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Why are there so many amputations in the United States when there are alternative treatments? [Dr. Shams]

Q: Why are there so many amputations in the United States when there are alternative treatments?

A: In general, patients who develop tissue loss, patients who develop wounds that don’t heal, patients who develop infections, or gangrene, these patients are at high risk of developing what’s called a systemic infection. In other words, once they get an infection in that area, and there’s no blood flow to that area, the infection can rapidly progress and spread to the rest of the body. In these situations, sometimes you may just have to amputate the toe, or even the foot, or even the leg to prevent overwhelming sepsis from occurring. Sometimes you have no choice, in the setting of a severe infection or in a really large amount of dead tissue, you’ve got to get rid of that quickly to prevent the patient from dying. So that’s one reason why you have to have an amputation.

The more likely scenario is that a patient develops a wound in the toe that starts to progress, they may develop a spot of gangrene or they may develop a red toe that becomes painful. In those cases, you have a little bit more time. A lot of times, people who are not skilled in revascularization may feel there’s no other choice but they’d better just get this thing off and treated. Therefore they’ll recommend an amputation. Now that we have exquisite techniques to get down into the really small blood vessels in the feet and the toes, there are a lot more options than we have to save the limb.

More videos from the interview with Dr. Shams of the Lower Manhattan Endovascular Center as he explains the warning signs of Peripheral Artery Disease: 

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