Limb Salvage Surgery Center
ProVascularMD has four limb salvage surgery centers in Southern California. We’re committed to saving limbs and saving lives, and we’ve made it our mission to do everything we can to prevent all but the most necessary amputations.
What is Limb Salvage?
In vascular medicine, limb salvage surgery refers to a surgical approach that is used to heal feet and legs that are at risk of amputation, including those affected by severe ulceration, gangrene, tissue loss, or pain from underlying vascular disease. While these symptoms are multifactorial, some form of severe vascular obstruction, either in the arterial system or the venous system, is often a root cause.
Many amputations are preventable with modern vascular approaches, so the possibility of limb salvage surgery should always be evaluated before an amputation is prescribed. As vascular specialists, we play a critical role in treating the underlying occlusion and restoring blood flow, but this is one of many components of care that are needed to maximize the patient’s chances of healing, restoring function, and ultimately avoiding the need for amputation down the line. Successful limb salvage surgery relies on aggressive care from wound specialists, podiatrists, infectious disease specialists, endocrinologists, and other medical disciplines that can actively manage exacerbating comorbidities throughout the healing process. Always consider limb salvage surgery vs amputation.
Your Partner in Limb Salvage
Dr. Michael Lalezarian
Dr. Michael Lalezarian is a double-board certified Vascular Interventional Radiologist specializing in minimally invasive endovascular arterial revascularization. He is a committed partner in the battle against the devastating consequences of advanced vascular disease.
Terry T, October 2022
Limb Salvage Surgery Indications
When evaluating ulcer patients, it’s common to focus on the visible manifestations of the disease and to overlook the underlying vascular phenomenon. An ultrasound exam is usually all that’s needed to determine if a vascular intervention could be of benefit, and can make all the difference when a patient is on the path to amputation.
Peripheral Artery Disease
Critical Limb Ischemia
Chronic Venous Insufficiency
Deep Venous Obstruction
Limb Salvage Procedures
Limb salvage programs can include arterial revascularization, venous revascularization, and venous ablation. Arterial revascularization may consist of balloon angioplasty, stenting, and/or atherectomy, while venous revascularization may consist of balloon angioplasty, stenting, thrombolysis, and/or thrombectomy. The goal of a limb salvage procedure is to eliminate vascular obstructions, open up occlusions, and restore healthy blood flow throughout the limb. In turn, healthy blood flow helps the limb and its extremities to heal.
A skilled vascular specialist utilizes a deep armemotorium of techniques and a variety of devices to address the unique needs of each individual patient. While open vascular surgery is practiced by some vascular surgeons and reserved for special situations, many vascular procedures today are done with minimally invasive, catheter-based techniques. These are also referred to as pinhole procedures or keyhole procedures, because a vascular specialist can treat the vascular disease through a single tiny puncture in the leg, the foot, or the arm by threading a small tube through the vascular system to the treatment site.
The exact treatment parameters, anatomy, devices, and techniques vary enough between arterial and venous treatment that specialized training and practice is required to specialize in one or the other. Dr. Lalezarian specializes in both arterial and venous revascularization and is able to provide comprehensive vascular treatment to patients in his care.
Limb Salvage vs Amputation
At ProVascularMD, we strongly recommend limb salvage over amputation. The goal of limb salvage is to save the limb and restore function, thus improving symptoms, quality of life, and mobility.
Amputation, on the other hand, is associated with high mortality rates, high healthcare costs, and an irreversible reduction in quality of life. Over 55% of patients who undergo amputation as a result of diabetes or peripheral artery disease end up permanently disabled, and approximately the same amount are never able to walk again. Mortality is also strikingly high following amputation. In a recent US Medicare study, 1-year mortality following amputation for critical limb ischemia was 40%, which was 10% higher than the subpopulation that did not undergo amputation. From these data points, it’s clear that patients are better off if they can avoid amputation, and for many, limb salvage is the best path forward.
Peripheral Artery Disease Screening: Why Early Detection is Critical in PAD
Endovascular Treatment of
Lower Extremity Arterial Disease
Vascular Specialist in Los Angeles
Learn more about Los Angeles Vascular Specialist Dr. Michael Lalezarian.
 Sanguily J, Martinsen B, Igyarto Z, Pham M. Reducing amputation rates in critical limb ischemia patients via a limb salvage program: a retrospective analysis. Vasc Dis Manage. 2016; 13(5):E112‐E119.
 Barnes JA, Eid MA, Creager MA, Goodney PP. Epidemiology and Risk of Amputation in Patients With Diabetes Mellitus and Peripheral Artery Disease. Arterioscler Thromb Vasc Biol. 2020;40(8):1808-1817. doi:10.1161/ATVBAHA.120.314595
 Tsai, S., Dubovoy, A., Wainess, R., Upchurch, G. R., Wakefield, T. W., Henke, P. K., & Arbor, A. (2000). Severe Chronic Venous Insufficiency : Magnitude of the Problem and Consequences, 705–711. http://doi.org/10.1007/s10016-005-5425-8
 BackTable, LLC (Producer). (2020, March 28). Ep. 60 – Building A Limb Salvage Program [Audio podcast]. Retrieved from https://www.backtable.com/podcast/60/building-a-limb-salvage-program
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