Limb Preservation Program
The Yale New Haven Hospital Limb Preservation Program is a multidisciplinary program for managing patients with non-healing lower extremity wounds, including patients with critical limb ischemia, peripheral arterial disease, diabetic foot and ankle complications and other cardiovascular disease.
The Limb Preservation Program is designed as a team-based approach with Yale New Haven Hospital medical staff providing coordinated patient care that delivers better outcomes. Our team involves specialists in vascular medicine, vascular surgery, interventional cardiology, interventional radiology and others. Our combined expertise enables high-risk patients to be diagnosed early and therefore facilitate timely treatment that is proven to preserve threatened limbs.
What is Critical Limb Ischemia?
Critical ischemic limb disease occurs when an artery in the legs is partially or completed blocked by atherosclerotic plaque, limiting blood flow and reducing the amount of oxygen supplied to the extremities. This is the most severe form of peripheral arterial disease and patients with critical limb ischemia are at risk for tissue necrosis and limb loss. Patients with advanced leg ischemia often suffer from pain in their feet and toes, even while at rest, and may suffer from non-healing wounds, skin ulcers, and poor foot/ankle surgical wound healing. Active patients may also suffer pain during exercise.
Diagnosis and Treatment
When patients enter the Limb Preservation Program, they receive priority access to multi-specialty care in one convenient location. Patients are able to undergo immediate non-invasive testing such as ankle-brachial index and lower extremity ultrasound studies at the time of their visit.
All patients are evaluated by a vascular provider, as well as a podiatrist, during the same initial visit. From cases affecting only one limb, to more complex situations involving patients with heart disease or stroke, our experts consider “the whole patient” as a coordinated team.
As part of Yale New Haven Health, we are able to provide access to cutting-edge clinical trials for lower extremity revascularization and novel therapies for advanced wound care. Interventions for lower extremity peripheral arterial disease include complex endovascular procedures (angioplasty, stenting, atherectomy) and bypass surgery. The multidisciplinary nature of the program allows the adequate selection of procedures for our patients.
Involvement with the Vascular Medicine Outcomes Program
Yale New Haven Hospital Heart and Vascular Center participates in the Yale University Vascular Medicine Outcomes (VAMOS) program that partners with patients who have peripheral artery disease (PAD) to help manage their vascular health. This includes tracking patients’ quality of life outcomes and working with patients to design innovative treatments to address issues like stress and depression. The VAMOS program incorporates several resources toward managing patient care, including participation in clinical trials, and leading national and international vascular outcomes studies.