July 28, 2022

The five-year mortality rate for critical limb ischemia (CLI) is higher than for many types of cancers.(1) With diabetes and chronic kidney  disease on the rise, CLI is also on the rise, and many patients are presenting with more severe disease than in years past, making it more important than ever for podiatric physicians to develop a close working relationship with their colleagues in interventional radiology.

Jason Levine, DPM, and Srini Tummala, MD, presenters at Thursday morning’s Breakfast Symposium 1 and colleagues at the University of Miami Miller School of Medicine, will share their own firsthand experience of the value of that professional collaboration.

“Podiatrists have all the tools and skills to take care of wounds, but they need optimal blood flow to do it,” said Dr. Tummala. “We’ve taken referrals from other hospitals in Florida who were sent because they were told the only option was major amputation. I’ve been able to open complex blockages to increase blood flow to the foot and leg and then refer those patients to my colleagues in podiatry, who were able to heal their wounds with podiatric surgery and wound care.”

During the breakfast symposium, Drs. Levine and Tummala will cover the importance of screening for peripheral arterial disease and when to refer to a vascular specialist. They suggest that anyone with a wound should be considered for referral. “Patients with lower extremity ulcers should undergo vascular testing and when appropriate should be referred immediately,” Dr. Levine said. They also recommend podiatrists not rely on an ABI alone in patients with diabetes and kidney disease. Look for changes in the temperature and skin of the foot, as well as diminished pulses. The program will also cover advice for building referral relationships. “Investigate the physician you’re referring to,” said Dr. Tummala. “Is it someone who is skilled at advanced limb salvage from an endovascular and surgical standpoint? Many vascular doctors are not experienced in advanced limb salvage techniques regardless of their specialty.”

The key takeaway from the session, according to Dr. Tummala: Collaboration between podiatry and interventional radiology is critical. “Collaboration between our specialties optimizes wound care, prevents amputations, improves quality of life, and ultimately reduces  mortality.”

1. CLI Global Society. Critical Limb Ischemia is a Major Public Health Concern With Prognosis Worse Than Many Types of Cancer. (2021,  March). https://www.cliglobalsociety.org/news/cli-is-a-major-public-healthconcern-with-prognosis-worse-thanmany-types-of-cancer/ 

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