs) or skin perfusion pressures (SPPs), in patients with non-healing wounds. She told attendees that these screenings are essential for detecting underlying arterial disease and preventing severe complications like amputations. 

Despite existing guidelines from the Wound Healing Society and the AHA recommending arterial assessments for all patients with lower extremity ulcers, Dr. Fife noted that adherence remains low. She highlighted data from the US Wound Registry showing that even with reminders, less than 30% of wound centers documented non-invasive arterial screenings as of 2023.

Dr. Fife concluded with a powerful call to action: clinicians must "do the right thing" by prioritizing thorough arterial assessments and timely interventions for patients with CLI. She emphasized that doing so not only prevents unnecessary amputations but also saves lives. She urged the medical community to elevate the voice of CLI patients, ensuring they receive the care they deserve.