Risks of amputation from vascular disease

This month, we celebrate Limb Loss and Limb Difference Awareness Month, which highlights the support needed to advance equitable medical access, care and coverage to those living with amputation. Every year alone, there are 185,000 amputations performed in the United States.

While many instances of limb loss come from traumatic injury, a staggering 54% are from vascular disease. Patients who experience limb loss due to vascular disease are often met with serious health complications and short life expectancy.

Amputation as treatment

When a patient presents with peripheral artery disease or it’s severe form, critical limb ischemia, they are typically coping with other health issues, including diabetes, high blood pressure, heart and kidney disease, among others. When left untreated, PAD causes severe blocking of the arteries in the lower extremities, limiting – or even stopping – blood flow.

There have been significant strides in procedures to restore blood flow in the past years and, ultimately, reduce the number of amputations needed. Despite this, a general lack of knowledge among vascular surgeons and healthcare systems still leads approximately a third of patients with vascular disease to undergo amputation as a primary treatment source. However, the latest data shows amputation is only appropriate in 15% of cases.

Patients living in rural areas and those who are non-white are even more likely to receive poor vascular care. Black Americans are four times more likely than their white counterparts to undergo an amputation. Latinx adults with PAD are 80% more likely to access inpatient vascular care by going to the emergency room rather than seeking preventive treatment.

Caring for patients with PAD poses a significant strain on our healthcare system – estimated to cost $4 billion annually. Amputations, while sometimes necessary, are seen as an efficient way for healthcare providers to treat patients perceived beyond intervention.

But at what cost?

The statistics are sobering – 48% of patients over 65 years old die within the first year after a major amputation and 71% die within three years. And patients who undergo an amputation are more likely to suffer from a second one in the future. Even more so given we’ve made significant strides in the treatment of PAD, especially when caught early.

The non-medical impact is vast, as well. Individuals who lose a limb are often met with limited mobility, a high degree of depression, social isolation and difficulties maintaining employment. Additionally, ongoing care, such as prosthetics and homecare, can have a significant impact on a family’s budget.

Hope for the future

While the understanding of vascular disease prevention is still somewhat in its infancy, great strides have been made to reduce the number of amputations in the United States. Recently, the American Heart Association put out a statement challenging health care professionals to decrease nontraumatic leg amputations by 20% by 2030.

Many physicians focused on preventing amputations have moved from traditional hospital settings into outpatient clinics, allowing them to provide higher quality of care. In fact, a recent study found procedures in an outpatient lab were just as safe as in a hospital and reduced out-of-pocket costs for patients.

Always seek a second opinion

At ACV Centers, we are passionate about second opinions. We believe this is the most important act a patient can do to take their health into their own hands. If you are ever told you need an amputation due to vascular disease, say no and seek another opinion.