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    The content on this page is not current guidance and is only for the purposes of the consultation process.

    Indications and current treatment

    CLTI of the lower extremities is caused by severely narrowed or blocked arteries. It is an advanced stage of peripheral arterial disease. The severely diminished blood supply causes ischaemic pain, ulceration, tissue loss or gangrene. It is associated with high amputation and mortality rates, and poor quality of life.

    CLTI usually needs treatment to re-establish blood flow to the affected area and to prevent major amputation. Treatment options include medications, endovascular interventions (such as angioplasty, stents and directional atherectomy), surgical treatments (such as bypass) or a combination of the two. Management of CLTI is described in NICE's clinical guideline on peripheral arterial disease.