Statement details key skills endovascular specialists need to treat CLTI

April 25, 2022

2 minute read

Disclosures: The authors report no relevant financial information.

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The Society for Cardiovascular Angiography and Interventions has released a position statement that details the key competencies needed by all endovascular specialists caring for patients with chronic limb-threatening ischemia.

Posted in the Journal of the Society of Angiography and Cardiovascular Proceduresthe document highlights specific key skills categorized into six core skills and provides examples of basic and advanced skill sets for the treatment of chronic limb threatening ischemia (CLTI), also known as ischemia member criticism.

Ischemia_Adobe Stock_106780557

Source: Adobe Stock

The position statement has been endorsed by the American College of Radiology, American Podiatric Medical Association, SCAI, Society of Interventional Radiology, Society for Vascular Medicine, Society for Vascular Surgery, Society for Clinical Vascular Surgery and the Vascular & Endovascular Surgical Society.

“The care of patients with CLTI is generally complex, multifaceted and multidisciplinary. Standardizing the competencies expected of endovascular specialists is an important step in ensuring the delivery of patient-centered, evidence-based therapy,” Beau M. Hawkins, MD, FSCAI, assistant professor of medicine at the University of Oklahoma Health Sciences Center and chair of the paper’s writing group, said in a press release. “This new framework is a starting point to enable education programs, professional medical societies and other entities to develop programs that meet the needs of this unique patient population.”

The six key skills

The key competencies have been categorized into six core competencies based on the framework established by the Accreditation Council for Higher Medical Education: medical knowledge, patient care and procedural skills; systems-based practice; practice-based learning and improvement; interpersonal and communication skills; and professionalism.

Below are some of the key competencies recommended in each of the six core competencies for endovascular specialists treating patients with CLTI.

The basic medical knowledge recommended in the statement included, but was not limited to:

  • knowledge of peripheral arterial anatomy;
  • the causes, epidemiology and natural history of CLTI; and
  • indications for non-invasive testing for patients with suspected or proven CLTI.

Some of the core patient care and procedural skills recommended in the statement included:

  • performing a focused history and physical examination of patients with CLTI;
  • interpretation of non-invasive vascular imaging, physiological and perfusion tests before and after revascularization procedures in the context of CLTI; and
  • prescribe medical treatment before and after revascularization to mitigate CV risk and optimize limb outcomes.

In the context of systemic practice, the statement recommended that physicians use an interdisciplinary and coordinated approach to the management of ITLC along with a cost-benefit analysis.

Instructions for practice-based learning and improvement included the following:

  • Identify and act on performance gaps found through review of studies, records and guidelines;
  • participate in quality improvement initiatives; and
  • participate in efforts to improve the management of patients with CLTI.

The interpersonal and communication skills of the endovascular specialists included improving communication and education of patients and families from diverse populations and communicating with various professionals on the CLTI team.

The professionalism recommendations specified in the document require physicians to:

  • practice only within the reach of expertise and technical skills;
  • promote compliance with appropriate guidelines and criteria for use; and
  • interact with respect and integrity with patients, families and all members of the CLTI team.

“An unprecedented collaborative effort”

Mehdi Shishehbor

“This unprecedented collaborative effort between these eight multidisciplinary medical societies is another step forward in advancing care for patients with CLTI,” Mehdi Shishehbor, DO, MPH, PhD, FSCAI, president of the Harrington Heart & Vascular Institute, University Hospitals Cleveland, and co-chair of the writing group, said in the statement. “I hope these efforts will evolve and result in better care for these high-risk patients who are at risk of losing a limb.”

Please see the document for more details on SCAI’s position statement.


  • SCAI publishes a multi-society position statement focusing on the core competencies of endovascular specialists providing care for CLTI. Published April 25, 2022. Accessed April 25, 2022.

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