Amputation Prevention

Peripheral Arterial Disease occurs when blood flow to the extremities—in most cases legs and feet—becomes blocked due to the buildup of plaque in the arteries. Critical Limb Ischemia (CLI) is the most severe form of PAD, causing leg pain at rest, poorly healing foot wounds, or gangrene.

It’s the 21st century. Why are there still so many amputations?

Amputation—the complete or partial removal of a limb—is the most conventional and common approach to treating severe CLI, particularly for older individuals. As recently as 2017, 70% of CLI patients received amputation before any intervention. Unfortunately, after amputation, most patients deteriorate rapidly. According to a recent study on amputation for chronic CLI.

  • The mortality rate is 44% one year after amputation
  • 66% mortality rate three years after amputation
  • 85% mortality five years after amputation

Patients with severe CLI deserve better. That’s why the American Endovascular affiliated team of physicians is doing something about it.  The affiliated team of medical professionals saves limbs for most patients they treat, helping patients enjoy longer, healthier, and happier lives.


What are the symptoms of Critical Limb Ischemia?

A common symptom of Critical Limb Ischemia is known as ischemic rest pain, which is an intense pain in legs & feet which can be so severe it can often wake people when sleeping. Sometimes temporary relief occurs when dangling the legs, or standing. Other symptoms of CLI include:

  • Non-healing wounds on the feet or legs
  • Leg pain when walking
  • Diabetic foot ulcers
  • Foot pain or numbness
  • Excessively shiny, smooth, or dry skin on the legs and feet
  • Thickening of the toenails
  • Diminished, or no pulse in the legs or feet
  • Dry, black skin on the legs and feet (dry gangrene)
  • Foot infections
  • Leg swelling and discoloration

What are the risk factors of Critical Limb Ischemia?

There are many risk factors that can lead to CLI including:

  • Aging population
  • Smoking
  • Diabetes
  • Chronic Kidney Disease
  • Obesity
  • Sedentary lifestyle
  • High cholesterol
  • High blood pressure
  • Family history of atherosclerosis or claudication

If you or someone you know is at risk, it is essential that you schedule a medical consultation with an American Endovascular affiliated physician today.

Thanks to Dr. Rundback, I can do the things I took for granted. My life changed drastically when the plaque clogging my blood vessels made walking unbearable. For instance, I would walk two or three blocks and feel my legs cramping up and forcing me to stop walking while the pain subsided. Moreover, my legs felt heavy and lethargic. Now my legs feel great post-procedure with no more cramping or that heavy feeling. Thank you, Dr. Rundback for returning the smile and happiness that eluded me for the past two years. Quality of life isn’t everything. It’s the only thing!

Ernie P.

I love Dr. Rundback. They are great. Dr. Rundback is very caring and he saved my legs. He is a very good worker, my previous Endovascular said there was nothing they could do for me. I would recommend him to anyone. I have been working with Dr. Rundback for over a year and I have had a great experience

Delores L.

My experience here was absolutely phenomenal. I think the treatment here and the employees here are absolutely incredible.

Robert D.

How does the Pedal Loop technique help with limb salvage?

Pedal loop interventions can help with limb salvage and limb preservation in patients with non-healing wounds due to diabetes, chronic kidney disease, and other conditions. The pedal loop consists of arteries in the foot that are responsible for supplying blood to the toes and the heel. Patients with blockages in the pedal loop due to diabetes and other conditions can develop wounds, ulcers, or gangrene that don’t heal without restoring blood flow. While not every person needs a pedal loop intervention, there are certainly individuals for whom, when the wounds don’t heal, this type of intervention is extremely important in order to provide the best results. Most notably, it is a procedure that not many interventionalists are comfortable performing due to the small diameter of these arteries.

The Pedal Loop Technique

What should patients know about the pedal loop technique when they are facing an amputation?
Do all specialists perform the Pedal Loop?
Does the Pedal Loop procedure have to be done in a hospital setting?

How American Endovascular Affiliated Physicians can help treat Critical Limb Ischemia and salvage limbs

Licensed physicians provide patients with the most up-to-date minimally invasive-image guided treatment options to save limbs and prolong life. The American Endovascular affiliated physicians render endovascular treatments that have resulted in saving over 80% of limbs after amputation was recommended elsewhere.

Endovascular treatment is the least invasive way to restore blood flow to limbs. Here’s how some endovascular procedures work:

  • A catheter (thin plastic tube) is inserted into the artery, without surgery, through a small nick in the skin at the groin or in the foot…the nick is so small there is not even an incision to heal.
  • A catheter is threaded to the area of narrowing and disease which has been affected by plaque build-up.
  • Specialized catheters open the blocked arteries by removing or destroying plaque (called atherectomy), or displacing and disrupting it with a balloon that is inflated briefly. Atherectomy may include a variety of additional advanced tools such as laser as well as orbital and rotational atherectomy. The opening of arteries with a balloon catheter is called angioplasty.
  • A variety of additional state of the art methods may be utilized and inserted to keep the artery open including drug delivery systems, stents, covered stents, Drug Eluding Stents (DES), Drug Covered Stents (DCS).

American Endovascular affiliated physicians save the limbs that others can’t.

The American Endovascular affiliated team of physicians is at the forefront of the battle to prolong life by preventing amputations. They accomplish this by using the most advanced minimally invasive-image guided endovascular treatment options available anywhere, to save limbs and save lives.

  • The physicians affiliated with American Endovascular are recognized worldwide as innovators in the field of complex lower extremity PAD and CLI treatment.
  • They have demonstrated success in restoring optimal blood flow by targeting blocked arteries in the ankle and feet using specialized techniques and tools.
  • They can treat patients who have been told by other doctors that they have “no other options” than amputation.
  • They have access to clinical trials that others do not.
  • American Endovascular affiliated team of physicians specialize in treating the small, extremely difficult blocked arteries in the foot and toes that others do not attempt to treat.

Their track record speaks for itself.

The American Endovascular affiliated team of physicians have been able to restore blood flow and salvage treated limbs in 80% of patients that were told they needed a major amputation.

Before (left) and after (right) of critical limb ischemia recovery results. 12 weeks.

Photos courtesy of Dr. John Rundback, MD

I have worked with both Dr. Herman and Dr. Rundback. They saved the limb of one of my patients that the Endovascular surgeon told me was unsalvageable. I have not found too many doctors willing to restore flow to the foot and the plantar arch and who have been successful. If we want to pride ourselves in being the best we need to associate with the best.

Dr. Debra Manheim

Schedule your second opinion today