SVS iPG

- Stability Improved

We reorganized the home page items to make the calculators easier to access.

- Minor enhancement for application version control

- Minor bug fixes including single-click selection for calculator parameters

- Minor bug fixes and performance improvements. Society for Vascular Surgery (SVS) launched mobile apps on the interactive practice guideline (iPG) mobile platform. These new calculators are simple to use and meant for everyday practice setting: VQI CLTI Mortality Prediction Model for real-time estimation of patient risk SVS Threatened Limb Classification [WIfI] for staging system for severity of limb threat Global Limb Anatomic Staging System [GLASS] for anatomic complexity of disease. The SVS is excited to offer these new tools for all practicing vascular specialists who care for patients with CLTI. Broad dissemination and use of these calculators will increase the quality of patient and provider discussions about prognosis and treatment, provide opportunity for validation and future refinement of the tools, and promote evidence-based care for patients with this challenging disease.

Society for Vascular Surgery launches mobile apps for staging of chronic limb-threatening ischemia (CLTI) The recently published Global Vascular Guidelines on the Management of Chronic Limb-Threatening Ischemia (CLTI)1,2 highlight the importance of individualized clinical decision-making based on the assessment of Patient risk, Limb severity, and Anatomic pattern of disease ("PLAN"). PLAN provides an organized framework for provider-patient discussions as well as outcomes assessment and evidence-based practice. To facilitate the translation of these guidelines to practice, the SVS now provides three new apps on its interactive practice guideline (iPG) mobile platform. These apps allow for real-time estimation of patient risk (VQI CLTI Mortality Prediction Model), severity of limb threat (SVS Threatened Limb Classification [WIfI] staging system), and anatomic complexity of disease (Global Limb Anatomic Staging System [GLASS]). The calculators are simple to use and meant for everyday practice settings. The VQI CLTI Mortality Prediction Model was developed from a cohort of 38,470 unique patients who underwent infra-inguinal revascularization (open or endovascular) for CLTI and had data available in the VQI registry. Using baseline patient demographics, comorbidity, ambulatory status and medication use this model estimates both 30-day (peri-procedural) and 2-year patient survival. Risk groups are summarized as low (>97% 30-day and >70% 2- year survival), medium (95-97% 30-day, 50-70% 2-year survival), or high ( less than 95% 30-day or less than 50% 2-year survival). The SVS Threatened Limb Classification [WIfI] calculator uses the consensus scheme for estimating risk of major amputation that has since been validated across multiple institutional studies and registries.4 The target population for WIfI staging is any patient referred for possible CLTI excluding those with purely venous or traumatic wounds, acute limb ischemia, embolic or non-atherosclerotic disease. Wound, ischemia, and infection are each graded on a 0-3 scale. The combination of grades is then grouped into four clinical stages based on estimated 1-year risk for major amputation. WIfI staging is recommended for all patients at initial presentation, and over time to monitor response to interventions or disease progression. Finally, the Global Limb Anatomic Staging System [GLASS] calculator allows the treating vascular specialist to estimate the complexity of infrainguinal arterial disease from an angiogram. A high quality study including the ankle and foot is required. The treating physician first decides on the preferred Target Artery Path (TAP), which is the primary infrapopliteal artery selected for establishing in-line flow for the case at hand. Grades are then defined for the femoro-popliteal and infra-popliteal segments based on lesion location, length, and severity. These grades are then combined into three overall GLASS Stages for the limb that correspond to low, intermediate, and high complexity disease. These disease patterns are expected to correlate with both immediate technical success and one year limb-based patency for an endovascular approach. The SVS is excited to offer these new tools for all practicing vascular specialists who care for patients with CLTI. Broad dissemination and use of these calculators will increase the quality of patient and provider discussions about prognosis and treatment, provide opportunity for validation and future refinement of the tools, and promote evidence-based care for patients with this challenging disease.

Four years after launching, we've updated the SVS guidelines app! The same trusted, evidence-based recommendations, now featuring: - Enhancements to the overall look and feel, including easier navigation and searching - Streamlined content, with a focus on recommendations - New content: Follow-up (2018), and CLTI (2019) guidelines - Replaced PDF of guideline with links out to the journal website, providing a mobile-optimized version of the full text

New Guideline: • Diabetic Foot (2016)

• Font fix for iOS 9