Quality Initiative at UH Saves the Limbs of 75% of Patients Slated for Amputation

High-quality health care means exhausting every option to get the best outcome for the patient. At UH, one important way this goal comes to life is through an innovative panel that treats some of the highest-stakes patients – those scheduled for major amputation of a limb.

The Limb Salvage Advisory Council (LSAC) in the UH Harrington Heart & Vascular Institute engages diverse medical experts from across UH to thoroughly review and discuss each patient slated for amputation – quickly and in real-time. Vascular surgeons, endovascular and vascular medicine specialists, podiatrists and wound care experts all participate. The motivation is clear: Every patient deserves at least a second or third attempt at restoring blood flow to the arteries to save the leg. Eventually, the LSAC reaches one of two conclusions: the patient’s limb can be salvaged and the team creates a plan to do so, or the panel recommends the originally scheduled amputation. The LSAC model at UH is unique in the U.S.

Results published in 2022 show that this innovative approach to quality is working. A study published in Circulation: Cardiovascular Interventions reveals that the LSAC at UH saved the limbs of about 75 percent of the people they worked on.

Maurice Edwards is a case in point. Plagued by poor circulation in his right leg, he knew he might lose his leg someday to amputation. He lived with moderate to severe pain. But after a day when his foot was cold to the touch through his sock, he found himself under the care of the LSAC and its leader, Mehdi Shishehbor, DO, MPH, PhD, President of UH Harrington Heart & Vascular Institute, and Angela and James Hambrick Chair in Innovation.

“Maurice’s condition was very poor,” Dr. Shishehbor said. “His leg was dying and he was, in fact, scheduled for an amputation. But we created LSAC at UH to help patients like Maurice. Our team worked together to create a plan to save his leg, which was successful.”

“I’m okay now,” Maurice said. “I’m used to my legs being numb sometimes and aching sometimes, but they’re still warm and have blood flowing. I thank God and I thank Dr. Shishehbor.”

“It’s a great honor to help patients like Maurice,” Dr. Shishehbor added.