African American man educated about Critical Limb Ischemia

Critical Limb Ischemia Care

Multiple factors contribute to racial, gender and ethnic disparities in care for Critical Limb Ischemia (CLI). Get an overview of the differences in risk factors and barriers to care.

Who’s at Risk?

CLI often remains untreated, with significant disparities in revascularization and amputation rates according to race, socioeconomic status and where patients live.

Black men are more likely to progress from peripheral artery disease to CLI than Caucasian men.1

Women with CLI are more likely to have an above-the-knee amputation than men which leads to lower mobility, functional status and higher mortality.2


Insight from Underserved CLI Patients

In order to help you understand how to best reach undertreated minority groups at the local level, Boston Scientific commissioned a market research study on traditionally underserved populations across the country. Researchers engaged with people who identified as being either at high risk or who have already been diagnosed with CLI in order to capture demographic, psycho-graphic and behavioral insights. Below is a snapshot of patients’ perceptions. You can also download a one-page summary.

Download key insights

Barriers to Accessing CLI Care

The market research study found that people with heart failure identify these top obstacles in getting care after diagnosis:

  • 50% cite distance to care
  • 40% cite lack of specialists in the area
  • 33% cite cost of healtcare or insurance

Barriers to Delayed CLI Care

The study found that patients with CLI who delayed more than six months gave these top reasons:

  • 44% said they didn't think that they could possibly have critical limb  ischemia
  • 44% said they didn't think it was serious enough to seek urgent care
  • 31% shared that they were afraid

Barriers to CLI Treatment

60% of patients decided to put off surgery or a procedure for as long as possible in the past, with these reasons most often cited:

  • 50% were afraid to have the surgery or procedure
  • 50% were worried about complications
  • 33% just wanted to wait

What Can Help Underserved CLI Patients


Give Educational Materials

  • 53% prefer downloadable online materials
  • 53% would like information on diet and exercise
  • 46% would like websites with information on the disease/condition


Increase Communication & Access

  • 37% want to email a specialst
  • 37% say they'd like to call a nurse for more information
  • 37% ask for statistics on life expectancy


Connect with Your Patients

  • 27% of people with CLI get nervous around doctors, which means that they might not feel comfortable telling you about symptoms or concerns. You may want to connect with them by asking about barriers to care 
  • Half of the survey respondents with CLI cited distance to care as their biggest barrier

Healthcare Disparity Details

Clinical research diversity

Increase Clinical Research Diversity

A total of 60% of heart failure patient respondents say they’re “somewhat” or “very” likely to participate in a clinical trial – but 70% have never been asked to participate in one.  Learn about opportunities for increasing research diversity and find educational materials to inform your patients. 

Untreated areas around you

Who’s Going Untreated in Your Area?

Boston Scientific can provide you with a zip-code specific Disparity Index Report with epidemiological data on the health challenges impacting your community.

How Can Close The Gap Support You?

Boston Scientific's dedicated Health Equity Consultants are here to build a personalized program
to help you target your at-risk demographics – at no expense to you.


1 Rivero, M. Nader, N. Blochle, R. Harris, L. Dryjski, M. Dosluoglu, H. (2016). Pooper limb salvage in African American men with chronic limb ischemia is due to advanced clinical stage and higher anatomic complexity at presentation. Journal of Vascular Surgery. 63(3) pg. 1318-1324
2 Long, C. Jones, WS. (2017). Disparities in the Care of Patients with Peripheral Artery Disease and Critical Limb Ischemia. American College of Cardiology.