CRITICAL LIMB ISCHEMIA - A CASE AGAINST CONSENSUS .2.

Critical limb ischaemia (CLI) is a serious clinical condition that oft en immediately precedes limb loss. The Consensus Documents of 1989 and 1991 attemped to define CLI and give direction to its investigation a nd management. Whilst the need for such a consensus was clear and shou ld be supported we believe the definition of CLI as documented in the Consensus Documents I and II recommendation number I is wrong. We pres ent evidence from 140 patients with severe limb ischaemia taken from t he PARTNER Group studies to support our request for an amendment to th e anakle pressure recommendation from less than or equal to 50 mmHg to >50 mmHg and big toe pressure from less than or equal to 30 mmHg to > 30 mmHg for the purpose of conducting clinical trials and to include D oppler index and tcPO(2) as additional parameters. We also believe tha t the current document may be actually excluding the only group of pat ients likely to benefit from drug treatment or other interventions and that the above amendment should be prioritised.